Strategy for a Service Model for Early Identification of Autistic Spectrum Disorders in Ethnic Communities in Southern Israel

Abstract

Abstract: The occurrence of autistic spectrum disorder (ASD) is increasing worldwide. Early detection is a precondition for effective intervention, enabling significant improvements in functioning. However, in Israel and in other countries, ASD is underreported in ethnic minorities. In Israel, toddlers undergo general developmental screening by public health nurses (PHNs) at maternal and child health centers (MCHCs). Nevertheless, there are disparities among ethnic groups in the reported incidence of ASD. Objective: Using an ecological model, we identify strategies that improve the screening for ASD in minorities by investigating the social factors influencing diagnosis. Methodology: We conducted in-depth interviews with 18 policymakers and service providers and 3 FGs of PHNs and pediatricians. Results we used to construct a service model for identifying toddlers with ASD. Results: Each of the three ecological levels contains factors that affect screening. On the macro level, of policymakers, factors include clear official policy, ideology, values, and goals and professional identification of the PHNs, and the MCHCs as the exclusive institution involved in assessing ASD. On the meso level, of service providers, the key factors are actualizing the professional potential of the PHNs and case management. On the micro level, the main factor is that the population utilizes the services and complies with its recommendations. We established a correlation between the nurses’ values and objectives, and their case management. Actualizing their professional potential influenced the population’s compliance. Discussion: On the macro level, there is a need to determine a clear policy supported by the requisite budget and professional staff, while maintaining and developing the strengths of the MCHCs. On the meso level, there is a need to use specific tools for ASD screening, along with professional training. Funding Statement: None to declare Declaration of Interests: None to declare Ethics Approval Statement: I received the approval of the Ben Gurion University Ethics Committee and the Israeli Ministry of Health to conduct the research.