Improving autism and developmental screening and referral in US primary care practices serving Latinos.

The study used a quasi-experimental design without a control group, so external factors (such as state-level financial incentives for screening) may have contributed to the observed increases. Data was collected by non-clinical clinic staff, which introduces potential for reporting bias or errors. The study could not track child-level data to see if the same children were screened and referred, limiting the ability to assess individual patient pathways. Two clinics had lower-than-expected proportions of Latino patients, which may have reduced the power to detect specific effects in that subgroup. Long-term durability of the changes is unknown, as one clinic saw screening rates drop due to staff turnover.

The authors declare no conflicts of interest. The study was supported by the National Institute of Health (N.I.H.).

Do not assume that increasing screening rates leads to more referrals for those who screen positive. The study found that while screening became nearly universal, the proportion of children with positive results referred to early intervention did not change, suggesting a disconnect between detection and action.