Examination of the impact of the Get SET Early program on equitable access to care within the screen-evaluate-treat chain in toddlers with autism spectrum disorder.
Christie Pham, Elizabeth C Bacon, Andrea Grzybowski and 6 others
PMID 36629055WHAT IT FOUND
The Get SET Early program achieved equitable access to autism care.
Hispanic and minority-race toddlers were screened and evaluated at rates matching local demographics. Crucially, age at screening, evaluation, and therapy start did not differ by race or ethnicity, suggesting the program successfully removed access barriers.
Key findings
01Hispanic and minority-race toddlers were screened and evaluated at significantly higher rates than expected based on local census data.
02There were no significant differences in the age at which toddlers received their first evaluation or started ABA therapy across ethnic or racial groups.
03Parents from Hispanic, Black/African American, Asian, and Mixed backgrounds expressed significantly greater concern about their child's development compared to White parents.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This was not a randomized controlled trial and lacked pre-intervention data, so it cannot definitively prove the program caused the equity, only that it coincided with it. The study was conducted in San Diego County, which is service-rich and has specific demographic and economic characteristics that may not generalize to other regions. Only digital screening data were analyzed, potentially excluding families with lower eHealth literacy who used paper forms. Treatment data were missing for over 100 toddlers with ASD, and the reason for this loss to follow-up is not fully explained. The CSBS screen may have cultural biases, as it flagged Hispanic and minority-race children as 'concerned' at higher rates than White children, which could reflect item bias rather than true prevalence.
Declared interests
The authors declared no conflicts of interest. The study was funded by the National Institute of Mental Health (NIMH grant R01MH104446).
The easy way to misread this
Do not assume that higher screening concern rates in minority groups reflect a true increase in autism prevalence. The authors note this could be due to cultural differences in reporting, acculturation stress, or potential bias in the screening tool itself, rather than a difference in the actual condition.