Enhancing Resident Education in Autism Diagnosis: Training on the Screening Tool for Autism in Toddlers

Abstract

Objective: Pediatricians feel inadequately prepared to diagnose and manage autism spectrum disorders (ASDs). We developed a curriculum that trains pediatric residents in the Screening Tool for Autism in Toddlers and Young Children (STAT), a tool used to diagnose ASD, and assessed its impact.

Methods: Pediatric residents completed training in the STAT that included interactive video and practice-based elements. Residents completed pretraining and posttraining surveys assessing comfort with diagnosing and treating ASD, knowledge-based pretests and posttests, posttraining interviews, and follow-up assessments at 6 and 12 months after training.

Results: Thirty-two residents completed the training. Posttest scores significantly increased [M (SD) 9.8 (2.4) vs 11.7 (2), p < 0.0001]. Knowledge gains were not maintained at 6-month follow-up. Residents reported increased comfort with several ASD management methods and an increased likelihood of using the STAT. More residents reported using the STAT at follow-up: 2 of 29 before training, 5 of 11 at 6 months, and 3 of 13 at 12 months. We identified 4 themes in interview responses: (1) increased sense of empowerment in managing patients with ASD but ongoing reluctance to make a formal diagnosis, (2) logistical barriers affected successful implementation of the STAT, (3) access to developmental pediatricians played an essential role in comfort levels, and (4) the main educational value of the STAT training came from interactive components.

Conclusion: An ASD curriculum including training in the STAT increased resident knowledge and comfort in diagnosing and managing ASD. Although logistical barriers continue to affect the ability of general pediatricians to diagnose ASD, use of this curriculum has potential to improve long-term outcomes.