Department of Health Science and Administration, University of West Florida , Pensacola, Florida, USA.
Unaffiliated (Retired) , Clayton, Georgia, USA.
Soc Work Public Health. 2020 Apr 1;35(4):137-151. doi: 10.1080/19371918.2020.1764431. Epub 2020 Jun 1.
Best practice recommendations by the American Academy of Pediatrics support routine screening for developmental delays in early childhood, specifically at 18 and 24 months for Autism Spectrum Disorder (ASD). During this critical developmental period, early identification and intervention are associated with best outcomes for ASD. Pediatricians perform a critical role in the early recognition of ASD, which can co-exist with other disorders further complicating the diagnosis. However, little is known about the current screening practices in Mississippi. This study provides a unique view of Mississippi pediatricians' perspectives of barriers to routine ASD screening. The intent of this phenomenology study was to better understand current practices and potential barriers, for performing ASD screening at the 18 and 24 month well child visits, as perceived by a sample of Mississippi's pediatric providers. Data collected through key informant interviews were coded to identify commonalities and patterns in responses and aided in the identification of current practices and perceived barriers through qualitative analysis. Although there was increasing implementation of ASD screening by health care providers, routine screening was not consistently conducted. The results suggest a need for a screening tool embedded in the electronic health record for easy access and monitoring. Findings replicated prior studies and endorsed the relevance of barriers that exist in screening Mississippi's youngest population. Mississippi children are at risk of delayed ASD diagnosis if modifications cannot be made to support the clinical environment for pediatricians.
AAP: American Academy of Pediatrics; ASD: Autism Spectrum Disorder; EHR: Electronic Health Record; M-CHAT-R/F: Modified Checklist for Autism in Toddlers, Revised with Follow-Up; CAY: Center for Advancement of Youth; ABA: Applied Behavior Analysis.
美国儿科学会的最佳实践建议支持在幼儿期进行发育迟缓的常规筛查,特别是在自闭症谱系障碍(ASD)的 18 个月和 24 个月时进行筛查。在这个关键的发育时期,早期识别和干预与 ASD 的最佳结果相关。儿科医生在 ASD 的早期识别中起着至关重要的作用,因为 ASD 可能与其他疾病同时存在,这进一步使诊断变得复杂。然而,人们对密西西比州目前的筛查实践知之甚少。这项研究提供了密西西比州儿科医生对常规 ASD 筛查障碍的看法的独特视角。这项现象学研究的目的是更好地了解当前的实践和潜在的障碍,以了解密西西比州儿科医生在 18 个月和 24 个月的儿童健康访视中进行 ASD 筛查的情况。通过关键知情人访谈收集的数据进行编码,以识别出反应中的共性和模式,并通过定性分析帮助确定当前的实践和感知障碍。尽管医疗保健提供者越来越多地实施 ASD 筛查,但常规筛查并未一致进行。结果表明,需要在电子健康记录中嵌入一种筛查工具,以便于访问和监测。研究结果复制了先前的研究,并证实了筛查密西西比州最年轻人群中存在的障碍的相关性。如果不能对儿科医生的临床环境进行修改以支持 ASD 筛查,密西西比州的儿童就有可能延迟 ASD 诊断。
AAP:美国儿科学会;ASD:自闭症谱系障碍;EHR:电子健康记录;M-CHAT-R/F:修订版自闭症儿童检查表,带随访;CAY:青少年发展中心;ABA:应用行为分析。