Sustainability of an early detection program for autism spectrum disorder over the course of 8 years.
Mirjam Kj Pijl, Jan K Buitelaar, Manon Wp de Korte and 2 others
PMID 29068245WHAT IT FOUND
The early detection program's effect on referral before age 3 was not sustained after support ended; children with ASD were more likely to be referred early only while the program was active.
Key findings
01During the program, the odds of being referred before age 3 for children with ASD versus non-ASD were significantly higher than before the program (odds ratio 3.1) and than after the program (odds ratio 1.7).
02After the program, the odds of being referred before age 3 for children with ASD versus non-ASD were not significantly different from before the program (odds ratio 1.8).
03Among children with ASD, IQ below 70 was associated with 2.6 times the odds of referral before age 3 compared with IQ 70 to 89, and 10.0 times compared with IQ 90 or above.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The control region was not included because permission was not obtained, so the study could not compare the program region with an untreated region. The outcome was age at referral, not later development, quality of life, or intervention benefit. Cognitive data were missing for 45 children with ASD, although imputation did not change conclusions. The program ended because financial and staffing support ended, so the after period also lacked training and screening prompts. There may have been unknown changes in clinical practice or provider availability that affected referral timing.
Declared interests
The authors declared no potential conflicts of interest. The work was supported by European research funding, including the Seventh Framework Programme (TACTICS), the Innovative Medicines Initiative (EU-AIMS) with in-kind contributions from pharmaceutical companies through EFPIA, and Horizon 2020 (BRAINVIEW).
The easy way to misread this
Do not conclude that the program's effect on early referral lasts after funding ends. The after-program odds were not significantly different from the before-program odds, and the study did not show that earlier referral improved child outcomes.