Developmental screening in community-based settings

Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting 1 in 59 children in the United States. The benefits of early detection and intervention for ASD have been clearly documented. However, significant delays exist in access to early screening, diagnosis, and service provision. Despite the American Academy of Pediatrics’ guidelines recommending developmental screening for ASD at 18 and 24 months, less than 20% of children with ASD receive their diagnosis before age 3. For many, this diagnosis comes several years later, which further delays entry into support services. There are documented barriers to appropriate developmental screening occurring in primary care, largely due to the lack of time that primary care clinicians have to conduct this screening. Thus, there is a need to expand developmental screening to also occur in accessible community-based settings, such as the home, preschool, child care, and other community programs. This chapter provides the rationale for developmental screening to occur in community settings and describes several existingmodels that may be positioned to offer innovative solutions to overcome the limitations with families solely relying on the primary care clinic as a developmental screening source.