Date of Award

2012

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Psychology

First Advisor

Marcia Gragg

Keywords

Autism Spectrum Disorder, Primary care, Screening

Rights

CC-BY-NC-ND 4.0

Abstract

The present research study investigated screening and referral practices for Autism Spectrum Disorders (ASDs) among a group of Canadian primary care physicians. The purposes of the study were to compare physicians' reported practices with published best practice guidelines, to explore whether demographic and attitudinal factors predict physicians' behaviour, and to investigate gender and age differences in ASD-related attitudes. A random sample of General Practitioners (GPs) within the province of Ontario and a subsample of Ontario medical school students were surveyed. Participants included 126 GPs and 65 students (65 males and 126 females between the ages of 25 and 79). GPs completed a questionnaire examining their screening and referral practices for ASDs, perceived barriers to conducting screening and referral activities, and ASD-related beliefs and attitudes. Students completed an abbreviated questionnaire examining their beliefs and attitudes. Slightly less than half of the physician sample endorsed using some type of formal screening measure in conjunction with informal methods. Consistent with previous research findings, female physicians reported a significantly higher rate of using formal screening tools than did male physicians. With respect to perceived barriers to screening and referral, the top rated barriers reported by participants were insufficient time to screen, a lack of familiarity with available screening tools, and long waitlists to access referral services. In addition, physician attitudes were found to significantly predict reported screening and referral behaviour, independent of physician gender and age. Specifically, GPs with more favourable attitudes towards early identification and GPs with stronger feelings of self-efficacy in identifying and screening for ASDs reported that they would conduct a greater number of best practice activities. Last, the study found specific ASD-related attitudes that differ between male and female physicians and between physicians and medical school students. Female GPs demonstrated more favourable attitudes toward early identification and greater self-efficacy beliefs than did male GPs. In addition, students demonstrated greater self-efficacy beliefs and more positive attitudes towards their educational training and available community resources than did practicing physicians. Clinical implications and recommendations for improving physicians' ASD-related practices are provided. Study limitations and suggestions for future research are also discussed.

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