Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Ethnic Disparities in Autism Spectrum Disorder Screening and Referral

Implications for Pediatric Practice

Rea, Kelly E. BA*; Armstrong-Brine, Melissa PhD; Ramirez, Lisa PhD; Stancin, Terry PhD

Journal of Developmental & Behavioral Pediatrics: September 2019 - Volume 40 - Issue 7 - p 493–500
doi: 10.1097/DBP.0000000000000691
Original Article
Buy

Objective: Autism spectrum disorder (ASD) screening completion rates are often low despite their validity and influence on earlier intervention and positive treatment outcomes. This study sought to examine the use of one ASD screening tool, the Modified Checklist for Autism in Toddlers-Revised (MCHAT-R), in a racially and ethnically diverse urban pediatric clinic to review potential disparities within screening rates and referral practices.

Methods: A retrospective chart review was conducted for children (N = 999) within the ages of 17 to 34 months seen for a well-child appointment at one of 3 pediatric clinics: a general pediatric clinic, resident pediatric clinic, and Hispanic pediatric clinic.

Results: MCHAT-R screening completion rates were low for all clinics. There were no significant differences in MCHAT-R screening completion based on ethnicity; however, the percentage of children screening positive on the MCHAT-R was significantly higher for Hispanic versus non-Hispanic children. Referral practices were highly variable across positive screenings, and few children received the appropriate combination of referrals.

Conclusion: Ethnic disparities in ASD positive screening rates and inconsistent referrals represent a critical issue in current pediatric practice. There is a great need for the development of more culturally sensitive ASD screening instruments. Additionally, to help increase ASD screening rate and accuracy, as well as consistency in referrals, greater emphasis is needed on professional training, parental education, and technology use within pediatric clinics.

*Department of Psychology, University of Georgia, Athens, GA;

Division of Child & Adolescent Psychiatry & Psychology, MetroHealth Medical Center, School of Medicine, Case Western Reserve University, Cleveland, OH.

Address for reprints: Melissa Armstrong-Brine, PhD, Division of Child & Adolescent Psychiatry & Psychology, MetroHealth Medical Center, School of Medicine, Case Western Reserve University, 2500 MetroHealth Dr., Cleveland, OH 44106; e-mail: marmstrongbrine@metrohealth.org.

Disclosure: The authors declare no conflict of interest.

See the Video Abstract at www.jdbp.org

Received June 06, 2018

Accepted April 11, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.