Screening Tool for Autism in Toddlers and Young Children (STAT) Training: Clinician Confidence, Implementation Barriers, and Ongoing Support Needs.
OBJECTIVE The STAT-MD training program aims to address limited access to specialty autism evaluation services by teaching pediatric professionals to conduct autism assessments using the Screening Tool for Autism in Toddlers and Young Children (STAT). While previous research has demonstrated increased autism-focused assessment and diagnosis in community settings following STAT-MD training, implementation in real-world practice has been hindered by logistical barriers, limited follow-up support, and challenges with integration into community-based care. This study aimed to gather input from past STAT-MD training participants to better inform diagnostic training offerings for primary care clinicians and community providers. METHOD We invited 1,190 eligible participants from past STAT-MD trainings (2004-2024) to complete an electronic survey. Survey respondents (n = 58) reported on the training's long-term impact on provider confidence, clinical use, and barriers to implementation. RESULTS Results showed significant increases in provider confidence across 9 assessment-related domains (p < 0.001), but only 64% of respondents reported applying training content in practice or administering the STAT, and only 54% reported diagnosing autism following training. Reported barriers to implementation included time constraints, limited access to specialists, and inadequate reimbursement. Respondents highlighted the need for ongoing support, implementation guidance, and additional training on caregiver counseling and assessing a broader range of autism presentations. CONCLUSION These findings underscore the need for training models that provide tailored resources and sustained support around integration within existing practice systems. Future efforts should refine diagnostic training based on provider feedback to increase their long-term impact and facilitate community-based autism assessment.