Impact of training in autism for primary care
                    providers: a pilot study

Bordini, Daniela; Lowenthal, Rosane; Gadelha, Ary; Araujo Filho, Gerardo M.de; Mari, Jair de J.; Paula, Cristiane S.

doi:10.1590/1516-4446-2014-1367

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Brazilian Journal of Psychiatry

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Sumário

BRIEF COMMUNICATIONS • Rev. Bras. Psiquiatr. 37 (01) • Jan-Mar 2015 • https://doi.org/10.1590/1516-4446-2014-1367 copy

Impact of training in autism for primary care providers: a pilot study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

To evaluate the impact of a training program on autism spectrum disorder (ASD) identification offered to Brazilian health professionals.

Methods:

Twenty-two primary care providers participated in five 3-hour weekly training sessions.

Results:

The trained providers significantly improved their ASD knowledge after training in comparison with pre-training (mean score, 6.73 vs. 9.18, p < 0.01). Clinical practice also changed: 4 months after the training program, the providers had referred six times as many suspected cases of ASD to a specialized mental health service in comparison with the previous 4 months.

Conclusion:

This pilot training model seems a promising, feasible, and inexpensive way to improve early identification of ASD in the primary care system.

Autistic disorder; inservice training; early diagnosis; primary health care

Child (gender, age)	Main complaints that motivated referral	Main symptoms identified at CAPSI	Final diagnosis^* * In accordance with DSM-IV criteria, by a multidisciplinary CAPSI team, including a child psychiatrist with extensive experience in ASD.	Outcome
Male, 2 years 5 months	- Suspected autism- Request for psychiatric assessment	- Difficulty socializing with other children- Little visual contact- Aggressiveness- Does not verbalize- Instrumental use of the mother's hands- Altered sleep- Irritability, crying- Toe-walking- Distress from loud noises- No delay in NPD	ASD	Accepted to CAPSI for treatment by the multidisciplinary team
Female, 2 years 8 months	- Suspected autism- Request for psychiatric assessment	- Does not verbalize- Points at the desired object- Inattention- Enjoys music- Repetitive gestures- Good visual contact- Shares objects and interests- Looks for other children to play with- No delay in NPD	Suspected hearing impairment	Referred to speech-language pathologist at the local primary care unit
Male, 5 years	- Delayed language development- Suspected ASD	- Incomprehensible speech- Interaction with other children exists, but is inappropriate- Delay in NPD (walked and spoke at 3 years)- Impaired motor coordination- Disrupted sleep, social smile- Good visual contact- Attempts to communicate with people and to share interests- Semi-dependent for ADLs	Intellectual disability and impaired language development	Accepted to CAPSI for speech therapy only
Male, 8 months	- Lack of response to the mother	- Good visual contact- Responds to his own name- Social smile- Joint attention	Difficulties in mother-infant relationship	Mother was given advice on developing relationship and instructed to return if necessary
Male, 3 years	- Difficulty using language- Unusual behavior- Suspected ASD	- Language exists, but is non-functional- Pronoun reversal, decreased visual contact- Stereotyped movements- Difficult relationship with peers and relatives- Lack of attention, irritability- No delay in NPD	ASD	Accepted to CAPSI for treatment by the multidisciplinary team
Male, 12 years	- Diagnosed with autism at 9 months: request for diagnostic confirmation	- Walked at 3 years, good visual contact- Adequate and functional language- Never exhibited stereotypy- Good social skills- Much difficulty at school	Intellectual disability	Referred to the regional Basic Health Unit

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[1] Correspondence: Daniela Bordini, Rua Borges Lagoa, 570, CEP 04038-000, São Paulo, SP, Brazil. E-mail: danibordini4@gmail.com