Evaluation of a Training Workshop to Enhance General Pediatrician Diagnostic Skills for Autism Spectrum Disorder

Background: The increase in autism spectrum disorder (ASD) diagnoses over the past decade has placed strain on access to ASD diagnostic assessments. One potential way to improve diagnostic capacity is through training general pediatricians to provide ASD diagnoses in their practices.

Objectives: The objective of this work was to evaluate a workshop designed to enhance ASD diagnostic abilities among general pediatricians, specifically evaluating whether participants changed their practice and their motivation for practice change.

Methods: Twenty-four general pediatricians attended a workshop that was designed to teach skills in: assessing for ASD (including history/observation and interaction); communicating the ASD diagnosis through in situ simulation with actors playing parents; connecting families to resources; and billing effectively. Further ongoing mentorship was also available in the six months after the workshop for participating pediatricians. A web-based survey was sent out to all participants before the workshop to provide information on attendees and six months after the workshop to determine the impact of the workshop on their practice. Eight participants were also interviewed by a researcher who was not part of the workshop. Interviews were transcribed, coded, and reviewed by study team to determine whether the workshop achieved its objectives.

Results: Prior to the workshop, 15 of the 23 respondents (65.2%) performed ASD diagnostic assessments in their practice. Fifteen participants completed the six-month post-workshop survey (62.5% response rate); of these, 80% (n = 12) performed ASD diagnostic assessments. Among the six-month post-workshop survey respondents, 43% of participants agreed or strongly agreed with feeling confident diagnosing ASD prior to the workshop; after the workshop, this increased to 67%. Analysis of the eight in-depth interviews grouped participants into three categories: 1) Participants who were already diagnosing ASD in their practices (5 of the 8 participants interviewed); 2) Participants who started diagnosing ASD as a result of attending the workshop (2 of the 8 participants interviewed); and 3) Participants who continued not diagnosing ASD after the workshop (1 of the 8 participants interviewed). Participants who already diagnosed ASD prior to the workshop still ascribed value to attendance. The workshop increased their feelings of confidence, let them know that their peers were also diagnosing ASD, gave them approval from experts for their practice, and gave them direct access to experts. The two participants who started performing ASD assessments after attending the workshop described a change of perspective about whether ASD diagnosis was a “reasonable” part of their practice. They felt empowered to be able to help families access resources faster. One participant did not perform ASD diagnoses before or after the workshop. This participant still did not feel comfortable communicating the ASD diagnosis to the family.

Conclusions : For general pediatricians to start doing ASD diagnoses in their practices, they need to feel that this change is reasonable and supposed by both peers and experts. Attitudes towards ASD play a big role, particularly as they relate to communicating the ASD diagnosis to families.