What Happens After a Positive Primary Care Autism Screen Among Historically Underserved Families? Predictors of Evaluation and Autism Diagnosis.
Jocelyn Kuhn, Julia Levinson, Manisha D Udhnani and 6 others
PMID 33631787WHAT IT FOUND
Families already in Early Intervention were five times more likely to get a diagnostic evaluation.
However, Hispanic families and those with public insurance were significantly less likely to follow through. The screening tool also produced fewer true diagnoses for minority families and females.
Key findings
01Families receiving Early Intervention were 5.01 times more likely to receive a diagnostic evaluation than those not enrolled.
02Hispanic families were significantly less likely to receive a diagnostic evaluation compared to White, non-Hispanic families.
03Children screened using a telephonic interpreter were 3.57 times less likely to receive an ASD diagnosis compared to those screened directly in their preferred language, suggesting lower accuracy of the screen in these cases.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study assumed that the clinical diagnoses made by specialists were 100% accurate, which may not be true given potential provider bias. The sample was drawn from integrated care networks serving low-income, diverse populations, so results may not apply to higher-income or less diverse groups. Researchers re-administered the autism screen by phone to ensure consistency, which does not reflect real-world clinical practice where this is rarely done. All participants received some form of care management, which may have reduced the disparities seen in a standard, unsupported care system.
Declared interests
The authors declared no conflicts of interest. The study was supported by NIH grants.
The easy way to misread this
Do not assume that a negative autism screen in a minority family or one screened via telephonic interpreter rules out autism. The study found that these groups were significantly less likely to receive a diagnosis even after a positive screen, suggesting the tool may have lower accuracy for them.