Use of COACH for Autism Screening in Speech and Language Pathology Evaluations; Preliminary Outcomes

This brief report investigates whether the use of a novel screening tool (Clinical Observation for Autism CHecklist - COACH) developed for use in speech-language pathology (SLP) evaluations improves the identification and documentation of autism traits in SLP evaluations and decreases wait times for diagnostic evaluation for autism spectrum disorder (ASD).

28 patients aged 16-56 months identified by SLP as having increased suspicion for ASD were retrospectively identified by chart review. 14 of the patients were evaluated by SLP who utilized the COACH tool and subsequently referred the patient for ASD diagnostic evaluation (pilot/investigation group). 14 of the patients were referred for ASD diagnostic evaluation through standard diagnostic pathways (standard/control group).

Both groups demonstrated high rate of diagnostic consensus (93%); there were significantly shorter wait times for ASD diagnostic evaluation in the pilot (investigation) group vs. standard pathway (control) group (4.85 ± 3.21 weeks vs. 38.21 ± 14.93 weeks). Female and racial/ethnic minority children were also proportionally more likely to be identified in the pilot group compared to the standard pathway group.

These results demonstrate that SLPs who utilize a standardized tool specific to identifying/documenting ASD traits demonstrate a high degree of diagnostic consensus with subspecialty ASD diagnostic evaluation. Earlier identification by SLP may lead to decreased wait time for formal diagnosis and identification of ASD in traditionally under-diagnosed populations.