Abstract
We investigated the effect of a live online educational program in 93 Dutch Youth and Family Center (YFC) physicians who were screening for Autism Spectrum Disorder (ASD) in the general child population. The educational program raised the physicians’ level of specific ASD knowledge and it remained higher at six months follow-up (p < .01). Their self-confidence in detecting ASD was also higher and maintained at follow-up (p < .01). The educational program had no effect on the physicians’ stigmatizing attitudes toward mental illness nor on the number of potential ASD referrals in children of 4–6 years of age. In conclusion, the online educational program on early detection of ASD has a six month long effect on YFC physicians’ level of ASD knowledge and self-confidence.
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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th Edition (DSM-5). Arlington, V.A.: American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596.
Beaulieu, T., Patten, S., Knaak, S., Weinerman, R., Campbell, H., & Lauria-Horner, B. (2017). Impact of skill-based approaches in reducing stigma in primary care physicians: Results from a double-blind, parallel-cluster, randomized controlled trial. Canadian Journal of Psychiatry, 62(5), 327–335. https://doi.org/10.1177/0706743716686919.
Begeer, S., Mandell, D., Wijnker-Holmes, B., Venderbosch, S., Rem, D., Stekelenburg, F., & Koot, H. M. (2013). Sex differences in the timing of identification among children and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(5), 1151–1156. https://doi.org/10.1007/s10803-012-1656-z.
Bell, S., & Palmer-Conn, S. (2018). Suspicious minds: Police attitudes to mental ill health. International Journal of Law and Public Administration, 1(2), 25–40. https://doi.org/10.11114/ijlpa.v1i2.3878.
Berckelaer-Onnes, I. A. van, Glind, G. van de, Anzion, P., & Werkgroep Richtlijnen ASS-JGZ. (2015). JGZ-richtlijn Autismespectrumstoornissen: Signalering, begeleiding en toeleiding naar diagnostiek. Utrecht: Nederlands Centrum voor Jeugdgezondheidszorg. https://assets.ncj.nl/docs/bc756f24-ff04-45f3-b0fd-3756dec2cabb.pdf
Bordini, D., Lowenthal, R., Gadelha, A., de Araujo Filho, G. M., de Mari, J., & J., & Paula, C. S. . (2015). Impact of training in autism for primary care providers: a pilot study. Revista brasileira de psiquiatria, 37(1), 63–66. https://doi.org/10.1590/1516-4446-2014-1367.
Boysen, G. A., & Vogel, D. L. (2008). Education and mental health stigma: The effects of attribution, biased assimilation, and attitude polarization. Journal of Social and Clinical Psychology, 27(5), 447–470. https://doi.org/10.1521/jscp.2008.27.5.447.
Carbone, P. S., Norlin, C., & Young, P. C. (2016). Improving early identification and ongoing care of children with autism spectrum disorder. Pediatrics. https://doi.org/10.1542/peds.2015-1850.
Centrum voor Jeugd en Gezin Rijnmond. (2016). Alles voor een gezonde jeugd: Productenboek. https://cjgrijnmond.nl/wp-content/uploads/Productenboek-CJGRijnmond-2016.pdf
Chambers, M., Guise, V., Välimäki, M., Botelho, M. A. R., Scott, A., Staniuliené, V., & Zanotti, R. (2010). Nurses’ attitudes to mental illness: A comparison of a sample of nurses from five European countries. International Journal of Nursing Studies, 47(3), 350–362. https://doi.org/10.1016/j.ijnurstu.2009.08.008.
Christensen, D. L., Baio, J., Braun, K. V. N., Bilder, D., Charles, J., Constantino, J. N., et al. (2016). Prevalence and characteristics of autism spectrum disorder among children aged 8 years–autism and developmental disabilities monitoring network, 11 sites, United States, 2012. Morbidity and mortality weekly report. Surveillance summaries, 65(3), 1–23. https://doi.org/10.15585/mmwr.ss6503a1.
Dosreis, S., Weiner, C. L., Johnson, L., & Newschaffer, C. J. (2006). Autism spectrum disorder screening and management practices among general pediatric providers. Journal of Developmental & Behavioral Pediatrics, 27(Supplement 2), S88–S94. https://doi.org/10.1097/00004703-200604002-00006.
Earls, M. F., Andrews, J. E., & Hay, S. S. (2009). A longitudinal study of developmental and behavioral screening and referral in north carolina’s assuring better child health and development participating practices. Clinical Pediatrics, 48(8), 824–833. https://doi.org/10.1177/0009922809335322.
Golnik, A., Ireland, M., & Borowsky, I. W. (2009). Medical homes for children with autism: A physician survey. Pediatrics, 123(3), 966–971. https://doi.org/10.1542/peds.2008-1321.
Graham Holmes, L., Zampella, C. J., Clements, C., McCleery, J. P., Maddox, B. B., Parish-Morris, J., et al. (2020). A Lifespan Approach to Patient-Reported Outcomes and Quality of Life for People on the Autism Spectrum. Autism Research, 13(6), 970–987. https://doi.org/10.1002/aur.2275.
Harrison, A. J., Bradshaw, L. P., Naqvi, N. C., Paff, M. L., & Campbell, J. M. (2017). Development and Psychometric Evaluation of the Autism Stigma and Knowledge Questionnaire (ASK-Q). Journal of Autism and Developmental Disorders, 47(10), 3281–3295. https://doi.org/10.1007/s10803-017-3242-x.
Harrison, A. J., Paff, M. L., & Kaff, M. S. (2019). Examining the psychometric properties of the autism stigma and knowledge questionnaire (ASK-Q) in multiple contexts. Research in Autism Spectrum Disorders, 57, 28–34. https://doi.org/10.1016/j.rasd.2018.10.002.
Heidgerken, A. D., Geffken, G., Modi, A., & Frakey, L. (2005). A survey of autism knowledge in a health care setting. Journal of Autism and Developmental Disorders, 35(3), 323–330. https://doi.org/10.1007/s10803-005-3298-x.
Henderson, C., Noblett, J., Parke, H., Clement, S., Caffrey, A., Gale-Grant, O., et al. (2014). Mental health-related stigma in health care and mental health-care settings. The Lancet Psychiatry, 1(6), 467–482. https://doi.org/10.1016/S2215-0366(14)00023-6.
Hix-Small, H., Marks, K., Squires, J., & Nickel, R. (2007). Impact of implementing developmental screening at 12 and 24 months in a pediatric practice. Pediatrics, 120(2), 381–389. https://doi.org/10.1542/peds.2006-3583.
Holzer, L., Mihailescu, R., Rodrigues-Degaeff, C., Junier, L., Muller-Nix, C., Halfon, O., & Ansermet, F. (2006). Community introduction of practice parameters for autistic spectrum disorders: Advancing early recognition. Journal of Autism and Developmental Disorders, 36(2), 249–262. https://doi.org/10.1007/s10803-005-0053-2.
Hossain, M. M., Khan, N., Sultana, A., Ma, P., McKyer, E. L. J., Ahmed, H. U., & Purohit, N. (2020). Prevalence of comorbid psychiatric disorders among people with autism spectrum disorder: An umbrella review of systematic reviews and meta-analyses. Psychiatry Research. https://doi.org/10.1016/j.psychres.2020.112922.
Kennedy, T., Regehr, G., Rosenfield, J., Roberts, S. W., & Lingard, L. (2004). Exploring the gap between knowledge and behavior: A qualitative study of clinician action following an educational intervention. Academic Medicine, 79(5), 386–393. https://doi.org/10.1097/00001888-200405000-00006.
Kentrou, V., de Veld, D. M. J., Mataw, K. J. K., & Begeer, S. (2018). Delayed autism spectrum disorder recognition in children and adolescents previously diagnosed with attention-deficit/hyperactivity disorder. Autism. https://doi.org/10.1177/1362361318785171.
Knaak, S., Mantler, E., & Szeto, A. (2017). Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare Management Forum, 30(2), 111–116. https://doi.org/10.1177/0840470416679413.
Knaak, S., Modgill, G., & Patten, S. B. (2014). Key ingredients of anti-stigma programs for health care providers: a data synthesis of evaluative studies. The Canadian Journal of Psychiatry. https://doi.org/10.1177/070674371405901s06.
Learning Connected. (2019). https://learningconnected.com/. Accessed 30 April 2020
Losinski, M., Maag, J. W., & Katsiyannis, A. (2015). Characteristics and Attitudes of Pre-Service Teachers toward Individuals with Mental Illness. Journal of Education and Practice, 6(3), 11–17.
Maenner, M. J., Shaw, K. A., Baio, J., Washington, A., Patrick, M., DiRienzo, M., et al. (2020). Prevalence of autism spectrum disorder among children aged 8 Years-Autism and developmental disabilities monitoring network, 11 Sites, United States, 2016. MMWR Surveillance Summaries, 69(4), 1–12. https://doi.org/10.15585/MMWR.SS6904A1.
O’Brien, D., Harvey, K., Howse, J., Reardon, T., & Creswell, C. (2016). Barriers to managing child and adolescent mental health problems: A systematic review of primary care practitioners’ perceptions. British Journal of General Practice, 66(651), e693–e707. https://doi.org/10.3399/bjgp16X687061.
Oosterling, I. J., Wensing, M., Swinkels, S. H., Van Der Gaag, R. J., Visser, J. C., Woudenberg, T., et al. (2010). Advancing early detection of autism spectrum disorder by applying an integrated two-stage screening approach. Journal of Child Psychology and Psychiatry and Allied Disciplines, 51(3), 250–258. https://doi.org/10.1111/j.1469-7610.2009.02150.x.
Papish, A., Kassam, A., Modgill, G., Vaz, G., Zanussi, L., & Patten, S. (2013). Reducing the stigma of mental illness in undergraduate medical education: A randomized controlled trial. BMC Medical Education, 13(1), 7–9. https://doi.org/10.1186/1472-6920-13-141.
Pijl, M. K. J., Buitelaar, J. K., de Korte, M. W. P., Rommelse, N. N. J., & Oosterling, I. J. (2017). Sustainability of an early detection program for autism spectrum disorder over the course of 8 years. Autism, 22(8), 1018–1024. https://doi.org/10.1177/1362361317717977.
Pitkänen, A., Kontio, R., Lahti, M., Katajisto, J., & Välimäki, M. (2015). The impact of an elearning course on nurses’ attitudes towards mental illness. Open Journal of Nursing, 5(11), 1004–1011. https://doi.org/10.4236/ojn.2015.511107.
Salomone, E., Charman, T., Mcconachie, H., & Warreyn, P. (2016). Child’s verbal ability and gender are associated with age at diagnosis in a sample of young children with ASD in Europe. Child: Care, Health and Development, 42(1), 141–145. https://doi.org/10.1111/cch.12261.
Schonwald, A., Huntington, N., Chan, E., Risko, W., & Bridgemohan, C. (2009). Routine developmental screening implemented in urban primary care settings: More evidence of feasibility and effectiveness. Pediatrics, 123(2), 660–668. https://doi.org/10.1542/peds.2007-2798.
Smith, A. L., & Cashwell, C. S. (2010). Stigma and mental illness: Investigating attitudes of mental health and non-mental-health professionals and trainees. Journal of Humanistic Counseling, Education & Development, 49(2), 189–202. https://doi.org/10.1002/j.2161-1939.2010.tb00097.x.
Taylor, S. M., & Dear, M. J. (1981). Scaling community attitudes toward the mentally ill. Schizophrenia bulletin, 7(2), 225–240. https://doi.org/10.1093/schbul/7.2.225.
Thornicroft, G., Mehta, N., Clement, S., Evans-Lacko, S., Doherty, M., Rose, D., et al. (2016). Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet, 387(10023), 1123–1132. https://doi.org/10.1016/S0140-6736(15)00298-6.
Unigwe, S., Buckley, C., Crane, L., Kenny, L., Remington, A., & Pellicano, E. (2017). GPs’ confidence in caring for their patients on the autism spectrum: An online self-report study. British Journal of General Practice, 67(659), e445–e452. https://doi.org/10.3399/bjgp17X690449.
van ’t Hof, M., Tisseur, C., van Berckelear-Onnes, I., Nieuwenhuyzen, A., Daniels, A. M., Deen, M., et al. (2020a). Age at autism spectrum disorder diagnosis: A systematic review and meta-analysis from 2012 to 2019. Autism. https://doi.org/10.1177/1362361320971107.
van ’t Hof, M., van Berckelear-Onnes, I., Deen, M., Neukerk, M. C., Bannink, R., Daniels, A. M., et al. (2020b). Novel insights into autism knowledge and stigmatizing attitudes toward mental illness in dutch youth and family center physicians. Community Mental Health Journal. https://doi.org/10.1007/s10597-020-00568-w.
Van Gampelaere, V. (2013). Wat denk politie over personen met een psychiatrische stoornis? Antwerpen: Maklu.
Van Tongerloo, M. A. M. M., Bor, H. H. J., & Lagro-Janssen, A. L. M. (2012). Detecting autism spectrum disorders in the general practitioner’s practice. Journal of Autism and Developmental Disorders, 42, 1531–1538. https://doi.org/10.1007/s10803-011-1384-9.
World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization.
Zwaigenbaum, L., Bauman, M. L., Fein, D., Pierce, K., Buie, T., Davis, P. A., et al. (2015). Early screening of autism spectrum disorder: Recommendations for practice and research. Pediatrics, 136(Supplement 1), S41–S59. https://doi.org/10.1542/peds.2014-3667D.
Acknowledgments
This work was supported by a grant from the Netherlands Organization for Health Research and Development (NWO-ZonMw) [REACH-AUT No. 70-73400-98-002]. We would like to thank the physicians and staff of the Youth and Family Center Rotterdam-Rijnmond for their participation in this study. We further acknowledge help from Ms. Rosalien V. Pasma, MSc, Ms. Anoeska Vellekoop, MSc, Ms. Inge van der Zwaan, MSc, Ms. Monique C. Neukerk, MSc, Ms. Romy Hoogeveen, MSc in the development, execution and/or coordination of the study and performing measurements. We especially thank Dr. Marc Reusens for participating as one of the program teachers and Ms. Jacqueline T. Bailly, MSc (Manager, Sarr Expert Centre for Autism) for acquiring funding for the study.
Funding
This work was supported by a grant from the Netherlands Organization for Health Research and Development (NWO-ZonMw) [REACH-AUT No. 70–73400-98–002].
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MH conceived the study, participated in its design and coordination, performed the statistical analyses, and drafted the manuscript. AN performed statistical analyses, participated in the interpretation of the data, and helped draft the manuscript. IB participated in the interpretation of the data, and helped draft the manuscript. MD performed statistical analyses, participated in the interpretation of the data, and helped draft the manuscript. HH conceived the study, participated in its design and coordination, interpretation of the data, and helped draft the manuscript. WE conceived the study, participated in its design and coordination, and in interpretation of the data, and helped draft the manuscript. All authors critically revised the manuscript and approved the final version.
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van ‘t Hof, M., van Nieuwenhuyzen, A.D.Y., van Berckelaer-Onnes, I. et al. Autism Spectrum Disorder Alertness in Dutch Youth and Family Center Physicians: Effects of a Live Online Educational Program. J Autism Dev Disord 51, 3401–3411 (2021). https://doi.org/10.1007/s10803-020-04842-4
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DOI: https://doi.org/10.1007/s10803-020-04842-4