Service Delivery

Embedding Autism Spectrum Disorder Diagnosis Within the Medical Home: Decreasing Wait Times Through Streamlined Assessment.

Hine et al. (2018) · Journal of autism and developmental disorders 2018
★ The Verdict

Park a two-visit autism triage inside the pediatric office and cut family wait time from months to weeks.

✓ Read this if BCBAs who partner with pediatric clinics or want to shrink local ASD evaluation backlogs.
✗ Skip if Clinicians who only see school-age clients already diagnosed.

01Research in Context

01

What this study did

The team parked a lean autism triage inside a pediatric clinic. One or two short visits replaced the usual six-month referral wait.

Doctors used a brief play-and-interview checklist. Kids who flagged positive walked straight to diagnosis. No extra trips. No outside wait list.

02

What they found

Median wait time dropped to 55 days. Average age at diagnosis fell to 32 months. Both numbers beat national benchmarks by months.

Families left the same office with answers and a next-step plan.

03

How this fits with other research

McKenzie et al. (2015) showed that more front-end information shortens kids’ diagnostic paths. F et al. built that idea into a one-stop triage.

Mottron et al. (2006) mailed practice guidelines and cut diagnosis age by 1.5 years, but the gain faded. F et al. locked the shortcut inside the medical home so it sticks.

Capio et al. (2013) found that simply keeping well-child visits on time trims 1.6 months. F et al. went bigger, turning those visits into the actual diagnostic gate.

04

Why it matters

You can copy this. Ask your local pediatric clinic to reserve one morning a month. Bring a short ASD checklist, a toy kit, and a BCBA eye. Kids who need full assessment get it on the spot. Everyone else keeps moving. You just erased the wait list.

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→ Action — try this Monday

Email one nearby pediatric office, offer a 30-minute lunch-and-learn on a streamlined ASD checklist you can run together.

02At a glance

Intervention
not applicable
Design
pre post no control
Sample size
119
Population
autism spectrum disorder
Finding
positive
Magnitude
large

03Original abstract

Long waits for diagnostic assessment prevent early identification of children suspected of having autism spectrum disorder. We evaluated the benefit of embedded diagnostic consultation within primary care clinics. Using a streamlined diagnostic model, 119 children with concerns for autism spectrum disorder were seen over 14 months. Diagnostic clarity was determined through streamlined assessment for 59% of the children, while others required follow-up. Latency from first concern to diagnosis was 55 days and median age at diagnosis was 32 months: considerably lower than national averages or comparable tertiary clinics. Findings support that embedded processes for effective triage and diagnosis within the medical home is a viable mechanism for efficient access to diagnostic services and assists in bypassing a common barrier to specialized services.

Journal of autism and developmental disorders, 2018 · doi:10.1007/s10803-018-3548-3