2025 Annual Report

IMPROVING ACCESS THROUGH TIMELY DIAGNOSIS

Autism is a spectrum neurodevelopmental difference with a wide range of presentations and support needs. While subtle or complex cases still require evaluation by developmental pediatric specialists, many children present with clear features that can be accurately identified by trained general pediatricians using DSM-5 criteria. Long waitlists for specialist evaluations can delay access to therapies during critical developmental windows. In traditional pathways, children may wait 18 months or longer for an evaluation and face additional delays before beginning services such as applied behavior analysis. “If we’re seeing a 2-year-old and we’re worried about autism, the traditional path can mean they don’t get services until they’re 4 or older,” said Vincent. “That’s a huge developmental period without recommended support.” When the clinical picture is straightforward, the pediatrician-led approach allows families to move forward sooner, often confirming a diagnosis within weeks and helping children begin services during key stages of early development. “At that age, even a few months can make a meaningful difference,” said Vincent. “Being able to diagnose clear cases sooner helps families move forward during an important period of growth.” At this time, autism assessments through this approach are available for established patients of the Primary Care Clinic, ensuring evaluations are completed by clinicians who know the child and family and can provide consistent follow-up care.

TRAINING, STRUCTURE, AND QUALITY SAFEGUARDS

What began as informal teaching has become a standardized part of pediatric education. All residents receive DSM-5 autism assessment training by the end of their first year, supported by structured teaching sessions, practical tools, and refresher materials. The approach recognizes that comfort levels vary and is designed to help clinicians feel prepared, even if evaluations are spaced months apart. Clear guardrails guide case selection to maintain quality. Pediatricians self-screen referrals so children with nuanced or complex presentations are directed to developmental pediatric specialists. The Primary Care Clinic’s academic setting also allows for extended appointment times, typically 90 minutes, and dedicated nursing support to ensure evaluations are thorough and well-coordinated.

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CHILDREN’S OF ALABAMA | UAB MEDICINE