491 - Evaluation Of An Autism Screening And Diagnosis Training During Pediatric Residency

Poster Number: 491
Publication Number: 491.3060

Background: Long wait times and lack of qualified providers are barriers to accessing diagnostic evaluation for autism spectrum disorder (ASD). Primary care physicians (PCPs) are the first line of surveillance for children at risk of ASD, however, pediatric training in ASD screening and diagnostic skills is limited.

Objective: (1) Evaluate satisfaction of an ASD screening and diagnosis training during pediatric residency, (2) assess effectiveness of training on confidence and behavior change, and (3) identify barriers to implementation of skills post-training.

Design/Methods: A mixed methods evaluation was conducted among 9 residents from 4 residency programs in New England (Table 1). Participants completed (1) the Rapid Interactive Screening Test for Autism in Toddlers training, a 3-hour online training for screening, and (2) the Childhood Autism Rating Scale training, a 3-hour virtual live training for diagnosis. We modeled our assessment on Levels 1 and 3 of the Kirkpatrick Model of Learning Evaluation. Quantitative data of learner perception was collected through pre- and post-training surveys completed before and after training and was analyzed using a T-Test of Likert scale ratings from 1-10. Audio transcript from a 4-month follow-up virtual focus group around post-training behavior change was thematically analyzed.

Results: Participants found value in the training (mean=8.8) and would recommend the training to other residents (m=9.44). Post-training surveys demonstrated an increase in confidence in ability to screen (P=0.075) and diagnose (P= < 0.001) ASD, in ability to recognize signs of ASD during a well child visit (P=0.009), and in explaining an ASD diagnosis to families (P=0.001) (Figure 1). Qualitative data revealed that the 8 residents who participated in the focus group stated that ASD screening and diagnosis training should be a required educational component in pediatric residency and a skillset that should be required by pediatric PCPs. However, by the time of the 4-month follow-up focus group, none of the 8 participants had been able to conduct formal screenings or diagnostic testing in their respective resident primary care clinics. Common themes were found regarding reported barriers (Table 2).

Conclusion(s): Training pediatric residents in ASD screening and diagnosis is valuable and increases confidence in identification in the primary care setting. However, training alone may not be sufficient to increase the ASD diagnostic workforce and patient access. There must be time allotted in clinic schedules for diagnostic visits and supervising attendings should be familiar with the diagnostic tools.