Effect of Brief Training to Identify Autism Spectrum Disorder During Toddler Well-Child Care Visits.
Andrea Trubanova Wieckowski, Rebecca P Thomas, Chi-Ming A Chen and 5 others
PMID 34618724WHAT IT FOUND
A brief training for pediatricians did not improve their ability to spot autism or refer toddlers for evaluation.
While providers noticed more language and behavioral signs, their overall detection rates and accuracy remained unchanged compared to standard informational training.
Key findings
01The enhanced training did not significantly improve providers' accuracy in identifying autism concerns or their sensitivity in detecting actual cases.
02Providers who received the enhanced training were more likely to note specific concerns about language and restricted/repetitive behaviors after the training, though these subgroup findings had small sample sizes.
03Providers in the control group significantly reduced their response rate to the autism concern prompt over time, while those in the enhanced group maintained their response rate.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study population consisted of providers who voluntarily enrolled, potentially skewing results toward those already interested in early detection. When providers left the concern field blank, it was unclear if this meant 'no concern' or simply non-compliance. The subgroup finding regarding increased attention to language and behavioral signs was based on small sample sizes and requires cautious interpretation. The training was brief; the authors suggest more intensive or repeated training may be needed to change behavior.
Declared interests
Several authors are co-owners of M-CHAT LLC, which licenses the Modified Checklist for Autism in Toddlers (M-CHAT) used in the study. One author sits on the advisory board of a biosciences company.
The easy way to misread this
Do not assume this training improves diagnostic accuracy. The study found no significant improvement in providers' ability to correctly identify autism or refer appropriately. The observed increase in noting specific symptoms like language delays was a secondary finding with small sample sizes and did not translate to better overall detection.