Battling the Bottleneck: Evaluating Autism Diagnostic Training in Primary Care.

Abstract

Purpose: The study purpose was to implement and evaluate the STAT™ (Screening Tool for Autism in Toddlers & Young Children 24-36 months old) for primary care providers (PCPs) in a Wisconsin, USA, cohort. It examined the impacts of the training and learning community on knowledge, attitudes, and change in self-reported provider confidence in autism diagnosis.

Methods: This study evaluated the implementation of a developmental assessment training program, for PCPs, using the STAT, followed by a year-long autism learning community involving monthly case-based discussions and knowledge exchange. English-speaking PCPs were assessed pre- and post-training on knowledge, screening and diagnostic practices, attitudes toward autism diagnosis in primary care, and comfort with autism identification and management. Descriptive statistics summarized baseline characteristics and practices. Paired-samples t-tests were used to evaluate pre- to post-training changes in provider comfort.

Results: Baseline findings (n=23) PCPs indicated limited use of autism-specific screening and diagnostic tools among PCPs. Among PCPs with matched pre- and post-training data (n = 11), significant improvements were observed across multiple domains of provider comfort identifying autism risk, distinguishing autism from other developmental conditions, making formal diagnoses, and providing diagnostic feedback. Improvements in care coordination domains, such as referral practices and mental health service linkage, were more limited.

Conclusions: STAT training was associated with meaningful improvements in provider confidence, particularly in autism identification and diagnostic decision-making within primary care settings. Training PCPs to diagnose autism in young children with obvious signs, has the potential to reduce diagnostic delays and improve access to early intervention.