Black Mothers' Perspectives on the Early Childhood Screening Process and the Modified Checklist for Autism in Toddlers in Primary Care
Objective
To understand Black mothers' perspectives on the autism screening process with the Modified Checklist for Autism in Toddlers (M-CHAT) and preferences in provider communications and interactions around autism screening.
Method
This qualitative study thematically analyzed semi-structured interviews of Black mothers (N = 11) whose child screened positive on an autism screener administered as part of a routine well-child visit in primary care. All interviews were audio-recorded, transcribed, and entered into NVivo software for data management and analysis. Coders achieved an average of over 95% agreement in double-coded transcripts across all thematic codes.
Results
Results from a qualitative thematic analysis of Black mothers' experiences with and preferences for early autism screening in primary care produced 5 primary themes: (1) preference for the pediatrician to report positive screening results, (2) desire to discuss developmental concerns with family members, (3) online resources as key information resources on autism and child development juxtaposed to, (4) valuing face-to-face time with early childhood providers, and (5) barriers to completing the M-CHAT.
Conclusion
Black mothers described their preferences for completing autism screening for their children and emphasized the role of the pediatrician, family members, and online resources in providing information about child development and autism concerns. Trust in the pediatrician emerged as a salient theme, which runs counter to prior narratives that describe earned mistrust between Black caregivers and medical providers. Results can inform the improvement of early autism screening processes and health care communication for underrepresented families in primary care settings.