OpenLB
Open Library of Bioscience
Advanced Search
Journal of autism and developmental disorders
Jan, 2025;55 (1): 181-201.

Training and Educational Pathways for Clinicians (Post-graduation) for the Assessment and Diagnosis of Autism Spectrum Disorders: A Scoping Review.

Christine Curran, Rachel Roberts, Anne Gannoni, Deepa Jeyaseelan
Author Information
  1. Christine Curran: School of Psychology, University of Adelaide, Adelaide, SA, Australia.
  2. Rachel Roberts: School of Psychology, University of Adelaide, Adelaide, SA, Australia. rachel.roberts@adelaide.edu.au. ORCID
  3. Anne Gannoni: Child and Adolescent Mental Health Service, Women's and Children's Health Network, North Adelaide, SA, Australia.
  4. Deepa Jeyaseelan: Child Development Unit, Women's and Children's Health Network, North Adelaide, SA, Australia.
PMID: 38177895 DOI: 10.1007/s10803-023-06202-4

Abstract

This review aimed to identify the post-graduation training pathways available for both clinicians and trainers in the assessment and diagnosis of Autism Spectrum Disorder (ASD). The study was guided by two research questions: What is known about ASD-specific educational, training, or other pathways available to support clinicians of any discipline, post-graduation, to meet the required expertise relevant to assessments of ASD concerns? What is known about the educational pathways available to clinicians seeking to provide training to other clinicians, post-graduation, in the assessment of ASD concerns? A scoping review was undertaken with searches completed across five databases (PubMed, PsycINFO, PsycEXTRA, ERIC and CINAHL). A Google search strategy was also executed using the "advanced" search function. Eligible records were literature, written in English, that examined post-graduation training and/ or education of clinicians to assess and/ or diagnose ASD. Fourteen relevant records were identified. Post-graduate training has the potential to enhance clinician confidence and service provision in ASD assessment and diagnosis. System-wide training approaches show promise in building large-scale, diagnostic capacity and the use of tele-mentoring offers a cost-effective, convenient mode of training delivery. A lack of evidence to support ASD diagnostic training pathways was found and may pose a challenge for clinicians and service users. The limited evidence found suggests that high quality research will be fundamental in determining how to build clinician capacity in ASD assessment and diagnosis and to ascertain whether training pathways are a necessary component.

Keywords

Adult education Assessment and diagnosis Autism spectrum disorder Healthcare professional training Train the trainer

References

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: APA. [DOI: 10.1176/appi.books.9780890425596]
  2. Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. [DOI: 10.1080/1364557032000119616]
  3. Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., Kurzius-Spencer, M., Zahorodny, W., Robinson Rosenberg, C., White, T., Durkin, M. S., Imm, P., Nikolaou, L., Yeargin-Allsopp, M., Lee, L. C., Harrington, R., Lopez, M., Fitzgerald, R. T., Hewitt, A., Pettygrove, S., & Dowling, N. F. (2018). Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. Morbidity and mortality weekly report. Surveillance summaries. 67(6), 1–23. https://doi.org/10.15585/mmwr.ss6706a1 .
  4. Becevic, M., Nair, P., Wallach, E., Hoffman, K., & Sohl, K. (2021). ECHO autism: Evaluation of participants’ perceptions of collaborative telementoring network. Journal of Patient Experience, 8, 23743735211065292–23743735211065292. https://doi.org/10.1177/23743735211065292 . [DOI: 10.1177/23743735211065292]
  5. Bradbury, K. R., Duvall, S. W., Armstrong, K., & Hall, T. A. (2022). Survey of training experiences and clinical practice in assessment for autism spectrum disorder by neuropsychologists. Clinical Neuropsychologist, 36(5), 856–873. https://doi.org/10.1080/13854046.2021.1948610 . [DOI: 10.1080/13854046.2021.1948610]
  6. Brian, J. A., Zwaigenbaum, L., & Ip, A. (2019). Standards of diagnostic assessment for autism spectrum disorder. Paediatrics & Child Health, 24(7), 444–460. https://doi.org/10.1093/pch/pxz117 . [DOI: 10.1093/pch/pxz117]
  7. Certification Examination in Psychiatry (2017, October 31). American Board of Psychiatry and Neurology. https://www.abpn.com/wp-content/uploads/2017/1-/2018_Psychiatry_CERT_Content_Speciifications.pdf .
  8. Dillenburger, K., McKerr, L., Jordan, J. A., & Keenan, M. (2016). Staff training in autism: The one-eyed wo/man. International Journal of Environmental Research and Public Health, 13(7), 716. https://doi.org/10.3390/ijerph13070716 . [DOI: 10.3390/ijerph13070716]
  9. Falkmer, T., Anderson, K., Falkmer, M., & Horlin, C. (2013). Diagnostic procedures in autism spectrum disorders: A systematic literature review. European Child & Adolescent Psychiatry, 22(6), 329–340. https://doi.org/10.1007/s00787-013-0375-0 . [DOI: 10.1007/s00787-013-0375-0]
  10. Fuller, E. A., & Kaiser, A. P. (2019). The effects of early intervention on social communication outcomes for children with autism spectrum disorder: A meta-analysis. Journal of Autism and Developmental Disorders, 50(5), 1683–1700. https://doi.org/10.1007/s10803-019-03927-z . [DOI: 10.1007/s10803-019-03927-z]
  11. Ghaderi, G., & Watson, S. L. (2019). Autism spectrum disorder knowledge, training and experience: Ontario physicians’ perspectives about what helps and what does not. Journal on Developmental Disabilities, 24(2), 51–60.
  12. Gilliam, J. E. (2001). Gilliam Asperger’s Disorder Scale manual second printing (2nd ed.). Austin: Pro-Ed.
  13. Gordon-Lipkin, E., Foster, J., & Peacock, G. (2016). Whittling down the wait time: Exploring models to minimize the delay from initial concern to diagnosis and treatment of autism spectrum disorder. Pediatric Clinics of North America, 63(5), 851–859. https://doi.org/10.1016/j.pcl.2016.06.007 . [DOI: 10.1016/j.pcl.2016.06.007]
  14. Green, R. M., Travers, A. M., Howe, Y., & McDougle, C. J. (2019). Women and autism spectrum disorder: Diagnosis and implications for treatment of adolescents and adults. Current Psychiatry Reports, 21(22), 1–8. https://doi.org/10.1007/s11920-019-1006-3 . [DOI: 10.1007/s11920-019-1006-3]
  15. GWAS Catalog. The NHGRI-EPI catalog of published genome-wide association studies. http://www.ebi.ac.uk/gwas/downloads/summary-statistics .
  16. Hayes, J., Ford, T., Rafeeque, H., & Russell, G. (2018). Clinical practice guidelines for diagnosis of autism spectrum disorder in adults and children in the UK: A narrative review. Bmc Psychiatry, 18(1), 222. https://doi.org/10.1186/s12888-018-1800-1 . [DOI: 10.1186/s12888-018-1800-1]
  17. Health Resources and Services Administration (2018). Training professionals in service delivery:Key findings from an evaluation of the autism CARES developmental-behavioural pediatrics training program. https://mchb.hrsa.gov/sites/default/files/mchb/programs-impact/dbp-factsheet.pdf .
  18. Hine, J. F., Wagner, L., Goode, R., Rodrigues, V., Taylor, J. L., Weitlauf, A., & Warren, Z. E. (2021). Enhancing developmental behavioral pediatric rotations by teaching pediatric residents how to evaluate autism in primary care. Autism, 25(5), 1492–1496. https://doi.org/10.1177/1362361320984313 . [DOI: 10.1177/1362361320984313]
  19. Horlin, C., Falkmer, M., Parsons, R., Albrecht, M. A., & Falkmer, T. (2014). The cost of autism spectrum disorders. PloS One, 9(9), e106552. https://doi.org/10.1371/journal.pone.0106552 . [DOI: 10.1371/journal.pone.0106552]
  20. Huerta, M., & Lord, C. (2012). Diagnostic evaluation of autism spectrum disorders. Pediatric Clinics of North America, 59(1), 103–xi. https://doi.org/10.1016/j.pcl.2011.10.018 . [DOI: 10.1016/j.pcl.2011.10.018]
  21. Hyman, S. L., Levy, S. E., & Myers, S. M. (2020). Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics, 145(1), 1–64. https://doi.org/10.1542/PEDS.2019-3447 . [DOI: 10.1542/PEDS.2019-3447]
  22. Klaiman, C., Fernandez-Carriba, S., Hall, C., & Saulnier, C. (2015). Assessment of autism across the lifespan: A way forward. Current Developmental Disorders Reports, 2(1), 84–92. https://doi.org/10.1007/s40474-014-0031-5 . [DOI: 10.1007/s40474-014-0031-5]
  23. Leff, S. S., Baum, K. T., Bevans, K. B., & Blum, N. J. (2015). Development, validation, and utility of an instrument to assess core competencies in the Leadership Education in Neurodevelopmental and related disabilities (LEND) program. Maternal & Child Health Journal, 19, 314–323. https://doi.org/10.1007/s10995-014-1514-z . [DOI: 10.1007/s10995-014-1514-z]
  24. Lord, C., Risi, S., DiLavore, P., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism from 2 to 9 years of age. Archives of General Psychiatry, 63(6), 694–701. https://doi.org/10.1001/archpsyc.63.6.694 . [DOI: 10.1001/archpsyc.63.6.694]
  25. Mandell, D. S., Listerud, J., Levy, S. E., & Pinto-Martin, J. A. (2002). Race differences in the age at diagnosis among medicaid-eligible children with autism. Journal of the American Academy of Child & Adolescent Psychiatry, 41(12), 1447–1453. https://doi.org/10.1097/00004583-200212000-00016 . [DOI: 10.1097/00004583-200212000-00016]
  26. Mandell, D. S., Novak, M. M., & Zubritsky, C. D. (2005). Factors associated with age of diagnosis among children with autism spectrum disorders. Pediatrics, 116(6), 1480–1486. https://doi.org/10.1542/peds.2005-0185 . [DOI: 10.1542/peds.2005-0185]
  27. Mazurek, M. O., Curran, A., Burnette, C., & Sohl, K. (2019). ECHO autism STAT: Accelerating early access to autism diagnosis. Journal of Autism and Developmental Disorders, 49, 127–137. https://doi.org/10.1007/s10803-018-3696-5 . [DOI: 10.1007/s10803-018-3696-5]
  28. McNally Keehn, R., Ciccarelli, M., Szczepaniak, D., Tomlin, A., Lock, T., & Swigonski, N. (2020). A statewide tiered system for screening and diagnosis of autism spectrum disorder. Pediatrics, 146(2), 1–10. https://doi.org/10.1542/peds.2019-3876 . [DOI: 10.1542/peds.2019-3876]
  29. NHS Education for Scotland (2014a). The NHS Education for Scotland Autism Training Framework http://www.knowledge.scot.nhs.uk/media/12392691/sct0117216030-3%20asd%20training%20framework%20cov_final.pdf .
  30. NHS Education for Scotland (2014b). The NHS Education for Scotland Autism Training Framework: Optimising Outcomes http://www.knowledge.scot.nhs.uk/media-/9595218/asd%20web%20final%20%282%29.pdf .
  31. Nurnberger, J. I., Austin, J., Berrettini, W. H., Besterman, A. D., DeLisi, L. E., Grice, D. E., Kennedy, J. L., Moreno-De-Luca, D., Potash, J. B., Ross, D. A., Schulze, T. G., & Zai, G. (2018). What should a psychiatrist know about genetics? Review and recommendations from the residency education committee of the international society of psychiatric genetics. Journal of Clinical Psychiatry, 80(1), 22411. https://doi.org/10.4088/JCP.17nr12046 [DOI: 10.4088/JCP.17nr12046]
  32. Pasco, G., Clark, B., Dragan, I., Kalambayi, F., Slonims, V., Tarpan, A. K., & Wittemeyer, K. (2014). A training and development project to improve services and opportunities for social inclusion for children and young people with autism in Romania. Autism: International Journal of Research and Practice, 18(7), 827–831. https://doi.org/10.1177/1362361314524642 . [DOI: 10.1177/1362361314524642]
  33. Penner, M., Anagnostou, E., Andoni, L. Y., & Ungar, W. J. (2018). Systematic review of clinical guidance documents for autism spectrum disorder diagnostic assessment in select regions. Autism, 22, 517–527. [DOI: 10.1177/1362361316685879]
  34. Peters, M., Godfrey, C., McInerney, P., Soares, C. B., Khalil, H., & Parker, D. (2015). Methodology for JBI scoping reviews. In E. Aromataris (Ed.), The Joanna Briggs Institute Reviewers manual 2015 (pp. 3–24). Adelaide: Joanna Briggs Institute.
  35. Peters, M., Godfrey, C., McInerney, P., Munn, Z., Tricco, A. C., & Khalil, H. (2020). Scoping reviews (2020 version). In E. Aromataris & Z. Munn (Eds.), JBI Manual for evidence synthesis. Adelaide: JBI.
  36. Pham, M. T., Rajić, A., Greig, J. D., Sargeant, J. M., Papadopoulos, A., & McEwen, S. A. (2014). A scoping review of scoping reviews: Advancing the approach and enhancing the consistency. Research Synthesis Methods, 5(4), 371–385. https://doi.org/10.1002/jrsm.1123 . [DOI: 10.1002/jrsm.1123]
  37. Randall, M., Egberts, K. J., Samtani, A., Scholten, R. J. P. M., Hooft, L., Livingstone, N., Sterling-Levis, K., Woolfenden, S., & Williams, K. (2018). Diagnostic tests for autism spectrum disorder (ASD) in preschool children. Cochrane Database of systematic reviews. https://doi.org/10.1002/14651858.CD009044.pub2 [DOI: 10.1002/14651858.CD009044.pub2]
  38. Robins, Fein, D., Barton, M. L., & Green, J. A. (2001). The modified checklist for Autism in toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31(2), 131–144. https://doi.org/10.1023/A:1010738829569 . [DOI: 10.1023/A]
  39. Rosen, N. E., Lord, C., & Volkmar, F. R. (2021). The diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond. Journal of Autism and Developmental Disorders, 51(12), 4253–4270. https://doi.org/10.1007/s10803-021-04904-1 . [DOI: 10.1007/s10803-021-04904-1]
  40. Samadi, A. S., Mohammad, M. P., Ghanimi, F., & McConkey, R. (2016). The challenges of screening pre-school children for autism spectrum disorders in Iran. Disability & Rehabilitation, 38(17), 1739–1747. https://doi.org/10.3109/09638288.2015.1107637 . [DOI: 10.3109/09638288.2015.1107637]
  41. Sengupta, K., Lobo, L., & Krishnamurthy, V. (2022). Physician voices on ECHO Autism India—evaluation of a telementoring model for autism in a low-middle income country. Journal of Developmental & Behavioral Pediatrics, 43(6), 335–345. https://doi.org/10.1097/DBP.0000000000001060 . [DOI: 10.1097/DBP.0000000000001060]
  42. Squires, J., Bricker, D., Twonbly, E., Nickel, R., Clifford, J., Murphy, K., Hoselton, R., Potter, L., Mounts, L., & Farrell, J. (2009). Ages and stages questionnaires (3rd ed.). Towson: Brookes Publishing.
  43. Stone, W. L., Coonrod, E. E., & Ousley, O. Y. (2000). Brief report: Screening tool for autism in two-year-olds (STAT): Development and preliminary data. Journal of Autism and Developmental Disorders, 30(6), 607–612. [DOI: 10.1023/A]
  44. Swanson, A. R., Warren, Z. E., Stone, W. L., Vehorn, A. C., Dohrmann, E., & Humberd, Q. (2014). The diagnosis of autism in community pediatric settings: Does advanced training facilitate practice change? Autism: The International Journal of Research and Practice, 18(5), 555–561. https://doi.org/10.1177/1362361313481507 . [DOI: 10.1177/1362361313481507]
  45. Taylor, L., Brown, P., Eapen, V., Midford, S., Paynter, J., Quarmby, L., Smith, T., Maybery, M., Williams, K., & Whitehouse, A. (2016). Autism spectrum disorder diagnosis in australia: Are we meeting best practice standards? Brisbane: Autism Co-operative Research Centre.
  46. Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K., Colquhoun, H., Kastner, M., Levac, D., Ng, C., Sharpe, J. P., Wilson, K., Kenny, M., Warren, R., Wilson, C., Stelfox, H. T., & Straus, S. E. (2016). A scoping review on the conduct and reporting of scoping reviews. BMC Medical Research Methodology, 16, 15. https://doi.org/10.1186/s12874016-0116-4 . [DOI: 10.1186/s12874016-0116-4]
  47. Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., Lewin, S., & Straus, S. E. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850 . [DOI: 10.7326/M18-0850]
  48. Veritas Health Innovation (2015). Covidence systematic review software In. www.covidence.org.
  49. Vi, L., Jiwa, M. I., Lunsky, Y., & Thakur, A. (2023). A systematic review of intellectual and developmental disability curriculum in international pre-graduate health professional education. BMC Medical Education, 23, 329. https://doi.org/10.1186/s12909-023-04259-4 . [DOI: 10.1186/s12909-023-04259-4]
  50. Volkmar, F., & McPartland, J. (2014). From Kanner to DSM-5: Autism as an evolving diagnostic concept. Annual Review of Clinical Psychology, 10(1), 193–212. https://doi.org/10.1146/annurev-clinpsy-032813-153710 . [DOI: 10.1146/annurev-clinpsy-032813-153710]
  51. Vorstman, J., Parr, J., Moreno-De-Luca, D., Anney, R. J. L., Nurnberger, J. I. Jr., & Hallmayer, J. F. (2017). Autism genetics: Opportunities and challenges for clinical translation. Nature Review Genetics, 18, 362–376. https://doi.org/10.1038/nrg.2017.4 . [DOI: 10.1038/nrg.2017.4]
  52. Warren, Z., Stone, W., & Humberd, Q. (2009). A training model for the diagnosis of autism in community pediatric practice. Journal of Developmental & Behavioral Pediatrics, 30(5), 442–446. https://doi.org/10.1097/DBP.0b013e3181ba0e4e . [DOI: 10.1097/DBP.0b013e3181ba0e4e]
  53. Welterlin, A., & LaRue, R. H. (2007). Serving the needs of immigrant families of children with autism. Disability & Society, 22(7), 747–760. https://doi.org/10.1080/09687590701659600
  54. Whitehouse, A. J. O., Evans, K., Eapen, V., & Wray, J. (2018). A national guideline for the assessment and diagnosis of autism spectrum disorders in Australia. Brisbane: Cooperative Research Centre for Living with Autism.
  55. World Health Organization (2018). International classification of diseases for mortality and morbidity statistics (11th Revision). Retrieved from https://icd.who.int/browse11/l-m/en .
  56. Zwaigenbaum, L., Bryson, S., & Garon, N. (2013). Early identification of autism spectrum disorders. Behavioural Brain Research, 251, 133–146. https://doi.org/10.1016/j.bbr.2013.04.004 . [DOI: 10.1016/j.bbr.2013.04.004]

MeSH Term

Humans
Autism Spectrum Disorder
Clinical Competence
Health Personnel
Journal Article Scoping Review

Word Cloud

Created with Highcharts 10.0.0trainingASDclinicianspathwayspost-graduationassessmentdiagnosisavailableAutismreviewSpectrumresearchknowneducationalsupportrelevantconcerns?searchrecordsand/educationclinicianservicediagnosticcapacityevidencefoundAssessmentaimedidentifytrainersDisorderstudyguidedtwoquestions:ASD-specificdisciplinemeetrequiredexpertiseassessmentsseekingprovidescopingundertakensearchescompletedacrossfivedatabasesPubMedPsycINFOPsycEXTRAERICCINAHLGooglestrategyalsoexecutedusing"advanced"functionEligibleliteraturewrittenEnglishexaminedassessdiagnose FourteenidentifiedPost-graduatepotentialenhanceconfidenceprovisionSystem-wideapproachesshowpromisebuildinglarge-scaleusetele-mentoringofferscost-effectiveconvenientmodedeliverylackmayposechallengeusers ThelimitedsuggestshighqualitywillfundamentaldeterminingbuildascertainwhethernecessarycomponentTrainingEducationalPathwaysCliniciansPost-graduationDiagnosisDisorders:ScopingReviewAdultspectrumdisorderHealthcareprofessionalTraintrainer

Similar Articles

Cited By (2)