Implications of Universal Autism Screening: Perspectives From Culturally Diverse Families With False-Positive Screens

Jenna Sandler Eilenberg, Deniz Kizildag, Ariel O Blakey, Nicole D Cardona, Anjali Oberoi, Sarabeth Broder-Fingert, Emily Feinberg, Kristin A Long, Jenna Sandler Eilenberg, Deniz Kizildag, Ariel O Blakey, Nicole D Cardona, Anjali Oberoi, Sarabeth Broder-Fingert, Emily Feinberg, Kristin A Long

Abstract

Objective: The American Academy of Pediatrics (AAP) recommends that pediatricians screen all young children for autism spectrum disorder (ASD). However, the US Preventive Services Task Force stated that there is insufficient evidence about the potential harms and benefits of universal ASD screening. To address this gap, we conducted qualitative interviews with caregivers of children who received a false-positive ASD screen to learn about families' perceptions of the harms and benefits of universal ASD screening.

Methods: Culturally diverse caregivers (N = 26) of children with false-positive ASD screens completed qualitative interviews focused on parents' experiences with and recommendations to improve the ASD screening and evaluation process. Interviews were transcribed verbatim, coded, and analyzed using applied thematic analysis.

Results: Parents explained that the ASD screening and evaluation process increased their knowledge about child development and substantiated existing concerns. The ASD screening and evaluation process resulted in connecting their child to services, which parents felt led to improvements in their child's delays. Parents endorsed anxiety during wait times for the formal developmental assessment. However, all parents expressed that, if given the option, they would repeat the screening and evaluation process again. Caregivers recommended universal screening for ASD and suggested that screening extend beyond the pediatrician to other settings.

Conclusions: From parents' perspectives, the connection to developmental services and increased knowledge of child development that resulted from the false-positive ASD screen outweighed the time-limited emotional distress triggered by a positive ASD screen. Overall, parents' preferences for universal ASD screening align with the AAP's recommendations.

Trial registration: ClinicalTrials.gov NCT02359084.

Keywords: autism spectrum disorder; health disparities; primary care; screening; young children.

Conflict of interest statement

Conflict of Interest Disclosures: The authors have no conflicts of interest relevant to this article to disclose.

Copyright © 2021 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Source: PubMed

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