Objectives: This study’s aims were to: 1) examine the characteristics of children served in a CMH clinic who received an ASD assessment from providers trained to use the Autism Diagnostic Observation Schedule (ADOS) and 2) identify the clinical characteristics associated with receiving a final ASD diagnosis in this setting.
Methods: Data were extracted from CMH clinical records (psychodiagnostic reports). CMH clinicians from three affiliated clinics referred children receiving services (therapy or therapy plus medication management) who were suspected of ASD based on results from screening measures and clinical judgment. Eighteen CMH clinical psychologists and psychology trainees were trained by an experienced and certified ADOS trainer and conducted ASD assessments. The ASD assessments included gathering developmental history, reviewing prior psychological testing and IEP assessments, administering the ADOS (and cognitive assessments for some children), and integrating information to determine diagnosis.
Results: A total of 62 children were referred for ASD assessment. Children were an average of 10.69 years old (SD = 3.48; range: 5-18 years) and 76% male. They were 42% Latino/Hispanic, 33% Caucasian, 12% African American, 8% Asian/Pacific Islander, and 5% Multiracial. Those referred had an average of 1.79 non-ASD diagnoses (range: 0-5; anxiety, mood, and ADHD disorders were most common) and 48% had two or more comorbid diagnoses. Approximately 70% (n=43) received scores that fell within the ASD or Autism categories on the ADOS. Approximately 56% (n=35) of the sample was assigned an ASD diagnosis by the CMH examiner, primarily Asperger’s Disorder (n=10) and PDD-NOS (n=12). Factors associated with receiving an ASD diagnosis, including provider and child clinical characteristics, will be discussed.
Conclusions: The clinical and age characteristics of the children who received an ASD diagnosis after an ASD assessment are consistent with research conducted in similar CMH settings. These data underscore the need for further targeted ASD screening efforts in CMH setting, especially with higher functioning children with comorbid psychiatric conditions. Findings illustrate the feasibility and utility of efforts to implement evidence-based ASD screening and diagnostic practices in CMH settings with relatively minimal extra costs.
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