Presentation Title

Physician Knowledge of Joint Attention in Diagnosing Autism Spectrum Disorders

Faculty Mentor

Hyon Soo Lee, Connie Kasari

Start Date

17-11-2018 10:30 AM

End Date

17-11-2018 10:45 AM

Location

C155

Session

Oral 2

Type of Presentation

Oral Talk

Subject Area

behavioral_social_sciences

Abstract

Autism spectrum disorders (ASD) is defined as deficits in social communication and restricted and repetitive behaviors (American Psychiatric Association, 2013), with 1 in 59 children diagnosed with ASD (CDC, 2018). As earlier interventions have been shown to provide the best outcomes, there has been an increased push for earlier diagnoses of ASD (Tager-Flusberg, 2014). Although children can be reliably diagnosed by 18-24 months (Charman et al., 2005), a study found the average age of diagnosis to be 4 years and 10 months (Roades, Scarpa, & Salley, 2007). In this study, developmental behavioral pediatricians were associated with the lowest age of diagnoses at 4 years, and diagnosed 2.5 years younger than most other specialties (Roades, Scarpa, & Salley, 2007). Other studies have reported challenges faced by various physicians when diagnosing ASD, such as fear of family reactions, and outdated beliefs about ASD (Heidgerken, Geffken, Modi, & Frakey, 2005).

As physicians are one of the first professionals families encounter when a child is born and have the opportunity to detect ASD during early well-child visits, there may be a need for specialized physician training in diagnosing ASD. In particular, physicians’ knowledge in joint attention (JA), nonverbal referential communication used to share an experience with others, may help early detection of ASD. JA is a pre-requisite to social communication and has been found to be associated with ASD (Ibanez et al., 2013; Charman, 2003).

In the current study, physicians in different specialties were interviewed to examine their understanding of JA and experiences diagnosing ASD. Preliminary findings suggest that physicians with different training backgrounds have different levels of JA knowledge. Some also expressed their lack of confidence diagnosing ASD given their time constraints, indicating there may be a need for more easily digestible training materials to increase physicians' awareness of ASD and JA.

Summary of research results to be presented

Physicians in primary care pediatrics, family medicine, and developmental-behavioral pediatrics in the LA community participated in a semi-structured interview on their current familiarity with JA and their experiences diagnosing ASD. Information on their demographics, screening methods, and challenges were collected. Interviews were transcribed, and audio recordings were coded in a scoring system derived from Early Social Communication Scale (Mundy et al., 2013) for accuracy of physicians’ definition of JA and associated behaviors. Differences in how participants described JA were observed among the participants. Developmental-behavioral pediatricians were able to provide an accurate and immediate definition of JA, perhaps due to their extensive training in fellowship involving child development and experience practicing. However, they also expressed concerns with the lack of training in ASD diagnosis outside of their fellowship. On the other hand, family practitioners and pediatricians interviewed, despite practicing for over 25 years, struggled to define JA and displayed some misconceptions associated with ASD, such as correlations with intelligence. One family practitioner also reported they did not use ASD screening tools. Additional interviews are currently being analyzed and will be presented.

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Nov 17th, 10:30 AM Nov 17th, 10:45 AM

Physician Knowledge of Joint Attention in Diagnosing Autism Spectrum Disorders

C155

Autism spectrum disorders (ASD) is defined as deficits in social communication and restricted and repetitive behaviors (American Psychiatric Association, 2013), with 1 in 59 children diagnosed with ASD (CDC, 2018). As earlier interventions have been shown to provide the best outcomes, there has been an increased push for earlier diagnoses of ASD (Tager-Flusberg, 2014). Although children can be reliably diagnosed by 18-24 months (Charman et al., 2005), a study found the average age of diagnosis to be 4 years and 10 months (Roades, Scarpa, & Salley, 2007). In this study, developmental behavioral pediatricians were associated with the lowest age of diagnoses at 4 years, and diagnosed 2.5 years younger than most other specialties (Roades, Scarpa, & Salley, 2007). Other studies have reported challenges faced by various physicians when diagnosing ASD, such as fear of family reactions, and outdated beliefs about ASD (Heidgerken, Geffken, Modi, & Frakey, 2005).

As physicians are one of the first professionals families encounter when a child is born and have the opportunity to detect ASD during early well-child visits, there may be a need for specialized physician training in diagnosing ASD. In particular, physicians’ knowledge in joint attention (JA), nonverbal referential communication used to share an experience with others, may help early detection of ASD. JA is a pre-requisite to social communication and has been found to be associated with ASD (Ibanez et al., 2013; Charman, 2003).

In the current study, physicians in different specialties were interviewed to examine their understanding of JA and experiences diagnosing ASD. Preliminary findings suggest that physicians with different training backgrounds have different levels of JA knowledge. Some also expressed their lack of confidence diagnosing ASD given their time constraints, indicating there may be a need for more easily digestible training materials to increase physicians' awareness of ASD and JA.