WIP 91 - Program Evaluation of an Early Autism Diagnostic Model in Primary Care

Publication Number: WIP 91.7506

Jennae Reken, Childrens Hospital of Philadelphia, Horsham, PA, United States; Aleksandra Swiatek, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Judith S. Miller, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Amanda Bennett, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States

Background: In 2023, the Centers for Disease Control (CDC) estimated that 1 in 36 children met criteria for an autism diagnosis. In response to this crisis, Children’s Hospital of Philadelphia (CHOP) created a pilot project that has trained primary care clinicians (PCC) to diagnose ASD in toddlers whose universal autism screening scores suggest a high likelihood of ASD. This project aims to evaluate the PCC program.

Objective: Demonstrate diagnostic agreement between PCCs and DBPs.
Evaluate time to receipt of autism-specific services using a comparison group of DBP patients.

Design/Methods: Children diagnosed with ASD by a PCC were recruited to complete a remote evaluation with a DBP and interview about services. We prioritized direct follow up with participants but used record review where possible to reduce participation bias. Remote evaluation included the TELE-ASD-PEDS (TAP), DSM-5 criteria and CARS-2 scores. Participants were asked to complete a survey about their child’s start date and current receipt of autism-specific services. This survey uses portions of Survey of Pathways to Diagnoses and Services and National Survey of Child Health. For comparison, we matched children from our DBP practice at CHOP using zip code, age at diagnosis, and childhood opportunity index, and compared time to intervention between the groups. A subset of PCC and DBP participants completed the survey as a semi-structured interview, which will be used for thematic analysis. This study utilizes mixed-methods. For quantitative methods, our study is appropriately powered with a sample size of 28 in each group. Demographic characteristics will be summarized by standard descriptive statistics. Therapy and services start dates will be compared between DBP and PCC groups. The length of time from diagnosis to services start dates will be reported descriptively and compared between groups. The primary analysis will include data from the survey, chart review and interviews. For qualitative methods, we will follow the six phases of thematic analysis with two independent coders. This study has IRB approval.