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Table 4 Participants’ viewpoints about implementation of ASD screening programs

From: Considerations about the implementation of an autism screening program in Iran from the viewpoints of professionals and parents: a qualitative study

Main Themes

Sub-Themes

Quotes

1. Screening children with early signs of ASD

• Impose lower cost to health system

• Voluntary participation of families

• “...Furthermore, passive screening method (Screening the children who have revealed early signs of ASD) has lower cost than active ones (the universal screening). I think, there is no need to screen everyone, therefor, this method of screening (the universal screening) imposes less cost to health system. However, there is a vital need to inform public on signs/symptoms of the disorder.” (Psychiatrist)

• “Although we expect to achieve more accurate results while screening based on parents’ concerns compared to the universal screening, in some cases parental over-concern creates bias in diagnosis process.” (Psychiatrist)

2. Screening all children in a specific age range

• Highlighting the importance of providing ASD services in public sector

• As a right for every child

• Require necessary infrastructure

• “Current services for children with ASD, particularly in public sector, are not adequate. One reason is that the policy makers do not consider providing these services as a priority. We know the prevalence of this disorder is high among children. It is necessary to understand that children are our country’s future human capital. The universal screening would highlight the importance of providing ASD services in public sector.” (Pediatrist)

• “Having access to the universal screening is a right for every child. If I knew that my daughter’s specific behavior was due to her especial condition (ASD), I would have understood her condition earlier, and I would have tried to find a better way to communicate with her.” (Parent 5)

• “If the aim of the implementation of ASD screening is solely providing statistics, then the screening would provide some vague results. It would not have a lot of benefits. The greater attention to statistics in recent years has led to an over-diagnosis of autism, while we faced under-diagnosis about 4 to 5 years ago.” (Pediatrist)