Initial diagnostic impressions of trainees during autism evaluations: High specificity but low sensitivity.
Ashley de Marchena, Andrea Trubanova Wieckowski, Yasemin Algur and 8 others
PMID 37084079WHAT IT FOUND
When trainees thought autism was present after five minutes, 86% were later diagnosed.
When they thought autism was absent, 29% still had autism. Extremely confident trainee impressions matched the final diagnosis 96% of the time.
Key findings
01Trainee first impressions that a child had autism were usually correct: 86% of those children were later diagnosed with autism.
02Trainee first impressions that a child did not have autism were often wrong: 29% of those children were later diagnosed with autism.
03Trainee confidence rose with agreement between first impression and final diagnosis: 36% match when trainees were not very confident and 96% match when they were extremely confident.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The trainees varied in level and previous autism exposure, and most were psychology graduate students. The paper gives limited information about trainee age, sex, race, discipline, or years of training. The study included only children aged 12 to 53 months, so it does not address older children or adults. The context of the five-minute observations varied between participants. All trainees were already in the autism field and not naive to autism presentation. The evaluations were offered as part of research studies, so routine service conditions may differ.
Declared interests
The supplied article text does not include a conflicts-of-interest statement or funding declaration. The journal metadata lists research support from the N.I.H.
The easy way to misread this
Do not conclude that a five-minute trainee impression can rule out autism. 29% of children initially judged not to have autism were later diagnosed. The finding supports using suspected autism to prompt early referral, not using a negative impression to stop evaluation.