Early Recognition of Autism (ERA)
Project Summary
Variable fidelity of toddler autism screening in primary care impacts early detection
of autism. This study will examine child, primary care clinicians (PCCs; physicians, nurse
practitioners), and practice factors that relate to when autistic children are detected by
examining medical records from a large, diverse group of practices (based on size, location,
affiliation with academic medical center) and collecting information from PCCs (surveys,
interviews).
Meet the research team working on ERA:
Diana Robins, PhD
Leslie Ain McClure, PhD, MS
Aubyn Stahmer, PhD
Anisha Srinivasan, PhD
Katherine Sand
Andrea Wieckowski, PhD
Giacomo Vivanti, PhD
Georgina Perez Liz, MD
Autumn Austin, MS
Renee’ Moore, PhD
Daniel Vader, PhD
Carol Weitzman, MD
Brian Freedman, PhD
Preliminary research findings:
Austin, A., Dufek, S., Perez Liz, G., Freedman, B., Wieckowski, A.T., Weitzman, C., McClure, L.A., Vader, D.T., Vivanti, G., Stahmer, A., Algur, Y., & Robins, D.L. (2025, May). Autism-Specific Training Predicts Primary Care Clinicians’ (PCCs) Confidence in Diagnosing Autism. Poster presented at the International Society for Autism Research, Seattle, WA.
Summary: Being trained to diagnose autism in some patients was significantly associated with higher odds of being confident in diagnosing autism in some patients, OR = 3.64, 95% CI = 2.04 – 6.49,p<.001. Years in practice, age, gender, and race were not associated with PCC’s confidence in diagnosing autism.
Austin, A., Dufek, S., Srinivasan, A., Stahmer, A., Wieckowski, A.T., Perez Liz, G., Moore, R., Algur, Y., Vader, D., Freedman, B., Weitzman, C., & Robins, D. L. (2026, April). Primary Care Clinicians’ Attitudes Towards the Evidence-Based Practices of Developmental and Autism Screening. Poster presented at the International Society for Autism Research, Prague, Czech Republic.
Summary: Primary care clinicians (including pediatricians, nurse practitioners) should be trained in evidence-based practices early in their careers, and likely benefit from ongoing education.
Robins, D.L., Vader, D.T., Algur, Y., Freedman, B., Wieckowski, A.T., McClure, L.A., Moore, R., Austin, A.C., Stahmer, A.C., Weitzman, C., Perez Liz, G., Srinivasan, A., & Dufek, S. (2026, April). Age of Autism Diagnosis Relates to Presence of Autism Screening in Children’s Medical Records. Oral presentation at the International Society for Autism Research, Prague, Czech Republic.
Summary: Primary care practices for early detection of autism relate to age of autism diagnosis. Children who have autism screening documented in their health records are diagnosed with autism at younger ages than children who do not have screening in their records. Among those with screening documented, children who screened positive (showed elevated likelihood of autism) was associated with younger age of diagnosis compared to children who screened negative.
Srinivasan, A., Dufek, S., Likhitweerawong, N., Assemi, Y., Austin A., Perez Liz G., Wieckowski, A.T., Weitzman, C., Freedman, B., McClure, L.A., Algur, Y., Vader, D.T., Moore, R.H., Robins, D.L.,& Stahmer, A.C. (2026, April). Modifiable clinician and practice factors to promote autism detection in primary care: A mixed-methods study. Poster presented at the Pediatric Academic Societies, Boston, MA.
Summary: Among clinicians with positive attitudes toward using evidence-based tools, practical barriers including time and language interpretation limits impede autism screening. Practices that embed autism evaluations in primary care may reduce barriers, but this strategy is not widely used.
Perez Liz, G., Vader, D., Austin, A., Frick, E., Moore, R., Boye, J., Freedman, B., McClure, L., Stahmer, A., Srinivasan, A., Weitzman, C., Wieckowski, A., & Robins, D. (2026, June). Multi-system electronic health record data: Common co-occurring medical conditions in autistic children ages 10 and under. Oral presentation at the Autism Centers of Excellence annual meeting, virtual.
Summary: Co-occurring health conditions are common in autistic individuals, and patterns may vary for males and females. Among children 10 and younger, conditions were common in five categories (neurological, gastrointestinal/diet/nutrition, sleep, allergy/immune, and developmental/behavioral/mental health); females showed a significantly higher rate of gastrointestinal/diet/nutrition than males, but other categories were not different between girls and boys.