Medical Residents Knolwedge of and Comfort Assessing for Autism Spectrum Disorders: A Model for Training

Background: Primary medical care provides are often the first professionals to identify potential autism spectrum disorders (ASDs). The American Academy of Pediatrics (AAP) has established guidelines for the screening of and referring for evaluation of ASDs. However, many barriers exist to training residents in screening for, identifying and referring for evaluation of ASDs, including limited exposure to children with ASDs, volume of other training activities, and limited presence of specialty training in primary care training clinics. Such factors may result in delays in identification of suspected ASDs and referral for evaluation.

Objectives: The objective in this study was to examine residents’ (1) knowledge of ASDs and (2) perceived comfort in screening, identifying, and referring for evaluation of ASDs before and subsequent to specialty training in ASDs during their Developmental-Behavioral Pediatrics Rotation.

Methods: Prior to beginning their Developmental-Behavioral Pediatrics rotation, residents completed a pre-test designed to assess knowledge of ASDs and a survey regarding their uses of screen tools and comfort in identifying and discussing ASDs with their patients’ families.  Residents then participated in structured training activities including educational materials, participating in autism-specific intake interviews, administering screening measures, and active observation of diagnostic evaluations.  Following completion of the rotation, the residents completed post-test measures assessing knowledge of and comfort with ASDs.

Results: Residents’ knowledge of ASDs pre and post intervention will be examined.  Differences in perceived comfort in screening for, identifying, and discussing ASDs with families will be determined.  Frequency of the use of screening tools for ASDs will also be analyzed.

Conclusions: The impact of structured training on residents’ knowledge of and comfort in screening for and discussing ASDs will be discussed.  Implications of how training is provided to residents on occurrence of and timing of referral will also be discussed.  Recommendations for training residents implementing AAP screening guidelines will be offered.