Jessica V. Smith, Mya Howard, Michelle Menezes, Christina Burroughs, Jessica Pappagianopoulos, Vibha Sastri, Sophie Brunt, Ryan Miller, Anzhelika Parenchuk, Jocelyn Kuhn, Micah O. Mazurek
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引用次数: 0
摘要
为了减少“等待名单危机”,研究人员开发了培训项目,以教育社区临床医生进行自闭症诊断评估的最佳实践。本系统综述旨在综合这些培训的有效性和实施结果。从成立到2023年8月,检索了以下数据库:PubMed, Web of Science, APA PsycINFO, CINAHL, ERIC,以及谷歌Scholar的选定号码。本综述纳入了10项研究,因为它们符合以下标准:开发和/或评估社区临床医生诊断自闭症的培训,发表英文全文,以及原创研究。偏倚风险通过美国国立卫生研究院质量评估工具进行评估。针对社区临床医生的自闭症诊断培训项目只有7个。培训在提高临床医生知识、自我效能、执业行为和诊断准确性方面显示出初步效果。据报道,许多培训对社区产生了积极影响,并且是可行的;然而,系统层面的因素(如时间和报销)仍然是基于社区的诊断的障碍。本综述的研究结果表明,临床医生培训是一种有希望的策略,可以增加家庭及时获得自闭症诊断。由于培训数量有限,报告的有效性和实施结果有限,需要对培训模式进行更多的研究。还需要进行今后的执行研究,以减少系统一级的障碍,并帮助确定哪些培训最适合不同情况的需要。
Building Capacity: A Systematic Review of Training in the Diagnosis of Autism for Community-Based Clinicians
In an effort to reduce the “waitlist crisis,” researchers have developed training programs to educate community-based clinicians in best-practice autism diagnostic assessments. This systematic review aims to synthesize the effectiveness and implementation outcomes of such trainings. The following databases were searched from inception until August 2023: PubMed, Web of Science, APA PsycINFO, CINAHL, ERIC, and a select number from Google Scholar. Ten studies were included in the present review because they met the following criteria: development and/or evaluation of a training for practicing community-based clinicians to diagnose autism, published full-text in English, and original research. Risk of bias was assessed through an adapted NIH quality assessment tool. Only seven distinct training programs in autism diagnosis for practicing community-based clinicians were identified. Trainings demonstrated preliminary efficacy in the improvement of clinician knowledge, self-efficacy, practice behavior, and diagnostic accuracy. Many of the trainings had a reported positive impact on the community and were feasible to participate in; however, systems-level factors (e.g., time and reimbursement) remain as barriers to community-based diagnosis. Findings from the present review position clinician training as a promising strategy to increase families' timely access to an autism diagnosis. More research on training models is needed due to both the limited number of trainings and the limited reported effectiveness and implementation outcomes. Future implementation studies are also needed to reduce systems-level barriers and to aid in the determination of what trainings best fit the needs of different contexts.
期刊介绍:
AUTISM RESEARCH will cover the developmental disorders known as Pervasive Developmental Disorders (or autism spectrum disorders – ASDs). The Journal focuses on basic genetic, neurobiological and psychological mechanisms and how these influence developmental processes in ASDs.