Primary Care Autism Assessment Training Program Pilot Trial

Pediatric primary care practitioners (PCPs) are not typically trained to conduct autism assessments, contributing to delayed autism diagnosis in the United States. From February to September 2024, PCPs in Portland, Oregon, were trained to conduct standardized autism assessments with young children, based on similar U.S.-based training models. This training consisted of an asynchronous online autism course sponsored by the American Academy of Pediatrics; a 2-day, in-person workshop on diagnostic assessment; and eight posttraining community learning sessions. Twenty-four PCPs were trained to conduct autism assessments with children using the Modified Checklist for Autism in Toddlers, the Screening Tool for Autism in Toddlers and Young Children, and a parent interview based on the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). A pilot trial of this program was conducted to examine its feasibility, acceptability, and initial outcomes related to self-reported PCP autism assessment knowledge and self-efficacy, as well as the number and characteristics of patients assessed. The program demonstrated high feasibility and acceptability. PCPs showed statistically significant improvement in their autism assessment knowledge and self-efficacy and used the assessment tools with 34 children ages 19-47 months during the study period. Similar training programs may help address PCP shortages and capacity contributing to diagnostic delays.Lay AbstractIn Oregon and other places across the United States, parents often face long wait times to get their children evaluated for autism. Getting an autism diagnosis before age 3 can help children and their families to get the services and supports they need to thrive. Families might have shorter wait times if pediatric primary care practitioners (PCPs) were trained to do autism assessments. Programs nationwide have been developed and used to train PCPs to conduct autism assessments for these reasons. Twenty-four PCPs in the Portland, Oregon, metropolitan area were trained to conduct autism assessments with young children in 2024. The training asked PCPs to participate in an online autism course; a 2-day, in-person workshop on autism assessment; and eight community learning sessions. We studied this training to understand (a) how practical it was to implement this training, (b) whether PCPs' self-reported knowledge and confidence about autism assessment changed, and (c) the number and characteristics of children who received autism assessments after the PCPs were trained. We collected data from the PCPs three times, including before training started, after the in-person workshop, and after the community learning sessions. We found that PCPs generally rated their participation and training experience positively. We also found that PCPs' knowledge and confidence increased. They evaluated 34 children across diverse groups for autism. Similar training programs may help to address shortages of PCPs who are qualified to conduct autism assessments and increase access to early autism evaluation.