Short report: Integrated evaluations for autism spectrum disorder in pediatric primary care clinics

Area of Science:

• Neurodevelopmental Disorders
• Health Services Research
• Health Equity

Background:

• Autism screening is common in primary care, but diagnosis is often delayed for years.
• Systemic inequalities, including racism and socioeconomic status, exacerbate delays in autism diagnosis and service access.
• Primary care mental health clinicians can bridge gaps in diagnostic evaluation but often lack autism-specific training.

Purpose of the Study:

• To evaluate a training program for mental health professionals in urban primary care.
• To assess the program's effectiveness in providing autism diagnostic evaluations for underserved populations.
• To determine if primary care-based evaluations reduce diagnostic delays and improve access to services.

Main Methods:

• The Autism in Primary Care (APC) program trained mental health clinicians in an urban primary care setting.
• Evaluations were conducted within the primary care setting, serving primarily Black and Latinx families with Medicaid insurance.
• Wait times for APC evaluations were compared to standard referral pathways.

Main Results:

• Two hundred fifty children completed diagnostic evaluations through the APC program.
• The APC program demonstrated significantly shorter wait times compared to traditional autism clinics.
• Referring providers and caregivers reported high satisfaction with the primary care-based evaluation services.

Conclusions:

• Integrating autism diagnostic evaluations into primary care settings is a promising strategy.
• This model can improve early diagnosis and access to services, particularly for marginalized communities.
• Primary care-based evaluations have the potential to reduce healthcare inequities and enhance child and caregiver well-being.