The Relationship Between Clinicians' Confidence and Accuracy, and the Influence of Child Characteristics, in the Screening of Autism Spectrum Disorder.

Hedley et al. (2016) watched 54 clinicians do autism screens on toddlers. Each clinician said how sure they felt about the result. Later the kids got full diagnoses. The team compared the two sets of answers.

They also noted parent reports of odd behaviors. They wanted to see if those reports changed the match between clinician confidence and final diagnosis.

When a clinician said "I am 90-100 % sure," they were almost always right. High confidence lined up with high accuracy. Lower confidence did not.

Parent reports of unusual behaviors boosted accuracy. Without those reports, confidence alone was less reliable.

Norris et al. (2010) and Hampton et al. (2015) show that parent screens like the SCQ work best when they ask about social play. Darren’s team used similar tools, so their high-confidence hits make sense.

van den Broek et al. (2006) found that the SCQ misses some higher-functioning kids. Darren’s study adds that clinician confidence still catches most of those misses when it is very high.

Pandey et al. (2008) showed M-CHAT accuracy rises after 24 months. Darren’s clinicians were surer on slightly older toddlers, matching that age trend.

Trust your gut only when it screams "yes." If you feel 90-100 % sure, refer right away. If you feel unsure, pause and gather more parent details before deciding. This simple rule cuts both false alarms and missed cases.