Guideline for Autism Screening in Primary Care
Abstract
Autism spectrum disorder (ASD), once thought to be rare, is now considered prevalent, with 1 of every 68 children diagnosed nationwide (Salley, 2016). There is no treatment for ASD, but early therapeutic interventions can help children with ASD live a higher quality of life and achieve major developmental milestones such as language development (Dreyer, 2016). Because ASD can challenge all members of a family, early identification and intervention is vital. This process improvement project was created to enable higher rates of detection for ASD and other developmental delays. The major process improvement intervention was implementing universal screening for ASD during all well-child exams between 18 and 24 months. A guideline was created to help providers know when to screen, what screening tool to use, and how to respond if the screening is abnormal. An educational seminar for all staff involved in the care of pediatric patients also occurred. A chart audit of the guideline and algorithm’s clinical use was done to evaluate the successes of the project. To further evaluate outcomes, a staff and provider basic ASD knowledge survey was conducted before and after the education was provided. Finally, steps were taken to work with IT from the electronic health record (EHR) to integrate documentation prompts for providers to ease the use of ASD screening and appropriate billing. With the conclusion of this project, all data acquired indicated the clinical guideline, algorithm, and educational platform were a success. Screening for ASD increased after the implementation. Furthermore, provider and staff knowledge regarding ASD and ASD screening was enhanced. Further work with this type of process improvement project should be conducted, as indicated with the findings of this study. Keywords: Autism Spectrum Disorders, M-CHAT R, universal screening algorithm