Improving Efficiency and Equity in Early Autism Evaluations: The (S)TAAR Model.
Meredith I Brinster, Briana H Brukilacchio, Autumn Fikki-Urbanovsky and 2 others
PMID 35020118WHAT IT FOUND
Average wait time fell from 18 to 4 months and average new patients per month rose from 19 to 55 during a one-visit team autism evaluation implementation; no clear differences by race, language or insurance.
No control group means the model alone cannot be credited.
Key findings
01Over 12 months, average wait time for the targeted age range was reduced by 77%, from an average of 18 months to an average of 4 months, and new patients seen per month increased by 190%, from an average of 19 to an average of 55.
02The average time-to-diagnosis, from referral to feedback, was 2.4 months; patients with pre-visit data available for review obtained a diagnosis in 2.04 months, and those without pre-visit data obtained a diagnosis in 2.92 months.
03There were no significant differences in time-to-diagnosis based on patient race, ethnicity, language, or insurance type.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This was a single-site retrospective service evaluation with no control group, so the wait-time and throughput changes cannot be attributed to the model alone. The 12-month period overlapped with hiring a nurse practitioner and psychologist, which likely increased clinic capacity and cannot be separated from the model's effect. The sample included 173 patients from a Central Texas area with many Spanish-speaking families and interpreter support, so results may not apply to clinics without that infrastructure. Provider satisfaction was based on 17 surveys from clinicians, support staff, and trainees, not on patient or family outcomes. The text reports 173 patients, while Table 2 lists 175; the paper does not explain the difference. Fewer than half of referrals included autism screening documentation, so prior data availability varied across patients.
The easy way to misread this
Do not read the 77% wait-time reduction or 190% throughput increase as proof that the (S)TAAR model works. The study had no comparison group, and new clinicians were hired during the same period, so the contribution of any single part of the model cannot be separated.