563 - A National Survey of Autism Clinic Intake Requirements

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 563
Publication Number: 563.109

Anisha Srinivasan, University of California Davis Children's Hospital, Sacramento, CA, United States; Erika Phelps Nishiguchi, UH Rainbow Babies & Children's Hospital, Cleveland, OH, United States; Cassandra I. Gonzalez, Rutgers, Robert Wood Johnson Medical School, Woodbridge, NJ, United States; Manuel E. Jimenez, Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, United States; Katharine E. Zuckerman, Doernbecher Children's Hospital at Oregon Health & Science University, Portland, OR, United States; K. Casey Lion, University of Washington/ Seattle Children's Hospital, Bothell, WA, United States

Presenting Author(s)

Anisha Srinivasan, MD, MS (she/her/hers)

Assistant Professor of Pediatrics
University of California Davis Children's Hospital
Sacramento, California, United States

Background: Autism (ASD) diagnosis is often delayed for families with lower educational attainment, language barriers and/or limited health literacy. ASD clinic intake processes may pose administrative barriers that disproportionately affect families underserved in ASD care. Little is known about intake requirements nationally.

Objective: To describe intake requirements, intake navigation strategies, and potential barriers to care, in a national sample of ASD clinics.

Design/Methods: We conducted a national survey of ASD clinics affiliated with Children’s Hospital Association member hospitals from 11/2021 - 8/2022. Clinics not conducting ASD diagnostic evaluations were excluded. For each eligible clinic, up to 3 staff were invited to complete an online survey. Survey questions pertained to intake requirements, availability of intake forms in multiple languages or formats, strategies used to help parents navigate intake, and clinic demographics. Close-ended responses were analyzed descriptively. Logistic regression models examined associations between clinic demographics (race and ethnicity, insurance, language) and odds of requiring intake paperwork.

Results: Of eligible clinics, 92 (56%) completed the survey, representing all US regions and 41 states (Table 1). Most ASD clinics require a referral (62%) and completed intake paperwork (55%) before evaluation (Table 2). Information requested includes medical history (60%), developmental history (55%), and individualized education plans (51%). Many clinics do not offer medical history forms (39%) or developmental forms (30%) in non-English languages. Few offer forms in plain language (11%); none offer forms in other alternate formats (large text, Braille). Few clinics have a formal intake support process; help is generally provided upon parent request. Strategies to help parents with intake include interpreter services, referral to an outside organization, or social work support. We found no significant associations between clinic demographics and odds of intake paperwork requirement.

Conclusion(s): Most ASD clinics require completed intake forms for diagnostic evaluation and many do not offer forms in non-English languages or alternate formats. Assistance with intake is generally offered upon parent request. Intake requirements may contribute to diagnostic delays for families with educational, language or health literacy barriers. Reducing intake requirements and standardizing intake support may facilitate access to ASD diagnostic services.