Autism Screening Practices Among Early Intervention Providers in Indiana

Tomlin, Angela M.; Koch, Steven M.; Raches, Christine M.; Minshawi, Noha F.; Swiezy, Naomi B.

doi:10.1097/iyc.0b013e31827842b1

Cited by 17 publications

(16 citation statements)

References 3 publications

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“…Using a shared decision-making approach and accompanying aids also may be helpful for EI providers given that they also have indicated uncertainty about how to communicate with parents about ASD concerns. 36,37 The development of such aids is currently underway and will include materials that PCPs and EI providers can use with parents to describe the early features and heterogeneity of ASD and to help them make decisions about possible next steps with consideration of each family's priorities, needs, and values.…”

Section: Discussionmentioning

confidence: 99%

Parent Perceptions About Communicating With Providers Regarding Early Autism Concerns

Locke¹,

Ibañez

Posner

et al. 2020

Pediatrics

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BACKGROUND: Long delays between parents' initial concerns about their children's development and a subsequent autism spectrum disorder (ASD) diagnosis are common. Although discussions between parents and providers about early ASD concerns can be difficult, they are critical for initiating early, specialized services. The principles of shared decision-making can facilitate these discussions. This qualitative study was designed to gain insights from parents of young children with ASD about their experiences communicating with primary care providers with the goal of identifying strategies for improving conversations and decisionmaking regarding the early detection of ASD.METHODS: Three 2-hour focus groups were conducted with 23 parents of children with ASD ,8 years old. Qualitative analysis employed an iterative and systematic approach to identify key themes related to parents' experiences.RESULTS: Eight themes related to communication about early ASD concerns emerged: characteristics of the child that caused parental concerns, the response of others when the parent brought up concerns, how concerns were brought up to the parent by others, parental responses when others mentioned concerns, information seeking, barriers to and facilitators of acting on concerns, and recommendations to providers. Parent responses suggest the need for increased use of shared decision-making strategies and areas for process improvements.CONCLUSIONS: Primary care providers can play a key role in helping parents with ASD concerns make decisions about how to move forward and pursue appropriate referrals. Strategies include responding promptly to parental concerns, helping them weigh options, and monitoring the family's progress as they navigate the service delivery system.WHAT'S KNOWN ON THIS SUBJECT: Challenges in parent-provider communication about early autism spectrum disorder (ASD) concerns can prevent young children from accessing appropriately specialized treatment at the age when it may be most effective. The process of shared decision-making can lead to more productive discussions and consensus building.WHAT THIS STUDY ADDS: This qualitative study provides insights from parents of young children regarding barriers to and facilitators of acting on their early concerns about ASD. Specific recommendations for shared decision-making strategies that may increase early access to ASD-specialized services are provided.

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Section: Discussionmentioning

confidence: 99%

Parent Perceptions About Communicating With Providers Regarding Early Autism Concerns

Locke¹,

Ibañez

Posner

et al. 2020

Pediatrics

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“…They were also much more likely to be reassured, and reassurance led to delays in diagnosis compared with children with ASD whose pediatricians were more receptive to parental concerns (Zuckerman, et al, 2015). Thus, some caregivers feel not listened to, frustrated, and that their physicians ignored their concerns or were not prepared to recognize ASD (Brookman-Frazee et al, 2012; Tomlin et al, 2013).…”

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confidence: 99%

Autism Spectrum Disorder Identification, Diagnosis, and Navigation of Services: Learning From the Voices of Caregivers

Crais

McComish

Kertcher

et al. 2020

Focus Autism Other Dev Disabl

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This study explored caregivers’ perspectives on facilitators and barriers to screening, diagnosis, and identifying and accessing other services for young children with autism spectrum disorder (ASD); and caregivers’ suggestions for improving the process. Eight focus groups with 55 caregivers were conducted. Four groups had a mix of White, African American, and Asian caregivers, and to gain broader populations, we recruited two groups of Spanish-speaking and two groups of American Indian caregivers. Some caregivers reported that their child and they received excellent services; however, the majority reported concerns about the services they and their child received. The findings also indicated a lower age of diagnosis and a smaller gap between concerns and diagnosis for White non-Hispanic children compared with Hispanic non-White children. Caregivers had many suggestions for ways to improve the process.

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“…As the field looks toward accelerating the dissemination and implementation of NDBIs, it is imperative to consider which “real‐world” systems are best poised for successful uptake and for having a meaningful impact on system‐level and family‐level outcomes of interest. Two of those considerations should be whether a system has the: (a) trifecta of fit between the intervention characteristics (e.g., complexity, effectiveness), provider goals, and the needs of their patients/clients (Albers et al, 2020; Haynes et al, 2002); and (b) capacity to scale implementation to reduce the staggering delays that exist for accessing early ASD‐specialized intervention (Carbone et al, 2013; Ibañez et al, 2019; Tomlin et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

The implementation of reciprocal imitation training in a Part C early intervention setting: A stepped‐wedge pragmatic trial

2021

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Despite the development of several evidence‐based Naturalistic Developmental Behavioral Interventions (NDBIs), very few have been adapted for use in community‐based settings. This study examines the implementation of Reciprocal Imitation Training (RIT)—an NDBI—by community Early Intervention (EI; IDEA Part C) providers serving toddlers from birth to 3 years. Of the 87 EI providers enrolled from 9 agencies in 4 counties across Washington State, 66 were included in the current sample. A stepped‐wedge design was used to randomly assign counties to the timing of RIT training workshops. Self‐report measures of practice and self‐efficacy regarding ASD care were collected at baseline (T1, T2) and 6‐months and 12‐months post‐training (T3, T4). At T3 and T4, providers reported on RIT adoption and rated items about RIT feasibility and perceived RIT effectiveness; at T4, they also reported on child characteristics that led to RIT use and modifications. From pre‐training to post‐training, there were significant increases in providers' self‐efficacy in providing services to children with ASD or suspected ASD. At T3 and T4, provider ratings indicated high levels of RIT adoption, feasibility, and perceived RIT effectiveness. At T4, providers indicated that they most commonly: (a) initiated RIT when there were social‐communication or motor imitation delays, or an ASD diagnosis; and (b) made modifications to RIT by repeating elements, blending it with other therapies, and loosening its structure. While additional research is needed, RIT may help families get an early start on accessing specialized treatment within an established infrastructure available across the United States. Lay Summary Reciprocal imitation training (RIT) is an evidence‐based treatment for ASD that might be a good fit for use by intervention providers in widely accessible community‐based settings. After attending an educational workshop on RIT, providers reported feeling more comfortable providing services to families with ASD concerns, used RIT with over 400 families, and believed that RIT improved important social communication behaviors.

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Autism Screening Practices Among Early Intervention Providers in Indiana

Cited by 17 publications

References 3 publications

Parent Perceptions About Communicating With Providers Regarding Early Autism Concerns

Parent Perceptions About Communicating With Providers Regarding Early Autism Concerns

Autism Spectrum Disorder Identification, Diagnosis, and Navigation of Services: Learning From the Voices of Caregivers

The implementation of reciprocal imitation training in a Part C early intervention setting: A stepped‐wedge pragmatic trial

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