Autism and Developmental Screening in a Public, Primary Care Setting Primarily Serving Hispanics: Challenges and Results
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We implemented screening of children 16–30 months of age (n = 1,760) from a typically under-served, primarily Hispanic, population, at routine pediatric appointments using the modified checklist for autism in toddlers (M-CHAT) and Ages and Stages Questionnaire. Screen positive rates of 26 and 39 %, respectively, were higher than previous reports. Hispanics were more likely to score M-CHAT positive than non-Hispanics (adjusted OR 1.7, 95 % CI 1.2–2.4), as were those screened in Spanish. About 30 % of screen-positive children were referred for further assessment, but only half were seen. Thus screening in this population is feasible, but may require additional resources. Attention to the cultural applicability of screening instruments, as well as to explaining the results or need for additional services to parents, is critical to serve the growing Hispanic population.
KeywordsAutism spectrum disorders Developmental screening M-CHAT ASQ Hispanics Children’s health
This project was supported by funding from the Centers for Disease Control and Prevention (CDC) Grant number 5U01DD000305 and the California Department of Public Health (salary support for GW and JG). We acknowledge the work carried out by study staff, Zulma Flamenco-Conerly, Astrid Arretz, and Tim McLaughlin; the support and efforts of local program staff, Nancy Crowe from Santa Clara County Office of Education, Michelle Oliver of the Early Start Program, Drs. Howard Doi and Carrie Molho, and Rajni Madan of the San Andreas Regional Center; and the Department of Pediatrics managers, pediatricians and medical records staff at SCCHHS. Portions of this work have been presented at IMFAR.
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