Primary care clinicians who receive special training can correctly diagnose autism in most cases, researchers say, potentially alleviating long waits children often face for evaluations.
In a new study, community-based providers who were trained agreed with autism specialists about whether or not a child qualified for a diagnosis in 82% of cases.
The development could help address a persistent problem facing families. Currently, children suspected of having autism must see a specialist to determine if they qualify for a diagnosis. But, in many parts of this country, getting an appointment can take a year or more and families may have to travel to access such services.
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As a result, the Centers for Disease Control and Prevention says that the median age of autism diagnosis is over age 4 even though it can be reliably identified by age 2.
“The bottleneck families experience in their road to an accurate diagnosis is a public health problem, because these delays in diagnosis lead to delays in accessing intervention services which are known to improve child and family outcomes,” said Rebecca McNally Keehn, an assistant professor of pediatrics at the Indiana University School of Medicine who led the study published this week in the journal Pediatrics.
For the study, 126 children ages 14 to 48 months who were all at increased risk of autism were evaluated by an autism specialist and a primary care clinician participating in Indiana University’s Early Autism Evaluation Hub system, which provides specialized training to community providers.
Accuracy among the community-based clinicians was largely consistent across providers and sites, the research found. In cases where the primary care providers differed from experts, it was mainly because they had difficulty differentiating between autism and global developmental delay.
“Tiered models like our hub system are not designed to definitively diagnose all children,” McNally Keehn said. “However, our data suggest that most young children can be served within the primary care setting, potentially leading to improved access to specialists for children who require a higher level of diagnostic expertise.”
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