Most primary care providers screening toddlers for autism

Most primary care providers screening toddlers for autism

(HealthDay)—A majority of toddlers are being screened for autism spectrum disorder (ASD) during primary care visits, according to a study published online July 6 in Pediatrics.

Paul S. Carbone, M.D., from the University of Utah in Salt Lake City, and colleagues analyzed data from 36,233 children attending 18- and 24-month visits between 2013 and 2016 at 20 clinics within a health care system. The authors sought to identify the characteristics associated with Modified Checklist for Autism in Toddlers (M-CHAT) screening completion, as well as the associations between screening and subsequent ASD diagnosis at age ≥4.75 years.

The researchers found that 73 percent of toddlers were screened and 1.4 percent were later diagnosed with ASD. Screening was less likely among Hispanic children (adjusted prevalence ratio [aPR], 0.95), and were less likely to perform screening (aPR, 0.12). Screen-positive children were more likely to be diagnosed with ASD (aPR, 10.3) and were diagnosed younger (38.5 versus 48.5 months) compared with unscreened children. The sensitivity of the M-CHAT for ASD diagnosis was 33.1 percent, while its was 17.8 percent. M-CHAT follow-up interviews were routinely omitted and referral patterns were uneven.

"Performance of the M-CHAT can be improved in real-world health care settings by administering screens with fidelity and facilitating timely ASD evaluations for screen-positive children," the authors write. "Providers should continue to monitor for signs of ASD in screen-negative children."


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