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The Effectiveness Of Using Video Modeling Techniques To Improve Motor Skills For Preschool Children With Autism Spectrum Disorders, Atya Abdullah Hadadi Dec 2018

The Effectiveness Of Using Video Modeling Techniques To Improve Motor Skills For Preschool Children With Autism Spectrum Disorders, Atya Abdullah Hadadi

Graduate Theses and Dissertations

Beside the main syndromes of socialization and communication for individuals with autism spectrum disorders, they also have impairments in motor skills, such as ball skills (catching and throwing) and postural stability (standing and walking balance). The main objective of this dissertation is to improve motor skills for preschooler children with ASD through use of video-modeling techniques. A secondary objective of this research was to find a correlation between the development and improvement of ball skills and balance tasks. Twenty-six children with ASD were divided into two groups. Twenty-six children with ASD from 3-5 years old participated in two groups: one …


The Need To Revisit Legal Education In An Era Of Increased Diagnoses Of Attention-Deficit/Hyperactivity And Autism Spectrum Disorders, Heidi E. Ramos-Zimmerman Oct 2018

The Need To Revisit Legal Education In An Era Of Increased Diagnoses Of Attention-Deficit/Hyperactivity And Autism Spectrum Disorders, Heidi E. Ramos-Zimmerman

Dickinson Law Review (2017-Present)

The ever-fluctuating rhetoric from experts, in the field of neurodevelopmental disorders, has led to outdated notions and perplexity surrounding attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD). This Article tries to clarify some of the confusion. Better understanding of these disorders is imperative for today’s law professor, since law schools are likely admitting more students diagnosed with ADHD and ASD. This Article discusses the need for change in legal instruction and explores the link between the two disorders. An examination of recent history illuminates some of the commonly held misunderstandings and highlights the disparity in the diagnoses of ADHD …


A Comparison Of Traditional And Culturally Sensitive Parent Training Of Functional Communication Training, Adriana Rodriguez Aug 2018

A Comparison Of Traditional And Culturally Sensitive Parent Training Of Functional Communication Training, Adriana Rodriguez

Thesis Projects

The purpose of the present study was to evaluate the effect of culturally sensitive interventions on parent training. Behavior-analytic services were provided to 3 Latino/Latina families that included children diagnosed with developmental disabilities whose problem behaviors were maintained by social reinforcement. Children were exposed to preference assessments and a functional analysis. Parents then were trained on the implementation of Functional Communication Training (FCT) using English as well as Spanish protocols. Data were collected on the percentage of correct steps completed by the parent as well as levels of child problem behavior. Culturally sensitive intervention does not impact parent training. This …


A Comparison Of Traditional And Culturally Sensitive Parent Training Of Functional Communication Training, Adriana Rodriguez Aug 2018

A Comparison Of Traditional And Culturally Sensitive Parent Training Of Functional Communication Training, Adriana Rodriguez

Adriana Rodriguez

The purpose of the present study was to evaluate the effect of culturally sensitive interventions on parent training. Behavior-analytic services were provided to 3 Latino/Latina families that included children diagnosed with developmental disabilities whose problem behaviors were maintained by social reinforcement. Children were exposed to preference assessments and a functional analysis. Parents then were trained on the implementation of Functional Communication Training (FCT) using English as well as Spanish protocols. Data were collected on the percentage of correct steps completed by the parent as well as levels of child problem behavior. Culturally sensitive intervention does not impact parent training. This …


The Effect Of The Movie Time Social Learning Method On The Emotional Inferencing Skills In An Adult With Autism Spectrum Disorder, Jenna Reade Aug 2018

The Effect Of The Movie Time Social Learning Method On The Emotional Inferencing Skills In An Adult With Autism Spectrum Disorder, Jenna Reade

Electronic Theses and Dissertations

Individuals with autism spectrum disorder (ASD) have difficulty finding employment and maintaining social relationships. Professional and personal interactions require individuals to make inferences, or read between the lines. Inferencing is a challenge for individuals with ASD because it requires complex information processing. More specifically, it involves the integration of cognitive and linguistic information. There is a lack of research using complex stimuli to treat inferencing. An A-B-A-B design with one adult with ASD was used to examine the effectiveness of a movie-based method, Movie Time Social Learning(Vagin, 2012), on improving the emotional inferencing skills of one young adult with …


Parent-Toddler Conversations About Desires And Beliefs: Characterizing Mental State Talk Between Parents And Their Children With Typical Development, Autism, And Developmental Delays, Anita A. Hasni Aug 2018

Parent-Toddler Conversations About Desires And Beliefs: Characterizing Mental State Talk Between Parents And Their Children With Typical Development, Autism, And Developmental Delays, Anita A. Hasni

Psychology Dissertations

This study aimed to characterize parent-child conversations about the mind among typically-developing (TD) toddlers, toddlers with autism spectrum disorder (ASD), and toddlers with non-ASD developmental delays (DD). I systematically assessed how often and in what ways parents and their toddlers engaged in mental state talk (i.e., production of mental state utterances) in a semi-naturalistic setting. The sample included 141 22-month old toddlers (50 TD, 44 ASD, 47 DD) and their parents recruited upon completion of screening for ASD during a well-baby checkup. Overall, I found that parents of TD toddlers and parents of toddlers with ASD or DD did not …


Coping Strategies Among Caregivers Of Children With Autism Spectrum Disorders: A Cluster Analysis, Noor Ismael, Lisa Mische Lawson, Murad Moqbel, Lauren Little Jul 2018

Coping Strategies Among Caregivers Of Children With Autism Spectrum Disorders: A Cluster Analysis, Noor Ismael, Lisa Mische Lawson, Murad Moqbel, Lauren Little

Information Systems Faculty Publications and Presentations

Introduction/Background: The variability in coping strategies among caregivers of children with ASD may contribute to broader health outcomes; however, it is unclear if specific coping strategies are related to overall strain in this population. Therefore, this study identified groups of caregivers based on coping mechanisms and investigated differences in strain among groups.

Materials & Methods: This study utilized a secondary data analysis, and included survey responses of 273 caregivers of children with ASD. Measures consisted of the COPE Inventory, and the Caregiver Strain Questionnaire. Data analyses consisted of cluster analysis to group caregiver coping strategies, and Analysis of Variance to …


A Systematic Review Of The Efficacy Of Weighted Vests And Blankets On People With Asd Or Adhd, E. Denny, W. Folkes, I. Ghattas, H. Kaufmann, H. Williams, Marie-Christine Potvin Jun 2018

A Systematic Review Of The Efficacy Of Weighted Vests And Blankets On People With Asd Or Adhd, E. Denny, W. Folkes, I. Ghattas, H. Kaufmann, H. Williams, Marie-Christine Potvin

Student Papers, Posters & Projects

Sensory-based treatment methods are commonly used by occupational therapists and others working with individual with ADHD and ASD (Wan Yunus, Liu, Bissett, & Penkala, 2015). Weighted vests or weighted blankets are popular sensory-based interventions used with people with these conditions. Weighted vests and weighted blankets are widely reported to have various benefits and positive outcomes with children with these conditions (Shulman, 2018). They are thought of as providing deep pressure that is reported to help clients self-regulate, diminish episodes of maladaptive behavior and anxiety or stress, and improve attention, sleep, and mood (Shulman, 2018). A series of systematic reviews have …


Developing Conversation Skills For Individuals With Autism Spectrum Disorders, Kimberley Muldoon May 2018

Developing Conversation Skills For Individuals With Autism Spectrum Disorders, Kimberley Muldoon

Masters Theses, 2010-2019

The purpose of this study is to explore and expand the literature on strategies to use to develop conversational skills for individuals with ASD. Children with ASD have difficulties creating and maintaining conversations and to participate in the community and its members, conversational skills are necessary to succeed. This study attempts to answer whether video modeling is an effective strategy alone for teaching social conversation skills; if video modeling is effective for increasing the length of conversation units; if external reinforcers are necessary to maintain social conversation skills; and if participants are able to generalize responses to novel topics during …


Picture Cues And Reading Comprehension: The Impact Of Picture Cues On The Reading Comprehension Of First Grade Students With Autism Spectrum Disorder, Brittany Rae May 2018

Picture Cues And Reading Comprehension: The Impact Of Picture Cues On The Reading Comprehension Of First Grade Students With Autism Spectrum Disorder, Brittany Rae

Education Masters

This action research project investigates the effects of picture cues on the reading comprehension abilities of first grade students with autism spectrum disorder (ASD). Data was collected through lesson data, anecdotal notes, student interviews, and parent perceptions surveys. Findings revealed that: picture cues can increase student engagement and comprehension by measure of their ability to answer “wh” questions. Parents perceived an increase in their child’s comprehension with the use of picture cues. Participants reported a preference for reading with picture cues. Implications suggest that picture cues can support reading comprehension in learners with ASD and their ability to accurately answer …


The Relationship Between Narrative Proficiency And Syntactic Complexity Of Spontaneously Generated Stories Elicited From Children With Autism Spectrum Disorder (Asd), Megan Israelsen May 2018

The Relationship Between Narrative Proficiency And Syntactic Complexity Of Spontaneously Generated Stories Elicited From Children With Autism Spectrum Disorder (Asd), Megan Israelsen

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

Purpose: The purpose of this study was to determine whether a narrative program designed to increase narrative language proficiency was associated with improved syntactic complexity for 5, school-aged children with Autism Spectrum Disorder (ASD).

Method: A multiple-baseline across participants design was employed. Children participated in a narrative intervention for 45 minutes, twice weekly for a period of time ranging from 19 to 33 sessions. Spontaneously generated narratives were collected after every other intervention session and analyzed for narrative and syntactic complexity.

Results: Results indicated that during baseline, three of the student’s spontaneous stories contained syntactically complex utterances that were comparable …


Survey Of Sensory Diet Use Among California Occupational Therapy Practitioners, Morganne Peterson, Allison Hunt, Emily White May 2018

Survey Of Sensory Diet Use Among California Occupational Therapy Practitioners, Morganne Peterson, Allison Hunt, Emily White

Dissertations, Masters Theses, Capstones, and Culminating Projects

The purpose of this study was to examine the use of sensory diets in the field of occupational therapy. This study investigated the use of sensory diets among California occupational therapy practitioners. A mixed-methods design was used to collect data through an online survey. The survey was sent out to members of the Occupational Therapy Association of California (OTAC) and received 98 respondents within one month. Participants worked among various clinical settings and implemented sensory diets with various client populations. Practitioners reported using terms such as “sensory strategies,” “sensory tools,” and “sensory supports” which indicates an overall misunderstanding associated with …


Exploring The Intersection Of Adolescents And Adults On The Autism Spectrum Enrolled In An Outdoor Behavioral Health Program, Denise K. Savidge May 2018

Exploring The Intersection Of Adolescents And Adults On The Autism Spectrum Enrolled In An Outdoor Behavioral Health Program, Denise K. Savidge

All Dissertations

This exploratory study examined an existing data set containing outcome scores of adolescents and adults on the autism spectrum who were enrolled in 18 different outdoor behavioral health programs in the United States, all of whom are members or cooperating programs of the National Association of Therapeutic Schools and Programs (NATSAP) Practice Research Network. The dataset contained demographic characteristics and self-reported psychosocial functioning of the participants at intake and again at discharge. Data suggest that the self-reported outcome scores for both adolescents and adults demonstrated statistically significant change after the intervention, but when examined for clinical significance, adolescent paired scores …


Social Support And Adherence To Recommendations Following Asd Diagnosis, Morgan Reiss May 2018

Social Support And Adherence To Recommendations Following Asd Diagnosis, Morgan Reiss

Honors Scholar Theses

This experiment aimed to look at how social supports effected adherence to recommendations following a diagnosis of autism spectrum disorder. We hypothesized that families with higher levels of structural social support, as defined as more adults living in the home, help with child care, presence of a co-parent, and day care utilization, would also report higher levels of adherence to intervention recommendations. The participants (n=8) were caregivers of children diagnosed with ASD at either the University of Connecticut or Drexel University. These children were screened for ASD during a well-visit to their pediatrician, and upon failing the M-CHAT-R, were eligible …


What Makes A House A Home? Supported Living Environments For Adults With Autism Spectrum Disorders, Rose Meadows May 2018

What Makes A House A Home? Supported Living Environments For Adults With Autism Spectrum Disorders, Rose Meadows

Dissertations, Masters Theses, Capstones, and Culminating Projects

My research aims to address how supported living environments for adults with Autism Spectrum Disorders (ASDs) can best support their stakeholders. This is an inherently human and personal problem, but existing research tackling this problem utilizing a person-centric and/or resiliency theory lens or framework is lacking. My research will use the perspective of parents/guardians and staff/caregivers in combination with existing knowledge and research to create ideas for how to maximize support in supported living environments for adults with ASD and their families. This is a qualitative study that uses a humanized approach and in-person interviews with stake-holders to highlight their …


The Effect Of An Aging Suit On Young And Middle-Aged Adults’ Attitudes Toward Older Adults, Kelly Allen May 2018

The Effect Of An Aging Suit On Young And Middle-Aged Adults’ Attitudes Toward Older Adults, Kelly Allen

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Ageism, a type of discrimination based on a person’s age, can lead to negative attitudes, intolerance, and judgment towards older adults. With the increase of older adults in society, understanding the correlates of negative attitudes becomes increasingly important. The use of aging simulation (the action of imitating or pretending to be an older adult) is one largely unexplored intervention for reducing ageist attitudes. Purpose: The purpose of this study was to examine the effects of an aging suit on the attitudes of young and middle-aged adults toward older adults. We hypothesized that after performing senior fitness tests in an …


Flow, Creativity And Autism Spectrum Disorder: Creatively Supporting Development And Pro-Social Behavior In Children With Asd, Mehdi Raoufi Apr 2018

Flow, Creativity And Autism Spectrum Disorder: Creatively Supporting Development And Pro-Social Behavior In Children With Asd, Mehdi Raoufi

Expressive Therapies Capstone Theses

This literature review is an analysis of the literature exploring the use of expressive arts modalities with children living with Autism Spectrum Disorder (ASD), with a focus on emotional regulation and behavior modification. Historically, Applied Behavior Analysis (ABA) has been the standard in terms of behavior modification for this population, but current research and qualitative inquiries suggested that members of this population need more support in emotional regulation and communication than ABA is able to provide. Using an intermodal arts-based method developmentally promotes social and communication abilities in children with ASD. Further, channeling stereotypic behaviors into creative flow can regulate, …


Raps—Measuring Problem Solving In Children With And Without Autism, Haley Jones Apr 2018

Raps—Measuring Problem Solving In Children With And Without Autism, Haley Jones

Mahurin Honors College Capstone Experience/Thesis Projects

This thesis discusses a study conducted that compared the Rapid Assessment of Problem Solving (RAPS) with the Ravens Progressive Matrices (RPM) in assessing the problem solving of children with and without autism. While the effectiveness of the RAPS had been evaluated for neurotypical children and adults, and adults with traumatic brain injuries, severe mental illness, and Alzheimer’s disease, no studies had yet been conducted with children with autism. The RAPS and the RPM were administered to twelve adolescents with autism and fifteen neruotypical, ages 10:0-17:11. To assess problem solving abilities, questions were analyzed in terms of inefficient constraint questions, frank …


Advocating For Students With Autism: How To Best Engage And Equip Your Student With Autism To Excel In The Music Classroom, Mackenzie C. Kastelein Apr 2018

Advocating For Students With Autism: How To Best Engage And Equip Your Student With Autism To Excel In The Music Classroom, Mackenzie C. Kastelein

The Research and Scholarship Symposium (2013-2019)

Within the educational system, students with autism are often misunderstood or overlooked, resulting in an inadequate educational experience for students with ASD. This research was conducted in pursuit of collecting information on students with autism so that current music educators might be better equipped to engage these students effectively within their classroom. Six, current music educators were interviewed with a series of 9 questions in order to gather a small sample of what is currently occurring in American school systems when it comes to the music education of students with Autism. These educators discussed what inclusion of students with ASD …


Peer-Mediated Communication Skill Instruction In The Reverse Mainstreaming Environment For Students With Autism, Rachel Gross Apr 2018

Peer-Mediated Communication Skill Instruction In The Reverse Mainstreaming Environment For Students With Autism, Rachel Gross

Capstone Projects and Master's Theses

Due to deficits in social and communication skills, students with Autism Spectrum Disorder (ASD) often have challenges developing relationships and engaging in social interactions. This study replicates a previous study that measured the success of teaching conversational skills to students with ASD using behavior skills training (BST). This study amended the previous study by using peers more frequently during intervention and probes. A single-case multiple-baseline across skills design was implemented. The conversation skills targeted included eye contact, beginning a conversation, asking questions, ending a conversation, and nodding and smiling. Five kindergarten to second grade students who have a primary diagnosis …


Increasing On-Task Behavior Of Students With Autism Using Classical Music, Amanda Greenleaf Apr 2018

Increasing On-Task Behavior Of Students With Autism Using Classical Music, Amanda Greenleaf

Capstone Projects and Master's Theses

On-task behavior is linked to higher achievement in school, but students with Autism Spectrum Disorders (ASD) often have difficulty staying on task. Effective interventions are needed to help students with ASD stay on task and be successful at school. This study provided classical music during independent student work to determine if playing classical music during independent learning activities would increase on-task behavior. This study utilized a single case AB design with three participants. During the baseline phase, no music was played while students worked independently. During the intervention phase, classical music was played while students completed their assignments. Results showed …


Using Video Modeling To Teach Vocational Skills To Young Adults With Autism Spectrum Disorder, Karl Schoenherr Feb 2018

Using Video Modeling To Teach Vocational Skills To Young Adults With Autism Spectrum Disorder, Karl Schoenherr

Dissertations

This study evaluated the effectiveness of video self-modeling as a method for teaching two young adults with autism spectrum disorders (ASD) how to perform job-related skills in a vocational setting. Prior to intervention, videos were recorded of the participants as they performed single steps of novel tasks at their jobsites. The researcher created video self-models by combining and editing the recordings of the single tasks into a video that depicted the participants performing all the steps of the task in succession. The videos included written instructions and voiceovers of the instructions. The videos were uploaded to Box, an app that …


The Benefits Of Unstructured Time For Students With Special Education Needs, Maggie P. Jensen/Kregness Jan 2018

The Benefits Of Unstructured Time For Students With Special Education Needs, Maggie P. Jensen/Kregness

All Electronic Theses and Dissertations

This research was completed with the goal of contributing to the discussion of unstructured time in the school day. Specifically, it looked at the question; what are the benefits of unstructured time for students with special education needs? A literature review was completed, where data from different studies across the US and similar countries (Canada, UK) was compared for similarities and discrepancies. Additionally, the search was narrowed to students receiving special education services under the categories of Autism Spectrum Disorder (ASD) and Other Health Disabilities (OHD). Based on the data compiled, it was concluded that for students with these needs, …


Elevated Anxiety In Youth With Autism Spectrum Disorder And The Implications Of Using Cognitive Behavioral Therapies As An Effective Treatment Plan, Nichole L. Olsen Jan 2018

Elevated Anxiety In Youth With Autism Spectrum Disorder And The Implications Of Using Cognitive Behavioral Therapies As An Effective Treatment Plan, Nichole L. Olsen

All Electronic Theses and Dissertations

As educators, we have seen Autism Spectrum Disorder (ASD), anxiety levels, mental health issues, and explosive behaviors rise in the general education population as well as the special education population in the last five years. The need for effective research based treatment plans is a very high demand in order to best serve our rising ASD population with comorbid anxiety in the school setting. There is building evidence in research that supports positive outcomes when using Cognitive Behavioral Therapies (CBT) for adolescents with ASD comorbid with anxiety who have some emotion recognition abilities as well as age appropriate intellectual and …


Partners In Innovation, Fanshawe College Of Applied Arts And Technology Jan 2018

Partners In Innovation, Fanshawe College Of Applied Arts And Technology

Centre for Research and Innovation Publications

A report about the Centre for Research and Innovation (CRI) support of innovation activities at Fanshawe college and throughout the region with industry, business and community partners.


Use Of Memantine In Autism Spectrum Disorder: A Case Report, Adam Schindzielorz Md, Kristina Bryant-Melvin Md, Suzanne Holroyd Md, Kelly Melvin Md Jan 2018

Use Of Memantine In Autism Spectrum Disorder: A Case Report, Adam Schindzielorz Md, Kristina Bryant-Melvin Md, Suzanne Holroyd Md, Kelly Melvin Md

Psychiatry

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder of varying severity and phenotypic expression that is characterized by persistent deficits in social relatedness, communication skills, and interfering repetitive behaviors. Associated behavioral pathology can include inattention, aggression, irritability, hyperactivity, anxiety, and self-injury. Currently, FDAapproved treatments exist to treat secondary symptoms but not core symptomatology. The etiology of autism and other ASD is thought to be multifactorial but is not well understood. Some studies suggest that glutamate excitotoxicity may play a role in the pathogenesis of ASD. Memantine, an NMDAreceptor antagonist, could potentially address core symptoms in ASD by targeting disease-specific pathophysiology. …


Neurodevelopmental Basis Of Autism Spectrum Disorder Based On Age And Gender, Sursatie Chetram Jan 2018

Neurodevelopmental Basis Of Autism Spectrum Disorder Based On Age And Gender, Sursatie Chetram

Walden Dissertations and Doctoral Studies

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects communication, socialization, and restricted/repetitive behaviors. In 2012, one out of every 55 children (1 in 42 boys and 1 in 189 girls) have been diagnosed with ASD in the United States. Only 30-40% of ASD has a known etiology (e.g., genetic predisposition) and the other 60-70% is unknown. Prior to this study, there was no known literature on age and gender differences related to neuro-developmental functioning of ASD. The purpose of this study was to examine how the differences in age and gender of people with ASD were related to …


Systematic Review: Comparative Efficacy Of The Picture Exchange Communication System (Pecs) To Other Augmentative Communication Systems In Increasing Social Communication Skills In Children With Autism Spectrum Disorder, Brittany Mahoney, Alyssa Johnson, Maggie Mccarthy, Cameron White Jan 2018

Systematic Review: Comparative Efficacy Of The Picture Exchange Communication System (Pecs) To Other Augmentative Communication Systems In Increasing Social Communication Skills In Children With Autism Spectrum Disorder, Brittany Mahoney, Alyssa Johnson, Maggie Mccarthy, Cameron White

Communication Sciences and Disorders: Systematic Review Publications

Purpose: This systematic review aims to compare the efficacy of the Picture Exchange Communication System (PECS) to other forms of Augmentative and Alternative Communication (AAC) in increasing social communication skills in children with Autism Spectrum Disorder (ASD).

Methods: A systematic review of the literature on PECS and other forms of AAC written between 2007 and 2018 was conducted. Studies were selected based on the established inclusionary and exclusionary criteria. The inclusionary criteria incorporated subjects with a formal diagnosis of ASD under the age of 18. Exclusionary criteria included individuals with severe sensory, motor, and/or other medical conditions that may …


Examining The Effects Of Aac Intervention On Oral Language In Children With Autism Spectrum Disorders: A Systematic Review, Alexandra F G Patch, Emily V. Mortner, Alison R. Joseph Jan 2018

Examining The Effects Of Aac Intervention On Oral Language In Children With Autism Spectrum Disorders: A Systematic Review, Alexandra F G Patch, Emily V. Mortner, Alison R. Joseph

Communication Sciences and Disorders: Systematic Review Publications

This systematic review researched the efficacy of augmentative and alternative communication (AAC) in increasing oral communication in children with Autism Spectrum Disorder (ASD). It may be used to inform best practice when working with children with ASD. The search strategy reviewed medical, social science, and communication databases. Inclusionary criteria consisted of peer-reviewed, quantitative research published after 2007 regarding children with ASD under age 18. The included studies used AAC interventions and measured spoken language outcomes. After conducting an initial database search with these criteria, a manual search was performed using references from the found articles. Results varied across studies. Although …


Using Informatics To Improve Autism Screening In A Pediatric Primary Care Practice, Jessica Teates Jan 2018

Using Informatics To Improve Autism Screening In A Pediatric Primary Care Practice, Jessica Teates

DNP Scholarly Projects

Background: According to the most recent report from the CDC (2018), autism spectrum disorder (ASD) affects approximately one in 59 children in the United States (U.S.). In 2007, the American Academy of Pediatrics (AAP) issued a strong recommendation for all primary care providers to screen children for autism, using a validated tool, at the 18 and 24-month well-child visits, in order to begin the referral process for more formal testing, and intervention, promptly. Despite the strong stance of the AAP and evidence supporting the importance of early intervention for children with ASD, not all primary care providers are screening for …