Evidence Uptake in Early Identification of Autism in Community-Based Settings

Background:

Several early identification tools and guidelines for screening have been developed in the recent years for autism. Nevertheless, there is a wide gap in uptake and implementation of such information by frontline clinicians, which often causes delays in diagnosis and referral for early intervention.

Objectives:

The goal of the current study was to understand barriers to uptake of evidence among front-line practitioners and to identify evidence-based strategies that could support informed decision-making among service providers in addressing the needs of families affected by autism.

Methods:

A scoping review was performed to comprehensively identify guidelines and studies addressing early screening and identification of autism and other neurodevelopmental disabilities in children ages 0 to 5 years old. Databases reviewed included  CINAHL, Medline, Embase, PubMed, PsycInfo and open access archives such as Google Scholar and Government sources (e.g. Canada Health). Search terms exploded on keywords and Mesh terms related to knowledge translation and exchange, evidence-based practice, early identification and developmental disabilities. Barriers to use and adherence of existing guidelines by frontline clinicians (i.e. paediatricians, general practioners and family physicians) were identified. Strategies that were demonstrated to be successful in optimizing use of evidence were extracted. 

Results:

In the scoping review, we identified lack of time or skills among front-line practitioners to appraise literature and understand research evidence as the main barrier to evidence uptake. Disseminating knowledge of guidelines through activities to inform clinicians of current evidence  (e.g. resource guides), developing other easy-to-access materials (e.g. checklists, screening tools), and improving communication between physicians and families may be fundamental to facilitate the early identification of autism. A follow-up national Canadian survey is currently underway to clarify the gaps in the use of evidence. This survey will generate a list of effective strategies to promote evidence-based early identification of neurodevelopmental disabilities that researchers and service providers can use to facilitate communication between research-based evidence and frontline practice.

Conclusions:

The early identification of autism can be facilitated and promoted by front-line clinicians in community settings. However, these professionals often face several barriers to the uptake of research-based evidence that could support the early identification process and promote early interventions that would ultimately result in better outcomes for this population. Knowledge of barriers and faciltiators to the use of evidence may facilitate the knowledge translation process from researchers to front-line clinicians in order to communicate the latest research finidngs and promote best practices.