@article{fc3c4fe63cb744f6a2ed0d9d82622ea8,
title = "Achieving diagnostic resolution in young children with social communication concerns in a predominantly low-income population",
abstract = "Children in low-income families are at risk for delayed diagnosis of autism spectrum disorder (ASD). The cascade-of-care model, which examines steps of care for quality and efficacy, can identify lesions in the process for evaluation and diagnosis for children at risk for ASD. Little is known about predictors that influence key steps in this process. We performed a retrospective chart review of 110 children under age five years from an academic medical center with social communication concerns. We assessed predictors of age of referral for ASD diagnostic evaluation, time to diagnosis, and likelihood of diagnostic completion. Children with continuity of primary care were referred at an earlier age than those receiving primary care at multiple centers. Compared with children with missed visits, children attending all well-child visits had a shorter median time to diagnosis. These findings illustrate a need for primary medical homes to facilitate early and timely ASD evaluations.",
keywords = "Autism spectrum disorder, Children, Diagnostic resolution, Low income, Primary care",
author = "Nguyen, {Hong An T.} and Jessica Rosenberg and Kistin, {Caroline J.} and Emily Feinberg and Sarabeth Broder-Fingert",
note = "Funding Information: Dr. Nguyen was supported by a National Research Service Award T32HP10028 from the Health Resources and Services Administration (HRSA) and BU-CTSI grant 1UL1TR0011430 from the National Center for Advancing Translational Sciences, National Institutes of Health (NIH). Drs. Feinberg and Broder-Fin gert were supported by grant R01MH104355 from the National Institute of Mental Health (NIMH), NIH, which is part of NIMH{\textquoteright}s national ASD PEDS research network and supported by the HRSA-unded Developmental and Behavioral Pediatrics Research Network (DBPNet). DBPNet is supported by the cooperative agreement UA3MC20218 from the Maternal and Child Health Bureau, HRSA. Dr. Broder-Fingert is also supported by grant K23MH109673 from the NIMH. The funders had no role in study design, data analysis, or preparation of the manuscript. All authors otherwise declare no conflicts of interest. Funding Information: Dr. Nguyen was supported by a National Research Service Award T32HP10028 from the Health Resources and Services Administration (HRSA) and BU-CTSI grant 1UL1TR0011430 from the National Center for Advancing Translational Sciences, National Institutes of Health (NIH). Drs. Feinberg and Broder-Fingert were supported by grant R01MH104355 from the National Institute of Mental Health (NIMH), NIH, which is part of NIMH?s national ASD PEDS research network and supported by the HRSA-funded Developmental and Behavioral Pediatrics Research Network (DBPNet). DBPNet is supported by the cooperative agreement UA3MC20218 from the Mater-nal and Child Health Bureau, HRSA. Dr. Broder-Fingert is also supported by grant K23MH109673 from the NIMH. The funders had no role in study design, data analysis, or preparation of the manuscript. All authors otherwise declare no conflicts of interest. We thank Andrea Chu, MPH, Nicole Melita, MS, and Julia Goupil for their contribu-tions to the study. A poster presentation using these data was previously presented at Pediatric Academic Societies on April 28, 2019 in Baltimore, MD. Publisher Copyright: {\textcopyright} Meharry Medical College Journal of Health Care for the Poor and Underserved.",
year = "2021",
month = aug,
doi = "10.1353/HPU.2021.0137",
language = "English (US)",
volume = "32",
pages = "1359--1371",
journal = "Journal of Health Care for the Poor and Underserved",
issn = "1049-2089",
publisher = "Johns Hopkins University Press",
number = "3",
}