Family navigation to increase evaluation for autism spectrum disorder in toddlers: Screening and Linkage to Services for Autism pragmatic randomized trial.
Carolyn DiGuiseppi, Steven A Rosenberg, Margaret A Tomcho and 6 others
PMID 33246390WHAT IT FOUND
Family navigation increased the likelihood of toddlers receiving an autism diagnostic evaluation but did not improve rates of referral to early intervention services or eligibility determination.
Benefits were concentrated among families who actually engaged with the navigator, while many eligible families could not be reached.
Key findings
01Intervention children were nearly three times as likely to undergo diagnostic evaluation for autism spectrum disorder compared to controls.
02There was no significant difference between groups in referral to early intervention services, eligibility determination, or Individualized Family Service Plan development.
03Among the small subset of families who consented to navigation, 73% completed the eligibility evaluation, whereas excluding these children, intervention group rates mirrored the control group.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Nearly 40% of eligible families in the intervention group could not be contacted, limiting the generalizability of the navigation model's effectiveness. The trial had reduced statistical power because many children did not attend scheduled well-child visits, and screening errors were common in the electronic records. The local early intervention agency conducted its own diagnostic evaluations, which may not reflect the experience in regions where families must navigate separate systems for diagnosis and services. The study could not evaluate engagement in early intervention services as originally planned due to missing data from the agency.
Declared interests
The authors declared no conflicting interests. The study was supported by the National Institutes of Health and the U.S. Public Health Service.
The easy way to misread this
Do not conclude that family navigation improves access to early intervention services. While it increased diagnostic evaluations, it had no significant effect on referrals to the early intervention agency or on the development of service plans.