Autism and General Developmental Screening Practices Among Primary Care Providers
Abstract
Objective: Using standardized screening tools increases accuracy in early identification of autism. The American Academy of Pediatrics recommends systematic developmental screening at all 9-, 18-, and 24- or 30-month well-child visits (WCVs) and autism-specific screening at all 18- and 24-month WCVs. The study objectives were to examine the extent to which these guidelines have been adopted in practice among primary care providers (PCPs) and to identify potential provider-level factors associated with screening practices. Method: Participants included 94 PCPs (79% pediatricians) from 13 states enrolled in a study of an autism training program. Self-report and chart-review data collected before training were examined. Screening practices were assessed through chart review of all 9-, 18-, and 24-month WCVs within a 30-day window. Results: Sixty-four percent of PCPs administered developmental screening tools at all 9-month WCVs, and 62% at all 18-month WCVs. Fifty-one percent administered autism screening tools at all 18-month WCVs, and 41% at all 24-month WCVs. Screening practices varied by provider type (pediatrician vs other PCP), self-efficacy in screening and identification, and previous autism training (autism screening only), but not by years of experience. Conclusion: Overall, general developmental and autism-specific screenings are not being consistently administered across recommended WCVs in primary care practices. Provider self-efficacy in autism identification and screening and previous autism training were associated with increased autism screening. As such, these results suggest a need for increased training and dissemination of information on screening implementation for practicing PCPs.
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A practitioner's lack of confidence in developmental screening skills is a barrier to implementation.
“Previous work identified that a practitioner's lack of confidence in developmental screening skills is a barrier to implementation (72, 73).”
Cites
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“Autism spectrum disorder (ASD) prevalence has increased dramatically in the United States, with 1 in 54 children currently identified as having ASD.1 Children with ASD experience significant developmental challenges and have critical needs for early intervention and services to maximize their learning potential and ou…”
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Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder
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Screening for autism spectrum disorders in primary care settings
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Outcome for children receiving the Early Start Denver Model before and after 48 months
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Trends in pediatricians’ developmental screening: 2002-2016
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Primary Care Pediatricians’ Perspectives on Autism Care
Hamp, N., DeHaan, S. L., Cerf, C. M., & Radesky, J. S. (2023) · Pediatrics · doi:10.1542/peds.2022-057712 · Cited by 23 · see citing works
Peterson-Katz, K., Piccone, C., Tuzi, N., Kulkarni, C., & Reynolds, J. N. (2023) · Frontiers in Health Services · doi:10.3389/frhs.2023.1160217 · Cited by 8 · see citing works
“Previous work identified that a practitioner’s lack of confidence in developmental screening skills is a barrier to implementation (72, 73).”
BackgroundSolgi, M., Calub, C., Feryn, A., Hoang, A., Fombonne, E., Matushak, C., Bush, A., & Zuckerman, K. E. (2025) · Academic Pediatrics · doi:10.1016/j.acap.2024.10.003 · Cited by 6 · see citing works
- Authors
- Mazurek, M. O., Kuhlthau, K., Parker, R. A., Chan, J., & Sohl, K.
- Affiliations
- University of Virginia (US)
- Harvard University (US)
- Massachusetts General Hospital (US)
- University of Missouri (US)
- Corresponding author
- Mazurek, Micah O.
- Venue
- Journal of Developmental & Behavioral Pediatrics
- Published
- 2021-01-25
- Volume
- 42
- Issue
- 5
- Pages
- 355-362
- ISSN
- 0196-206X (ISSN-L)
- OpenAlex
- W3123963388
- Cited by
- 30
- References
- 10
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 9 · 2023: 7 · 2022: 6
- FWCI
- 2.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Developmental & Behavioral Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- autism screening, developmental screening, primary care providers, pediatricians, well-child visits, guideline adherence, provider self-efficacy, autism training, early detection of autism
- MeSH terms
- Autistic Disorder, Child, Health Personnel, Humans, Mass Screening, Primary Health Care, United States
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