Abstract
Background: There are approximately 1.5 million children in the United States diagnosed with Autism Spectrum Disorder (ASD). This developmental disability has impacts on morbidity, mortality, as well as social and economic concerns. With signs appearing in early childhood, timely evaluation through validated screening tools lead to improved outcomes and quality of life.|Problem: Current screening practices to effectively identify children at risk for ASD are lacking a standardized process. Referral to early intervention services cannot occur if screening tools are not implemented in the primary care environment.|Purpose: The purpose of this project is to implement the use of the M-CHAT-R/F in a rural primary care clinic for all children age 18- to 24-months presenting for routine visits in order to increase the use of a validated screening tool to identify those at risk for ASD.|Methods: Education was provided to clinic nursing and providers on ASD and the use of the Modified Checklist for Autism in Toddlers-Revised, With Follow-Up (M-CHAT-R/F). A pre-implementation survey was administered to the clinic staff. Implementation of the M-CHAT-R/F took place for four months, followed by a post-implementation survey. A retrospective chart analysis was then performed to observe the number of M-CHAT-R/F screening tools administered to the target population. Pre- and post-implementation surveys were analyzed to identify barriers to the screening process.|Conclusion: Provider and nursing understanding of ASD and screening was improved with the project methodology as well as M-CHAT-R/F tool adoption. Visit time and lack of reimbursement were identified barriers to implementation. Although this was a small study population and timeframe, adjusting for barriers prior to implementation could be a direction for future studies.|Keywords: autism, autism spectrum disorder, primary care, screening, barriers