Autism Spectrum Disorder Screening during the COVID-19 Pandemic in a Large Primary Care Network.

TitleAutism Spectrum Disorder Screening during the COVID-19 Pandemic in a Large Primary Care Network.
Publication TypeJournal Article
Year of Publication2022
AuthorsWallis KE, Nekrasova E, Bennett AE, Fiks AG, Gerdes M, Jenssen BP, Miller JS, Shu D, Guthrie W
JournalAcad Pediatr
Date Published2022 Apr 20
ISSN1876-2867
Abstract

OBJECTIVE: To assess the impact of the COVID-19 pandemic on screening for autism spectrum disorder (ASD) and screening equity among eligible children presenting for well-child care in a large primary care pediatric network, we compared rates of ASD screening completion and positivity during the pandemic to the year prior, stratified by socio-demographic factors.

METHODS: Patients who presented for in-person well-child care at 16-26 months between 3/1/2020 and 2/28/2021 (COVID-19 cohort, n=24,549) were compared to those who presented between 3/1/2019 and 2/29/2020 (pre-COVID-19 cohort, n= 26,779). Demographics and rates of completion and positivity of the Modified Checklist for Autism in Toddlers with Follow-up (M-CHAT/F) were calculated from the electronic health record (EHR) and compared by cohort using logistic regression models.

RESULTS: Total eligible visits decreased by 8.3% between cohorts, with a greater decline in Black and publicly insured children. In the pre-COVID-19 cohort, 89.0% of eligible children were screened at least once, compared to 86.4% during the pandemic (p<0.001). Significant declines in screening completion were observed across all socio-demographic groups except among Asian children, with the sharpest declines among non-Hispanic White children. Socio-demographic differences were not observed in screen-positive rates by cohort.

CONCLUSIONS: Well-child visits and ASD screenings declined across groups, but with different patterns by race and ethnicity during the COVID-19 pandemic. Findings regarding screen-completion rates should not be interpreted as a decline in screening disparities, given differences in who presented for care. Strategies for catch-up screening for all children should be considered.

DOI10.1016/j.acap.2022.04.005
Alternate JournalAcad Pediatr
PubMed ID35460894