Mental health screening in pediatric primary care for children with autism.
Nicole A Stadnick, Kassandra Martinez, Karen J Coleman and 6 others
PMID 35105226WHAT IT FOUND
Mental health screening in pediatric primary care for children with autism identified clinically elevated needs in 36-47% of screened patients, but only about half of those positive screens resulted in a referral.
No demographic disparities were found in screening or referral rates.
Key findings
01Screening rates were similar across organizations (53% and 55%), but case positivity varied, with 47% of screened patients in Organization 1 and 36% in Organization 2 scoring above the clinical threshold.
02Approximately 45-47% of children with positive screens received a documented referral to mental health services.
03There were no significant differences in demographics between screened and unscreened patients, or between referred and non-referred patients.
STILL TO COME
How it was doneWhat they found
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What it does not show
Data could not be compared at the individual level between the two organizations, limiting direct analysis. The study took place during the early months of the COVID-19 pandemic, which reduced the volume of well-child appointments and the eligible patient pool. Small sample sizes in the latter stages of the screening and referral process. Reliance on caregiver-report for the PSC-17 may have led to under-reporting of internalizing symptoms, which are harder for caregivers to observe. The study did not examine provider decision-making regarding which eligible patients were selected for screening.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not interpret the lack of demographic disparities as proof that screening and referral systems are equitable in all contexts. The small sample size and the specific pandemic-era conditions of this pilot limit the generalizability of these findings.