HealthDay News — A multistage screening protocol for autism spectrum disorder (ASD) implemented in early intervention (EI) settings can increase detection of autism, according to a study published online Jan. 4 in JAMA Pediatrics.

R. Christopher Sheldrick, Ph.D., from Boston University, and colleagues examined whether a multistage screening protocol for ASD implemented in three EI settings would increase detection of autism. Administrative data were included from three implementation EI agencies and nine comparison EI agencies from 2012 to 2018. The final analytic sample included 33,326 patients who were assessed across 150,200 person-quarters.

The researchers found that implementation of screening at three EI sites was associated with a significant increase in ASD diagnoses (incidence rate ratio [IRR], 1.6; 95 confidence interval [CI], 1.3 to 2.1; P < 0.001), representing 8.1 additional diagnoses per 1,000 children per quarter. Screening was also associated with a significant increase in the rate of ASD diagnoses among Spanish-speaking families (IRR, 2.6; 95 percent CI, 1.6 to 4.3; P < 0.001), representing 15.2 additional diagnoses per 1,000 children per quarter (interaction IRR, 1.8; 95 percent CI, 1.0 to 3.1; P = 0.005). Screening was associated with a larger increase in the rate of ASD diagnoses among boys than girls in exploratory analyses.


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“We have known about disparities in ASD diagnoses for Latine and Spanish-speaking families for two decades. The time to move beyond identifying inequities to creating solutions to ameliorate them is upon us,” write the authors of an accompanying editorial. “Equipping EI staff with the ability to screen and develop trusted relationships with families is one layer to ensure that opportunities for early diagnosis and engagement in ASD-specific services are not missed.”

Two authors are cocreators of the first-stage screeners used in this study, and one receives royalties on the sale of one of the screeners.

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