Gore Katherine, Gilbert Melissa, Hawke Marguerite, Barbaro Josephine
Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia.
Front Neurol. 2024 Jan 9;14:1201292. doi: 10.3389/fneur.2023.1201292. eCollection 2023.
Early identification of children with a high likelihood of autism can lead to referral for diagnostic services and access to early supports, resulting in improved outcomes for children and families. Maternal and Child Health Nurses (MCHNs) in Victoria, Australia, are well-placed to monitor infants and toddlers for signs of autism, given children and caregivers attend free, regular, well-baby consultations from birth through to school age. This study aimed to identify the impact of personal and workplace factors on MCHNs' competencies of autism knowledge, self-efficacy in identifying autistic infants and toddlers, and confidence in speaking to parents/caregivers about autism. Additionally, the study sought to identify which personal and workplace factors might predict increased competency in these areas.
After identifying training needs and current competency levels via a training needs analysis (TNA), 1,428 MCHNs received training on the early signs of autism and in the use of the Social Attention and Communication Surveillance-Revised (SACS-R) tool for early autism identification; the training program was known as Monitoring of Social Attention, Interaction, and Communication (MoSAIC).
Previous MCHN autism training and knowledge of autism community resources significantly contributed to increased MCHN self-efficacy in identifying autistic infants and toddlers, while knowledge of community resources was the best predictor of confidence in speaking with parents/caregivers about autism. Perceived self-efficacy and confidence in speaking with parents/caregivers about autism significantly increased following the MoSAIC autism training.
Targeted autism training for primary health practitioners is an important first step for early autism identification and initiating conversations with parents/caregivers.
尽早识别出患自闭症可能性高的儿童，有助于转介其接受诊断服务并获得早期支持，从而改善儿童及其家庭的结局。澳大利亚维多利亚州的母婴健康护士（MCHN）非常适合监测婴幼儿是否有自闭症迹象，因为儿童及其照料者从出生到学龄期都会免费定期参加健康婴儿咨询。本研究旨在确定个人因素和工作场所因素对母婴健康护士自闭症知识能力、识别自闭症婴幼儿的自我效能感以及与父母/照料者谈论自闭症的信心的影响。此外，该研究还试图确定哪些个人因素和工作场所因素可能预示着这些领域的能力提升。
通过培训需求分析（TNA）确定培训需求和当前能力水平后，1428名母婴健康护士接受了关于自闭症早期迹象以及使用修订后的社会关注与沟通监测工具（SACS-R）进行自闭症早期识别的培训；该培训项目称为社会关注、互动和沟通监测（MoSAIC）。
之前的母婴健康护士自闭症培训以及对自闭症社区资源的了解，对提高母婴健康护士识别自闭症婴幼儿的自我效能感有显著贡献，而对社区资源的了解是与父母/照料者谈论自闭症时信心的最佳预测指标。在接受MoSAIC自闭症培训后，母婴健康护士在与父母/照料者谈论自闭症时的自我效能感和信心显著增强。
针对初级卫生保健从业者的针对性自闭症培训是早期自闭症识别以及与父母/照料者展开对话的重要第一步。
