Screening for pediatric behavioral health in primary care in rural and urban clinics.

INTRODUCTION: The prevalence of behavioral health disorders in children is approximately 15%-20%, yet less than half of the children ever receive treatment for these conditions. The lack of access to behavioral health care is common in urban areas but even more difficult to access in rural areas. Screening for behavioral health in a primary care setting is one of the first strategies to reduce this problem and improve access to care. The primary goal of this study was to examine behavioral health screening practices of pediatric primary care providers in a rural midwestern state. METHOD: A survey that queried family practice/internal medicine and pediatric providers who provide care to pediatric patients was delivered to over 300 primary care providers across the state. The number of surveys returned was 112. RESULTS: The Modified Checklist for Autism tool was administered by 80% of pediatric providers and 30% of family practice primary care providers. The Patient Health Questionnaire for depression was administered by 72% of pediatric and 80% of family practice providers. Most of the primary care providers had a behavioral health provider present in the clinic, which likely resulted in higher screening rates compared to the national average. DISCUSSION: The screening practices of the family practice and pediatric subspecialities reflect their respective current professional organization recommendations. Although most providers believe it is important to screen for developmental and behavioral disorders, further system changes are needed to support screening for development and broader behavioral problems along with depression among family practice providers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Disparities Based on Race, Ethnicity, and Socioeconomic Status Over the Transition to Adulthood Among Adolescents and Young Adults on the Autism Spectrum: a Systematic Review.

PURPOSE OF REVIEW: Few studies have examined disparities in autism services and functional outcomes over the life course. Transition to adulthood is an especially important developmental period, as it sets up trajectories of adult functioning. This systematic review summarizes patterns of service use and transition outcomes according to race, ethnicity, and socioeconomic characteristics over the transition to adulthood. RECENT FINDINGS: Forty studies were included. Low-income and racial/ethnic minority youth on the autism spectrum were less likely to participate in transition planning meetings, enroll in postsecondary education, find competitive employment after high school, live independently, participate in social activities, and receive health care transition services than their White and higher income peers on the autism spectrum. Racial/ethnic minority and low-income youth on the autism spectrum were more likely to be disconnected from educational, occupational, and social activities upon entering adulthood. Future research should explore the mechanisms underlying these disparities as a first step to addressing them.

Development and Psychometric Evaluation of the Autism Stigma and Knowledge Questionnaire (ASK-Q).

ASD knowledge deficits contribute to disparities in the timing and quality of ASD services. To address the limitations with existing measures of ASD knowledge, we developed and examined the Autism Stigma and Knowledge Questionnaire (ASK-Q), which comprehensively assesses multiple subdomains of ASD knowledge while maintaining strong psychometric support and cross-cultural utility. ASK-Q items derived from the published research are organized into four subscales: (i) diagnosis, (ii) etiology, (iii) treatment, and (iv) stigma. ASK-Q items were selected based on ratings of face, construct, and cross-cultural validity by a group of 16 international researchers. Using Diagnostic Classification Modeling we confirmed the proposed factor structure and evaluated the statistical validity of each item among a lay sample of 617 participants.