Improving Autism Identification in Primary Care: Diagnostic Outcomes of a Primary Care Based Autism Assessment Pathway
Abstract
Early identification of autism spectrum disorder (ASD) is essential to optimize developmental outcomes. Yet, prolonged waitlists for comprehensive evaluations create significant delays in diagnosis and access to early intervention. This project aimed to evaluate whether a primary care-based autism assessment pathway incorporating the Screening Tool for Autism in Toddlers and Young Children (STAT) could provide timely and reliable diagnostic outcomes while reducing unnecessary specialist referrals. We hypothesized that integrating a structured observational tool within a broader clinical evaluation would allow most children to receive definitive diagnoses in primary care while appropriately identifying those requiring further assessment. We conducted a retrospective chart review of children evaluated with the STAT as part of a primary care autism assessment between 2021 and 2024. Extracted variables included age, M-CHAT scores, STAT classification, and final diagnostic outcome categorized as ASD, deferred, other developmental diagnosis, or no ASD. Deferred diagnoses were defined as explicit documentation of diagnostic uncertainty with recommendation for further evaluation. Descriptive statistics were used to summarize outcomes. 69 patients met inclusion criteria, with 49 (71%) evaluated at age 2 and 17 (25%) at age 3. 37 (54%) were diagnosed with ASD, 6 (9%) received deferred diagnoses, and 26 (38%) did not meet criteria for ASD. Among deferred cases, 4 (67%) failed the STAT, 1 (17%) passed, and 1 (17%) was unable to complete testing. Two of the deferred were later confirmed to have ASD after comprehensive evaluation, while others were referred for continued monitoring or specialist assessment. These findings demonstrate a structured, primary care-based autism assessment pathway not only provides timely diagnostic clarity for most children but also effectively identifies cases requiring additional evaluation. This model reduces unnecessary specialist referrals without compromising diagnostic integrity. It represents a scalable solution to the persistent gap in timely ASD identification and access to early intervention.
Start Time
15-4-2026 1:30 PM
End Time
15-4-2026 4:30 PM
Room Number
Culp Ballroom 316
Poster Number
10
Presentation Type
Poster
Presentation Subtype
Posters - Competitive
Presentation Category
Health
Student Type
Graduate and Professional Degree Students, Residents, Fellows
Faculty Mentor
Stephanie Layne
Improving Autism Identification in Primary Care: Diagnostic Outcomes of a Primary Care Based Autism Assessment Pathway
Culp Ballroom 316
Early identification of autism spectrum disorder (ASD) is essential to optimize developmental outcomes. Yet, prolonged waitlists for comprehensive evaluations create significant delays in diagnosis and access to early intervention. This project aimed to evaluate whether a primary care-based autism assessment pathway incorporating the Screening Tool for Autism in Toddlers and Young Children (STAT) could provide timely and reliable diagnostic outcomes while reducing unnecessary specialist referrals. We hypothesized that integrating a structured observational tool within a broader clinical evaluation would allow most children to receive definitive diagnoses in primary care while appropriately identifying those requiring further assessment. We conducted a retrospective chart review of children evaluated with the STAT as part of a primary care autism assessment between 2021 and 2024. Extracted variables included age, M-CHAT scores, STAT classification, and final diagnostic outcome categorized as ASD, deferred, other developmental diagnosis, or no ASD. Deferred diagnoses were defined as explicit documentation of diagnostic uncertainty with recommendation for further evaluation. Descriptive statistics were used to summarize outcomes. 69 patients met inclusion criteria, with 49 (71%) evaluated at age 2 and 17 (25%) at age 3. 37 (54%) were diagnosed with ASD, 6 (9%) received deferred diagnoses, and 26 (38%) did not meet criteria for ASD. Among deferred cases, 4 (67%) failed the STAT, 1 (17%) passed, and 1 (17%) was unable to complete testing. Two of the deferred were later confirmed to have ASD after comprehensive evaluation, while others were referred for continued monitoring or specialist assessment. These findings demonstrate a structured, primary care-based autism assessment pathway not only provides timely diagnostic clarity for most children but also effectively identifies cases requiring additional evaluation. This model reduces unnecessary specialist referrals without compromising diagnostic integrity. It represents a scalable solution to the persistent gap in timely ASD identification and access to early intervention.
