Title | Screening Tools for Autism Spectrum Disorder in Primary Care: A Systematic Evidence Review. |
Publication Type | Journal Article |
Year of Publication | 2020 |
Authors | Levy, SE, Wolfe, A, Coury, D, Duby, J, Farmer, J, Schor, E, Van Cleave, J, Warren, Z |
Journal | Pediatrics |
Volume | 145 |
Issue | Suppl 1 |
Pagination | S47-S59 |
Date Published | 2020 04 |
ISSN | 1098-4275 |
Keywords | Autism Spectrum Disorder, Child, Preschool, Humans, Infant, Mass Screening, Primary Health Care |
Abstract | CONTEXT: Recommendations conflict regarding universal application of formal screening instruments in primary care (PC) and PC-like settings for autism spectrum disorder (ASD). OBJECTIVES: We systematically reviewed evidence for universal screening of children for ASD in PC. DATA SOURCES: We searched Medline, PsychInfo, Educational Resources Informational Clearinghouse, and Cumulative Index of Nursing and Allied Health Literature. STUDY SELECTION: We included studies in which researchers report psychometric properties of screening tools in unselected populations across PC and PC-like settings. DATA EXTRACTION: At least 2 authors reviewed each study, extracted data, checked accuracy, and assigned quality ratings using predefined criteria. RESULTS: We found evidence for moderate to high positive predictive values for ASD screening tools to identify children aged 16 to 40 months and 1 study for ≥48 months in PC and PC-like settings. Limited evidence evaluating sensitivity, specificity, and negative predictive value of instruments was available. No studies directly evaluated the impact of screening on treatment or harm. LIMITATIONS: Potential limitations include publication bias, selective reporting within studies, and a constrained search. CONCLUSIONS: ASD screening tools can be used to accurately identify percentages of unselected populations of young children for ASD in PC and PC-like settings. The scope of challenges associated with establishing direct linkage suggests that clinical and policy groups will likely continue to guide screening practices. ASD is a common neurodevelopmental disorder associated with significant life span costs. Growing evidence supports functional gains and improved outcomes for young children receiving intensive intervention, so early identification on a population level is a pressing public health challenge.. |
DOI | 10.1542/peds.2019-1895H |
Alternate Journal | Pediatrics |
PubMed ID | 32238531 |