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Abstract: The use of therapy or service dogs to assist children with autism spectrum disorder (ASD) is increasing in clinical settings. Research studies indicate that children with ASD display enhanced prosocial behavior and emotional regulation when canines are included in therapy. Despite increased application of animal-assisted therapy in clinical and inpatient settings, healthcare providers show limited understanding of best practices for its use and require a research-based approach to incorporate animals effectively into therapeutic plans of care for pediatric patients with ASD., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The age at which children are diagnosed with autism spectrum disorder (ASD) has not significantly decreased in the past 20 years. Adverse childhood events (ACEs) experienced by caregivers of autistic children may predict delays in caregivers attending ASD diagnostic evaluations, negatively impacting the age at which the child is diagnosed with ASD. The purpose of this study was to further explore the caregiver delay response by analyzing recurring events common in caregivers of children at risk for ASD., Methods: We used a quantitative research design with convenience sampling to categorize caregivers of children referred for an ASD diagnostic evaluation into three groups based on their ACEs score and medical history., Findings: A higher percentage of caregivers with four or more ACEs compared to the national average was noted. Parental separation or divorce, verbal aggression, emotional abuse, and parental alcohol or substance abuse occurred most frequently, and the latter predicted a prolonged time in attending the diagnostic evaluation., Discussion: ACEs experienced by caregivers of children with ASD may delay the age of ASD diagnosis. Further investigation into the effect of ACEs on caregivers' mental health status and executive functioning is warranted to develop best practice for assisting caregivers in ASD recognition, diagnosis, and care management., Application to Practice: Clinicians should consider caregiver ACEs score when referring a child for a diagnostic developmental evaluation. Resources to address caregiver mental health needs should be provided at the onset of the referral process to increase the likelihood of caregiver adherence., Competing Interests: Declaration of Competing Interest The authors declared that there are no conflicts of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Autism Spectrum Disorder (ASD), with the current prevalence at one in 44 children, is the most rapidly escalating neurodevelopmental disorder in the United States. While the 2000 to 2018 Autism and Developmental Disabilities Monitoring (ADDM) Network reports indicate progress toward identifying children with ASD by age 24 months, the actual age at which most children receive a diagnosis, ranging between age 51 to 53 months, has not significantly changed since 2000. Racial and gender disparities further complicate ASD identification. This article explores past ADDM findings to highlight ASD identification practices and provide relevant care management recommendations for primary care clinicians. Armed with this information, clinicians can improve ASD identification in their practice and advocate for beneficial, evidence-based health policies that decrease known disparities and enhance ASD care management for all., Competing Interests: Declaration of Competing Interest The authors declare that there is no conflict of interest. The authors would like to thank Mrs. Liliana Barrientos-Figueroa for her support in examining the 2014 ADDM report and Mr. Clay Kilmer for editing., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Early intervention is vital for improved health outcomes in children with autism spectrum disorder (ASD). Innovations that support primary care providers' management of ASD are needed. The conclusion of this series outlines a research pilot program testing the usability of an author-developed clinical practice guideline for the initial management of pediatric patients at risk for ASD.

Pediatric autism spectrum disorder (ASD) consists of multisystem components that primary care providers (PCPs) must address. PCPs improve health outcomes associated with ASD when they administer developmental screening tools and thoroughly assess identified concerns. Pursuing specialty health services early in childhood combined with managing comorbid conditions curtails symptom escalation and disease progression.

This series of articles aims to equip primary care providers (PCPs) with the tools to become healthcare leaders managing patients with pediatric autism spectrum disorder (ASD). Individuals with ASD can experience optimal health outcomes when timely, evidence-based interventions are implemented in the primary care setting. PCPs are uniquely situated to institute changes that redirect the trajectory of ASD.

Delays in identifying pediatric autism spectrum disorder (ASD) remain problematic despite directives aimed at improving early detection and intervention. Caregiver mental health concerns could be one explanation for this documented delay, necessitating further inquiry into mental health factors that predict delayed age of ASD diagnosis. This study investigated the impact of caregiver mental health concerns, diagnoses within the three-generation family history, and demographic data on delayed ASD diagnosis using a sample of caregivers of children with ASD (N = 63). Factors that predicted a delayed response between the time when a child was suspected of having developmental delay and when the child presented for a developmental diagnostic evaluation were examined. Mental health concerns were assessed by using standardized screening tools for traumatic childhood experiences, depression, and anxiety. The average time between suspicion of developmental delay and the child's presentation for a diagnostic evaluation was 36 months. Female gender of the child and family histories that contain intellectual disability, learning concerns, neurological concerns, or Tourette's syndrome predicted prolonged time to diagnostic evaluation. Adverse childhood events (ACEs) experienced by caregivers were identified as predictors of generalized anxiety disorder and depression. A positive correlation was found between caregiver generalized anxiety disorder and depression. Caregiver type, child gender, and child ethnicity predicted generalized anxiety but not depression. Health care providers should address identified predictors for delayed ASD diagnostic evaluations with caregivers upon initial suspicion of developmental delay. Practice recommendations for health care providers include assessing a three-generation family history and evaluating caregiver mental health concerns. Further, identifying protective factors to improve caregiver resiliency may reduce this disparity. [ABSTRACT FROM AUTHOR]