Initial diagnostic impressions of trainees during autism evaluations: High specificity but low sensitivity
| Autor: | Ashley de Marchena, Andrea Trubanova Wieckowski, Yasemin Algur, Lashae N. Williams, Sherira Fernandes, Rebecca P. Thomas, Leslie A. McClure, Sarah Dufek, Deborah Fein, Aubyn C. Stahmer, Diana L. Robins |
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| Rok vydání: | 2023 |
| Předmět: |
Parents
Autism Spectrum Disorder diagnosis Intellectual and Developmental Disabilities (IDD) Autism Clinical Sciences Developmental & Child Psychology Sensitivity and Specificity initial impression Predictive Value of Tests Clinical Research Behavioral and Social Science Humans Psychology Educational Autistic Disorder toddlers Child Preschool early detection Genetics (clinical) Pediatric screening and diagnosis General Neuroscience Early Intervention Neurosciences Brain Disorders Detection diagnostic confidence Mental Health Neurology (clinical) 4.2 Evaluation of markers and technologies |
| Zdroj: | Autism research : official journal of the International Society for Autism Research, vol 16, iss 6 |
| Popis: | Reducing the age of first autism diagnosis facilitates access to critical early intervention services. A current "waitlist crisis" for autism diagnostic evaluation thus demands that we consider novel use of available clinical resources. Previous work has found that expert autism clinicians can identify autism in young children with high specificity after only a brief observation; rapid identification by non-experts remains untested. In the current study, 252 children ages 12-53 months presented for a comprehensive autism diagnostic evaluation. We found that junior clinicians in training to become autism specialists (n = 29) accurately determined whether or not a young child would be diagnosed with autism in the first five minutes of the clinic visit in 75% of cases. Specificity of brief observations was high (0.92), suggesting that brief observations may be an effective tool for triaging young children toward autism-specific interventions. In contrast, the lower negative predictive value (0.71) of brief observations, suggest that they should not be used to rule out autism. When trainees expressed more confidence in their initial impression, their impression was more likely to match the final diagnosis. These findings add to a body of literature showing that clinical observations of suspected autism should be taken seriously, but lack of clinician concern should not be used to rule out autism or overrule other indicators of likely autism, such as parent concern or a positive screening result. |
| Databáze: | OpenAIRE |
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