Detection of Autism Spectrum Disorders in Children Aged 4-6 Years By Municipal Maternal and Child Health Physicians: An Educational Intervention Study

Background: The transition into primary school at age 4 can be challenging for children with autism spectrum disorders (ASD). Due to the new demands that are made to children in this period, their limitations in social functioning and school achievements may manifest and appear faster. Detection of possible ASD signals takes mainly place by parents, teachers and during obligatory municipal maternal and child health centre visits in The Netherlands.

Physicians of municipal maternal and child health centres have limited education and instruments to detect ASD. Further education on detecting ASD is needed to optimally equip these doctors for this task. Most research aims to increase the early detection of ASD in children aged 0-3 years and shows positive results. However, there is a lack of research on educational interventions to detect ASD in children aged 4-6 years by municipal maternal and child health physicians.

Objectives: To explore the effect of the online educational intervention: Detection of ASD in children aged 4-6 years for municipal maternal and child health physicians. This intervention is developed within the project “Reach-Aut Academic Centre for Autism; Transitions in education”, and will be available throughout The Netherlands.

Methods: Ninety-seven participants were invited to participate in the study and consisted of three sessions of each, one and a half hour duration. The sessions were offered through an online interactive classroom. The focus and content has been developed with three groups of stakeholders; autism scientists, clinical practitioners and parents of children with ASD. Outcomes consisted of: 1) knowledge about ASD: signals, early detection, communication with parents and referrals, 2) number of ASD related referrals, 3) attitude towards the mentally ill (CAMI), 4) perceived competency about ASD knowledge and detection skills, and 5) satisfaction about the educational intervention.

Results: Forty-two physicians (95.2 % female, mean age = 41.3 years, SD = 12.5) completed the intervention up till now. Participants scored on the ASD knowledge test (scored 1-10) 6,6 at start and 7,4 after the educational intervention (p<0.01). The perceived competence increased significantly regarding ASD knowledge, recognising signs of ASD, communicating ASD features towards parents and referring towards the proper healthcare. Physicians scored on the CAMI above average on Benevolence (M = 3.80, SD = 0.35) and Community Mental Health Ideology (M = 3.84, SD = 0.43), and below average on Authoritarianism (M = 2.16, SD = 0.35) and Social Restrictiveness (M = 2.13, SD = 0.43). Physicians rated the educational intervention with an average grade of 7.9.

Conclusions: The educational intervention Detection of ASD in children aged 4-6 Years for municipal maternal and child health physicians seems to be effective in increasing knowledge about ASD and perceived competence. Municipal maternal and child health physicians have in general a positive attitude towards the mentally ill. At IMFAR 2017 we will present updated results that include the complete group of participants (N=91).