"Purpose: To improve early identification and intervention for infants and children with developmental delays and Autism Spectrum Disorder in primary care. Data Sources: A web-based automated screening program for developmental delays and ASD was instituted in a nurse practitioner owned primary care practice using two standardized screening instruments; the Ages and Stages Parent Questionnaire-3 (ASQ-3) and Modified Checklist for Autism in Toddlers (M-CHAT). Conclusions: Developmental and ASD screening programs can be successfully implemented in primary care. Utilizing a web-based platform with automated scoring provides easy access to efficient, accurate, and cost-effective developmental and autism screening. Implications for practice: Developmental and Autism Screening at well-child visits promotes improved outcomes when instituted before age three. Advanced Nurse Practitioners working in primary care should utilize practice guidelines for developmental screening and be well versed in the use of standardized screening instruments available for use in the medical home. This web-based model can be utilized in primary care offices to increase the number of infants and children screened for developmental delays and autism spectrum disorders. Collaboration with public health, Title V State Programs, and rural health programs should be considered as vehicles for improving early detection of developmental delays and ASD utilizing web-based screening technologies. Keywords: Ages and Stages Parent Questionnaire, autism screening instruments, developmental delay, developmental screening instruments, pediatric developmental screening, Modified Checklist for Autism in Toddlers, and parent report developmental questionnaires." -- Abstract.

Although there appears to be a significant increase in the rates of screening for autism spectrum disorders (ASD), the average age of diagnosis is not decreasing. Even when formal ASD screening tools are used, physicians might not place referrals for developmental supports and ASD evaluations. The primary objective of this study was to explore, using a mixed-methods approach, the educational needs of primary care providers (PCPs) in the primary care network at a large children's hospital so that future educational and quality improvement efforts might more accurately meet their needs. The qualitative methodology of Interpretive Phenomenological Analysis was utilized to complete semi-structured interviews with 7 primary care pediatricians with a goal of exploring how primary care providers understand their role in the process of identifying children with ASD and how they integrate knowledge from clinical exams, parental history, developmental screening tools, behavioral observations, and their accumulated experience in making identification decisions and subsequent referrals for further treatment and evaluation. In addition, a survey was distributed using REDCap and completed by 42 PCPs which included demographic questions as well as portions of the Autism Spectrum Knowledge Scale Professional Version, Revised (ASKSP-R), and the Primary Care Autism Self-Efficacy (PCASE) Survey. On the PCASE, PCPs had an average score of 4.38, indicating overall confidence in their ASD screening practices. The average score was 58% on the ASKSP-R. The items with the lowest scores inquired about ASD epidemiology as well as restricted and repetitive patterns of interests and behaviors. Five salient themes were created based upon the semi-structured interviews completed with seven primary care pediatricians in the primary care network at Nationwide Children's Hospital which serve to highlight the factors which might influence a provider's decision-making during the process of screening for ASD and subsequent care. Providers were noted to be influenced by their own backgrounds and experiences in training and practice, often desiring to utilize their clinical skills gleaned from years of medical training when making decisions during the screening process. Providers also expressed frustration at the office and system-level factors which impact their decision-making, from long wait times to diagnostic evaluation and insufficient time during office visits to concerns about overwhelming families with placing too many referrals. They also reviewed how a lack of continuity impacts their ability to engage in discussions about their concerns for ASD. Providers also value the perspectives of the families themselves during the screening process and cite this as a common reason for not placing what would be recommended referrals. On the whole, providers demonstrated a strong desire to improve both their individual care as well as the care of children with ASD at the system-level and are interested in future educational programming which allows them to more effectively identify children at risk for ASD and connect them to appropriate resources in a timelier fashion.

People with autism spectrum disorder may have unique development challenges, but they face a range of health issues like all people, and many of these may be compounded by an ASD. This book provides the tools and information so the health care professional can think differently about caring for this patient and see through his or her eyes. The presentations of 28 contributors share the importance of early, continuous, coordinated, and individualized care that is integrated into the existing health care system. Examples of models and policies that have improved the access, experience, and outcomes for patients with ASD are shared. In addition, the importance of continuous quality improvement through data collection and monitoring of outcomes is emphasized. This information is essential for addressing the capacity crisis now in providing routine, specialized, and emergency care for individuals with ASD. Some of the major topics discussed include: the epidemiology of autism spectrum disorder; facilitating the role of parents in management and advocacy; the impact of the sensory environment on care; medications for the treatment of psychiatric comorbidities; frameworks to guide practice and research with patients; building a home for acute care needs; assisting parents in adapting and making decisions regarding treatment options; integrating genetic testing into health care; educating nurses with faculty and curricular issues; emergency medicine and improving service; physical therapy to promote health, function, and community participation; using big data to direct quality improvement; and monitoring patient outcomes in research and policy outcomes. This significant volume brings together a wealth of expertise with information and strategies across the lifespan for individuals with autism spectrum disorder.

This book examines early interventions for children with autism spectrum disorder (ASD) with the goal to enable primary care physicians as well as other clinicians, therapists, and practitioners to assist parents in making informed decisions based on current research. It provides a map for successfully navigating the maze of early interventions for ASD, focusing on evidence. Chapters review the similarities and differences between current evidence-based treatments, how these treatments work, the factors that facilitate their effectiveness, and the pros and cons of their use for different children and different needs. In addition, chapters discuss the services, laws, policies, and societal issues related to early intervention in ASD. Featured topics include: Criteria to evaluate evidence in ASD interventions. Effective approaches for Social communication difficulties in ASD. Effective approaches for Restricted and repetitive behaviors (RRBs) in ASD. Naturalistic, developmental approaches to early intervention for children with ASD The TEACCH approach and other visually based approaches for children with ASD. Applied Behavior Analysis (ABA) approaches to early intervention for children with ASD. What works for whom in ASD early intervention Clinical Guide to Early Interventions for Children with Autism is an essential resource for clinicians, primary care providers, and other practitioners as well as researchers, professors, and graduate students in the fields of child, school, and developmental psychology, pediatrics, social work, child and adolescent psychiatry, primary care medicine, and related disciplines.

All-new clinical resource for managing children with developmental and behavioral concerns. Developed by leading experts in developmental and behavioral pediatrics, the all-new AAP Developmental and Behavioral Pediatrics gives one place to turn for expert recommendations to deliver, coordinate, and/or monitor quality developmental/behavioral care within the medical home. The one resource with all the essentials for pediatric primary care providers. Evaluation and care initiation: Interviewing and counseling, Surveillance and screening, Psychoeducational testing, Neurodevelopment.

This book examines a group-based adaptation of the Early Start Denver Model (ESDM) designed for use with preschoolers with autism spectrum disorder (ASD). It describes the principles and procedures of the Group-Based Early Start Denver Model (G-ESDM) and provides practical and empirical guidelines for implementing effective, affordable programs across public healthcare and educational settings. Chapters offer rationales and strategies for designing and evaluating interventions, building interdisciplinary teams, and organizing learning spaces to engage student interest. Examples discuss the social interactions in groups that provide opportunities for learning, improving interpersonal skills, and reducing problem behaviors. In addition, the book offers ideas for retooling teaching strategies when an individual child lags behind the rest of the group. Featured topics include: Creating treatment objectives in the G-ESDM. Setting up the G-ESDM team and learning environment. Development of the G-ESDM classroom curriculum. Practical tools such as decision-making trees, teaching templates, and fidelity systems. Facilitating learning through peer interactions and social participation. Implementing the Group-Based Early Start Denver Model for Preschoolers with Autism is a must-have resource for clinicians and practitioners as well as researchers, professors, and graduate students in the fields of child and school psychology, behavioral therapy, and social work along with psychiatry, pediatrics, and educational and healthcare policy.

This book addresses the importance and relevance of interprofessional care coordination for children and youth with autism spectrum disorder (ASD). It covers the role of interprofessional collaborations across various settings for multiple service provision purposes. The volume examines interprofessional collaboration among professionals across such broad issues as screening, evaluation, intervention, and overall care management of ASD. In addition, the book explores more narrowly focused issues, such as providing transition services during early childhood and young adulthood, culturally responsive practice and advocacy issues for individuals with ASD from diverse backgrounds, and providing care for individuals with ASD and co-occurring trauma. Finally, the book concludes with the editors’ recommendations for future directions in interprofessional care for pediatric ASD. Topics featured in this book include: Autism screening tools and interdisciplinary coordination of the processes. Dell Children’s (S)TAAR Model of Early Autism Assessment. The Early Start Denver Model (ESDM). Transition from early schooling for youth with ASD. Postsecondary and vocational opportunities for youth with autism. Transitioning from pediatric to adult medical systems. International perspectives in coordinated care for individuals with ASD. Psychopharmacology of ASD. Interprofessional Care Coordination for Pediatric Autism Spectrum Disorder is an essential resource for researchers, clinicians and professionals, and graduate students in clinical child and school psychology, social work, behavioral therapy and related disciplines, including clinical medicine, clinical nursing, counseling, speech and language pathology, and special education.