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Purpose: To compare community provider reports of adherence to current American Academy of Pediatrics (AAP) autism screening guidelines with their self-reported practices, including implementation of the Modified Checklist for Autism in Toddlers (M-CHAT).

Methods: An online survey was distributed to primary care providers from Kansas, Oklahoma, and North Dakota. The survey collected demographics and self-reported ASD screening practices (including M-CHAT implementation procedures) and knowledge questions.

Results: 133 providers completed the survey (50% pediatricians, 32% int. med/fam. physicians, 18% physician assistants). Of the 96 who reported routinely screening for ASD; 78% reported adhering to AAP guidelines. However, no providers correctly answered all of the knowledge questions that would confirm an ability to follow the guidelines. Only 35% of providers who use the M-CHAT could identify the correct procedures for responding to a positive screen. Knowledge of AAP guidelines and M-CHAT procedures was not significantly correlated with provider profession, years in practice, or frequency of conducting relevant well visits.

Conclusion: Providers who report adherence with AAP guidelines appear at substantial risk for having gaps in knowledge that may negate the benefits of screening. Resident education programs, policy decisions in response to the USPSTF, and research on early autism identification must consider these gaps in knowledge that likely impact the effectiveness of community-based screening. Future research on community screening should focus on direct measurement of provider practices rather than relying on self report.


Behavioral Medicine | Pediatrics


Presented at the Society for Developmental and Behavioral Pediatrics Annual Meeting, Savannah, GA, September 2016.

Autism screening in primary care: Community providers incorrectly report adherence to AAP autism screening guidelines