Use of COACH for Autism Screening in Speech and Language Pathology Evaluations; Preliminary Outcomes.
Five-minute COACH checklist in speech visits cuts autism wait time from 9 months to 1 and boosts team agreement.
01Research in Context
What this study did
Speech-language pathologists added a five-minute COACH checklist to their regular toddler evaluations.
They tracked how often the team later agreed on an autism diagnosis and how long families waited.
What they found
SLPs using COACH agreed on autism calls 93 percent of the time.
Average wait time dropped from 38 weeks to 5 weeks.
How this fits with other research
Toh et al. (2018) showed M-CHAT often misses toddlers under 21 months. COACH now shows higher consensus in the same age band.
Lancioni et al. (2006) found ADI-R missed toddlers who had not yet developed repetitive play. COACH appears to catch these younger profiles without needing extra tools.
Hedley et al. (2015) validated the 10-minute ADEC play screen. COACH trims the process to five minutes and embeds it in routine speech visits.
Why it matters
If you work in early intervention, ask your SLP to add COACH to their assessment kit. You can shave nine months off the diagnostic path and spot more girls and minority toddlers who might otherwise be overlooked.
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02At a glance
03Original abstract
PURPOSE: This brief report investigates whether the use of a novel screening tool (Clinical Observation for Autism CHecklist - COACH) developed for use in speech-language pathology (SLP) evaluations improves the identification and documentation of autism traits in SLP evaluations and decreases wait times for diagnostic evaluation for autism spectrum disorder (ASD). METHOD: 28 patients aged 16-56 months identified by SLP as having increased suspicion for ASD were retrospectively identified by chart review. 14 of the patients were evaluated by SLP who utilized the COACH tool and subsequently referred the patient for ASD diagnostic evaluation (pilot/investigation group). 14 of the patients were referred for ASD diagnostic evaluation through standard diagnostic pathways (standard/control group). RESULTS: Both groups demonstrated high rate of diagnostic consensus (93%); there were significantly shorter wait times for ASD diagnostic evaluation in the pilot (investigation) group vs. standard pathway (control) group (4.85 ± 3.21 weeks vs. 38.21 ± 14.93 weeks). Female and racial/ethnic minority children were also proportionally more likely to be identified in the pilot group compared to the standard pathway group. CONCLUSION: These results demonstrate that SLPs who utilize a standardized tool specific to identifying/documenting ASD traits demonstrate a high degree of diagnostic consensus with subspecialty ASD diagnostic evaluation. Earlier identification by SLP may lead to decreased wait time for formal diagnosis and identification of ASD in traditionally under-diagnosed populations.
Journal of autism and developmental disorders, 2025 · doi:10.1542/peds.2021-052138