Aug 2026· Autism· pp.
13623613261474938
· 0 citations· 48 references
Medicine
TL;DR
It is argued that the critical advantages of adopting efficient service delivery models far outweigh the disadvantages, and that evidence supports updating the authors' current standards.
Abstract
Waiting lists for an autism evaluation delay timely diagnosis and entry into autism-specific early intervention. To solve this crisis, our field must increase capacity by embracing efficient diagnostic processes. Traditional diagnostic pathways involve complex evaluations and rely on a highly trained but limited pool of specialists, which elongate wait times. Evidence suggests that emerging approaches, including telehealth assessments, primary care diagnosis, and tiered models, reduce barriers. We guide readers through five core issues critical to updating the standard of care for early autism assessment: (1) What are the consequences of maintaining the status quo? (2) What do families prioritize? (3) What evidence supports efficient diagnostic models? (4) What are the consequences of reducing accuracy? and (5) What level of assessment depth is needed to inform action? Our team contends that the critical advantages of adopting efficient service delivery models far outweigh the disadvantages. Collaboration across disciplines, and trust in families' insights, will help build capacity. We conclude with actionable recommendations for clinicians and policymakers in support of adopting these models.Lay AbstractThe growing demand for autism diagnostic services has outpaced available resources. This creates significant delays in first diagnosis and entry into early intervention services (early diagnosis and intervention improve outcomes). Expert diagnosticians in the field have debated - and tested - streamlined and flexible alternative diagnostic processes to speed up access to services; we believe that the advantages of such approaches outweigh the disadvantages, and that evidence supports updating our current standards.
There has been a significant increase in the need for early identification and diagnosis of autism spectrum disorder (ASD). Limited access to care and long wait times are barriers to timely diagnosis. Integrated primary care is a promising avenue for early identification of signs and symptoms of ASD. This paper provides preliminary evidence for the effectiveness of an extension of the HealthySteps (HS) program for identifying and diagnosing ASD within an integrated pediatric primary care setting. The pilot extension resulted in shorter wait times for an ASD evaluation, more timely diagnoses leading to referrals to intervention at a younger age, and increased access to services addressing psychosocial risk factors that may serve as barriers to receiving care. Additionally, this article discusses implications and future directions for adapting the HS model in integrated behavioral health practices.
Emily Roemhild, Kristen Sanford, S. Ronis et al.· Journal of Primary Care & Co...· 0 citations
The evidence suggests delayed ASD diagnosis in Brazil reflects systemic gaps in care organization rather than isolated clinical factors, and strengthening PCP-based developmental surveillance and improving referral coordination are key strategies to reduce preventable delays and promote earlier access to intervention.
Bianca Teeny Sallum, Monaliza Ehlke Ozorio Haddad, Maria Gabriela Custódio de Figueiredo et al.· Children· 0 citations
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.
Tori E. Foster, Gabija Z. Bender, J. Hine et al.· Journal of Developmental and...· 0 citations
Autistic people require frequent support from first responders (FRs) as a function of the core and associated features of their diagnosis; however, they often report negative experiences with FRs and avoid contacting 911. The goals of this study were to generate sustainable, community-informed training standards on autism that are applicable across branches of emergency response to address this concern. Autistic adults, caregivers of autistic people, and first responders were interviewed and surveyed to generate core recommendations, which were cross-referenced with evidence-based practices. Multiple recommendations emerged: FRs should be trained in autism identification and strategies focused on supporting sensory needs and communication; streamlining response efforts across responding units; identifying and involving the person's best advocate to guide interactions; using special interests to support the person; and sharing resources to improve future interactions. FRs should be flexible in their implementation of procedures given the unique challenges many autistic people face. An Autism Response Protocol is proposed that outlines these key strategies to inform future first responder training in autism. This study has important practice implications for future autism training program standards in policing as well as across partnering FR disciplines.
Rose E. Nevill, Bridgett Kiernan, Leah Richardson et al.· Community mental health jour...· 0 citations
It is suggested that telehealth-based assessment may achieve high diagnostic concordance with in-person evaluation, and that telehealth-delivered interventions may yield similar outcomes in selected domains.
Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental
condition characterized by deficits in social communication and the presence of
restricted or repetitive behaviors and interests. Increasing prevalence rates underscore
the importance of early identification and timely intervention. This review
examines current and emerging diagnostic and management approaches to ASD.
Standardized diagnostic frameworks, such as the DSM-5 criteria, remain central
to clinical assessment. Recent advances in screening tools have enhanced early
detection. Due to the heterogeneity of clinical presentations, individualized care
is necessary. Management strategies commonly integrate behavioral and developmental
interventions, educational support, family involvement, and, when appropriate,
pharmacological treatment for associated symptoms. Functional outcomes
are further improved by strategies, such as executive function training, occupational
therapy, technology-assisted therapies, and caregiver-mediated programs.
Research indicates that extensive family involvement and coordinated, interdisciplinary
care lead to improved long-term outcomes. To maximise functioning,
engagement, and quality of life, the existing literature generally supports a
comprehensive, flexible, and person-centred approach that takes into account
each person's unique needs and strengths.
D. I. Khan, Sana Jameel· Current Psychiatry Research...· 0 citations
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