Rising to the Challenge of Early Screening in Primary Health Care Through the Web Italian Network for Autism Spectrum Disorder (Win4ASD) in the Pediatric Population: Retrospective Observational Study

TL;DR

This study evaluates a telemedicine platform in Italy that helps pediatricians screen toddlers for autism early, improving detection and access to care.

Contribution

The study demonstrates the successful integration and effectiveness of a telemedicine platform for early ASD screening in primary health care.

Findings

72.5% of Lombardy family pediatricians actively used the Win4ASD platform for autism screening.

58,419 infants were screened, with 1% identified as at risk for autism.

The platform facilitated rapid diagnostic evaluations for children flagged as at risk.

Abstract

Early identification of autism spectrum disorder (ASD) and neurodevelopmental disorders is a key element in the ability to intervene early and improve children’s outcomes. The American Academy of Pediatrics recommends routine autism screening for children aged 18 to 24 months. Telemedicine (health care services delivered remotely using digital technologies) is a valuable tool in supporting this objective. As highlighted in the literature, telemedicine increases the availability of treatment, reduces diagnostic waiting times, and supports the monitoring of neurodevelopmental disorders. The Web Italian Network for Autism Spectrum Disorder (Win4ASD) platform is a telemedicine-based screening tool designed to detect ASD early within the pediatric health care system in Italy.

This study investigated the integration of the Win4ASD platform into the Italian National Health Service, providing a detailed account of its operational features and use patterns among family pediatricians. It further examined the platform’s contribution to reinforcing preventive health care strategies and enhancing coordination across child health services. Finally, through a retrospective observational analysis, this study evaluated the clinical effectiveness of Win4ASD in facilitating the early detection of ASD and improving screening outcomes.

The Win4ASD platform, which is active in the Lombardy region, helps family pediatricians screen toddlers for autism at an early age (18-24 months) using the Checklist for Autism in Toddlers. Furthermore, children identified as at risk are referred for further diagnostic evaluation to the local specialized autism unit—a mental health specialist team comprising child neuropsychiatrists, psychologists, and developmental therapists. This platform, which created an integrated network for early identification of autism, ensures rapid access to diagnostic and therapeutic services. This study analyzed data collected from the platform between January 2022 and September 2024 to assess family pediatricians’ commitment and effectiveness in identifying children at risk of autism using descriptive analyses performed in SPSS.

The first key finding was the commitment of family pediatricians from the Regional Public Health Services in Lombardy to use the platform. In total, 72.5% (909/1253) of all family pediatricians working for the Regional Public Health Services actively used the platform. The platform enabled the screening of 58,419 infants from the general population in Lombardy, of whom 596 (1%) were identified as “at risk” and referred for fast-track diagnostic evaluation, which is consistent with global prevalence rates. In addition, diagnostic outcomes from a subsample are presented, showing the effectiveness of the platform in facilitating the early diagnosis of neurodevelopmental disorders.

Early identification of risk and timely intervention can prevent the progressive development of behavioral atypicalities, have a significant impact on the quality of life of the child and their family, and allow for a reduction in health care costs and a consequent improvement in the organization of the health care system.

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