Systematic, standardized screening for autism in toddlers through pediatric clinic visits

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Publication Type thesis
School or College College of Education
Department Educational Psychology
Author Gabrielsen, Terisa Poulsen
Title Systematic, standardized screening for autism in toddlers through pediatric clinic visits
Date 2009-04-10
Description Lack of systematic screening may delay identification of autism spectrum disorders (ASDs), which may limit developmental outcomes of affected children. Pediatric clinics are logical screening points due to frequency of visits for immunizations, well- and sick-child visits. The American Academy of Pediatrics established guidelines recommending use of formal autism-specific screening instruments for all children during well-child visits at ages 18 and 24 months. Most physicians, however, do not use formal, standardized screening instruments for ASDs in this age group. The current study controlled for the most frequently cited barrier to screening (e.g., time) in a community pediatric clinic by providing scoring and follow-up for parent-report screening questionnaires distributed by clinic staff. Parents of all patients born in 2006 who visited during the six-month study period were offered questionnaires. The pediatric clinic staff was successful in screening 813 or 81% of eligible children with minimal intrusion into existing practice. Of 13 children identified by a follow-up, in-person screening as showing significant early signs of autism, only 23% had previously been referred for autism early intervention. Another 31% had previously been referred to early intervention for other reasons. No previous referral had been given 46%. An additional benefit from screening was identification of 16 children with symptoms of non-ASD developmental delays, of which 67% had not previously been referred to early intervention. The at-risk incidence rate from the sample population was 1.6% or 1 in 63. This is higher than the prevalence rate from a study of 8-year-olds statewide with clinical diagnoses or ASD educational classification, which is 1 in 133. This study is the first to compare sensitivity and specificity of the Modified Checklist for Autism in Toddlers (MCHAT) and the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (ITC) within the same sample. The study concludes that screening all toddlers for autism in a pediatric clinic setting is capable of identifying children with significant early signs of autism and other delays, prompting earlier referral than present practice. The high incidence rate and lower sensitivity and specificity of screening questionnaires need to be verified by longitudinal follow-up to determine accuracy.
Type Text
Publisher University of Utah
Subject Autism spectrum disorders; ASD educational classification; Autism-specific screening
Dissertation Institution University of Utah
Dissertation Name MS
Language eng
Relation is Version of Digital reproduction of "Systematic, standardized screening for autism in toddlers through pediatric clinic visits" J. Willard Marriott Library Special Collections RJ25.5 2009 .G32
Rights Management ©Terisa Poulsen Gabrielsen
Format Medium application/pdf
Format Extent 21,753,055 bytes
Identifier us-etd2,107553
Source Original: University of Utah J. Willard Marriott Library Special Collections
Conversion Specifications Original scanned on Epson G30000 as 400 dpi to pdf using ABBYY FineReader 9.0 Professional Edition.
ARK ark:/87278/s6x06nhr
Setname ir_etd
ID 192310
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