Screening Practices and Factors Influencing Autism Spectrum Disorder (ASD) Screening by Community Paediatricians
CPS ePoster Library. Ip A. Jun 25, 2015; 99229; 168 Disclosure(s): Funding was provided by Holland Bloorview Centre for Leadership and SickKids Paediatric Consultant’s Education Research Grant.
Angie Ip
Angie Ip
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Abstract
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Background: The prevalence of ASD is estimated at 1 per 68 based on US surveillance data. In many cases, ASD can be accurately diagnosed at 2 to 3 years old and high risk children can be identified earlier than 24 months, but Canadian data shows a median age at diagnosis of 39 to 55 months. Despite advances in diagnosis of ASD, there is little data on ASD screening among Canadian general paediatricians.

Objectives: The objectives of this study were to examine community paediatricians’ ASD screening practices, obtain quantitative date on the use of ASD and general developmental screening tools, and identify factors influencing paediatricians’ use of ASD screening tools.

Design/Methods: A questionnaire was designed base on a survey by dosReis et al to assess developmental and ASD screening among general paediatricians (dosReis 2006) with questions added based on themes drawn from qualitative data from focus groups with community paediatricians on ASD screening (Ip 2015). Main focus areas were quantitative data on developmental and ASD screening tools use, facilitators and barriers of ASD screening, tool characteristics that encourage their use, and collection of demographic data. After revision by community (n=5) and developmental (n=5) paediatricians, the questionnaire was piloted to n=30 general paediatricians, further refined, and distributed to all general paediatricians (n=560) in a large multicultural urban centre. Descriptive statistics was used.

Results: Of 560 questionnaires sent, 267 were returned (response rate 48%) with 132 eligible respondents. Ninety-five percent of respondents routinely used a developmental screening tool with the majority using the Nipissing Developmental Screen (95%) and the Rourke Baby Record (42%). Fifteen percent routinely using an ASD screening tool while most (71%) used an ASD specific screening tool (most commonly the M-CHAT) when they suspected ASD on exam, history, or if there was parental concern. Respondents were divided regarding universal screening. Seventy-percent of respondents were interested in using a formal ASD screening tool in their practice and 66% felt there should be clearer guidelines on how and when to screen for ASD. The most valued ASD screening tool characteristics, were brevity, ability to be completed by a parent, and availability in multiple languages.

Conclusion

This study provides critical data on developmental and ASD screening practices and identifies factors influencing physician decision making and clinical practice. Assessing factors affecting screening in primary care is vital to the future design and implementation of sustainable programs for early detection of ASD.
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