Heidergerken, A.D., Geffken, F., Modi, A., & Frakey, L. (2005).  A survey of autism knowledge in a health care setting.  JADD, 35 (3), 323- 330.

• Diagnostic criteria for autism have refined over the lears
• identification, awareness and diagnosis has improved as well
• more referrals than before
• often peds and family practitioners are the first people to come in contact with
  • American Academy of Pediatrics - increased epidemiology, peds are more likely to encounter a child with autism
  • comorbidity - kids are more likely to see specialists
• diagnosis is often difficult - latency to diagnosis is often long
  • can impede early intervention and long-term outcomes
  • impacts services and advocacy
• some clinicians might have outdated knowledge and lack the most up-to-date education
• may also have misconceptions and beliefs
  • Stone's instrument
  • Shah (2001) - medical students could identifiy the diagnostic criteria, but did not necessarily know causes, profiles, or treatments
• parents and teachers often have misconceptions as well (Stone & Rosenbaum 1988)
  • this paper is awfully old!
  • Helps, Newson-Davis, and Callis (1999) replication
    • still misconceptions among mainstream and SPED teachers
    • much more training needed for teachers and parents
• are health professionals more knowledgable about diagnosis than they used to be?
• Current study - used DSM-IV criteria
  • compared those twho tend to work closely with kids with autism (e.g., psychiatrists) with front line providers, and CARD employees
• Participatns
  • 8 in family practice
  • 20 in peds
  • 5 neuro
  • 9 SLP
  • 16 clinical psychologists
  • 35 CARD
    • 44 MD or PhD
    • 15 MS
• Procedures
  • Autism Survey given to each
    • Part I - beliefs about autism
    • Part II - diagnostic criteria
• Results
  • Part I - MANOVA by group with Tukey's post hoc analyses
  • Significant effects on these questions
    • special education needed
    • higher socioeconomic status
    • do not show social attachments
    • do not show affectionate behavior
    • more intelligent
    • difficult to distinguish between autism and schizophrenia
    • usually grow up to be schizophrenic 
    • cold rejecting parents
    • deliberatively negativistic and noncompliant
    • eventually outgrown 
      • more likely in specialists and primary care providers than CARD
    • less likely to state comfort in diagnosis than CARD
    • Developmental disorder - less likely to say
  • Part II
    • MANOVA by group
      • helpful but not necessary - CARD employees were likely to use inappropriate laughing and giggling and sensory responses for diagnosis
      • Primary care providers - thought patterns
        • less likely to ID unusual mannerism
        • specialists - lack of social responsiveness considered helpful but not necessary
• Discussion
  • all three groups were accurate about the diagnostic criterion
  • primary care providers had some outdates beliefs about children with autism
  • less likely to endorse SPED - WAS THERE A TYPO?
    • less likely to advocate for services
  • more likely not to use responsiveness to sensory stimuli as a criterion
  • more differences the less likely a provider was to be a health care provider for a child with autism
  • primary providers still maintain that it is difficult to distinguish autism from childhood schizophrenia
    • prevalence rates of schizophrenia in childhood extremely low
    • sometimes more difficult in Asperger's syndrome
  • more specialists - refrigerator mother theory
  • also - outdated expectations about course and outcome
    • less likely to call it a developmental disorder
    • also thought kids could outgrow the disorder with the proper treatment
  • need for more training and awareness
    • sample may not have been representative
    • questions taken from DSM-III that are also still in the DSM-IV - could have been a confound
• More research is needed