Black Families' Experiences of Developmental Screening: Review of Well-Child Visits to Inform Enhanced Autism Spectrum Disorder Risk Assessment.
Amy S Weitlauf, Alison Vehorn, Alexandra Miceli and 4 others
PMID 36443922WHAT IT FOUND
For Black children later diagnosed with autism, parents voiced developmental concerns in 62% of visits.
Referrals were made in 53.5% of visits, and 10% of visits had parent-only concerns with no referral.
Key findings
01Parents expressed developmental or behavioral concerns in 62% of visits, and providers expressed such concerns in 67% of visits.
02Referrals were made in 53.5% of visits, in 88% of visits where only the provider was concerned, in 75% of visits where both parent and provider were concerned, and 10% of visits had parent-only concerns with no referral.
03Speech or language was the most common provider concern, and speech and language delay was the most common shared parent-provider concern.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The record review included only 39 children with 99 visits at one medical center, so it is a small, local description. It reviewed what was written in visit notes, not the full conversation between provider and family. Most children were seen by different providers, and provider characteristics were not available, so patterns of individual provider behavior or racial concordance could not be examined. Screening and referral practices may have changed over the years covered, and the paper gives different total catchment counts (204 and 177), making some comparison groups unclear. There was no comparison sample of White children, and the paper did not test whether any change in screening or referral improved outcomes.
Declared interests
The authors declared no conflicts of interest. The article is listed as supported by NIH and U.S. government research funding.
The easy way to misread this
Do not conclude that this paper shows a screening or referral intervention improved early diagnosis. It reviewed records of children later diagnosed with ASD and compared two small birth groups; the reported mean diagnostic ages differ, but this is observational, not proof of a change that worked.