No abstract

Objectives: Wait times for autism spectrum disorder (ASD) evaluations are long, thereby delaying access to ASD-specific services. We asked how our traditional care model (requiring all patients to see psychologists for ASD diagnostic decisions) compared to an alternative model that better utilizes the available clinicians, including initial evaluation by speech, audiology, and pediatrics (trained in Level 2 autism screening tools). Pediatricians could diagnose immediately if certain about diagnosis but could refer uncertain cases to psychology. Accuracy and time to diagnosis, charges, and parent satisfaction were our main outcome measures. Methods: Data were gathered through record extraction (n = 244) and parent questionnaire (n = 57). We compared time to diagnosis, charges, and parent satisfaction between traditional and alternative models. Agreement between pediatrician and psychologist diagnoses was examined for a subset (n = 18). Results: The alternative model's time to diagnosis was 44% faster (85 vs 152 d) and 33% less costly overall. Diagnostic agreement was 93% for children with ASD diagnoses and 100% for children without ASD diagnoses. Pediatricians expressed higher diagnostic certainty about children with higher levels of ASD symptoms. Parents reported no differences in high satisfaction with experiences, family-centered care, and shared decision making. Conclusion: Efficient use of available clinicians with additional training in Level 2 autism screening resulted in improvements in time to diagnosis and reduced charges for families. Coordination of multidisciplinary teams makes this possible, with strategic sequencing of patients through workflow. Flexibility was key to not only allowing pediatricians to refer uncertain cases to psychology for diagnosis but also allowing for diagnosis by a pediatrician when symptomatic presentation clearly met diagnostic criteria.

Middle school students' responses to the self-introduction of a student with autism: Effects of perceived similarity, prior awareness, and education message.

No abstract

The objective of this study was to assess whether implementation of an online tutoring program, MasteringNutrition©, would produce measurable gains in student learning outcomes. Research conducted by Pearson©, the creator of MasteringNutrition©, indicates that the inclusion of Mastering© tutoring programs into existing courses has the ability to increase student performance on assessments and total course grades. Students of a general education, nutrition course were invited to participate in this study: spring of 2013 (no Mastering; n=182), fall of 2013 (Mastering; n=86), and spring of 2014 (Mastering; n=410). NDFS 1020 is an introductory nutrition course taught in a blended style. Course structure includes course lectures (60% of instruction time) and online assignments (40% of instruction time), Mastering© is included as part of required assignments. Learning outcome progress was measured by questions on a pre-semester quiz, final exam, and posttest six months after course completion. Assessments measured student progress based on course learning objectives. Results of statistical tests reported no significant difference in test scores for each group over time. Students who scored lower than the mean on the pretest and used the Mastering© program demonstrated greater improvements in final and posttest scores compared to those who scored higher than the mean on the pretest (p=<.001). Implementation of online tutoring program did not significantly improve overall student outcomes. Online tutorial programs may be helpful for students who are enrolled in courses where they have little prior knowledge of subject matter.