1. Introduction In March of this year, the Center for Disease control estimated the incidence of Autism Spectrum Disorders to be 1 in 50, an increase from a previous estimate in 2007 of 1 in 150 1. In 2007 the American Academy of Pediatrics published guidelines recommending an Autism specific screen be performed at the 18 and 24 month well child visits 2-4. The increased public and health care provider awareness of autism spectrum disorders (ASD) and implementation of routine autism screening in primary care have contributed to recent increases in requests for autism evaluations and long waiting lists at regional tertiary care autism diagnostic clinics. Whether this increased awareness of ASD’s has led to overreferral of children to scarce autism diagnostic resources has not been well studied; however, significant overreferral of children who do not have ASD’s may delay diagnosis and early intervention for children who truly have ASD’s, making this a significant public health issue. Specific Aim: To determine by retrospective chart review the percentage of patients referred to the Autism Center who actually received an Autism Spectrum Diagnosis and of these patients the percentage of Autistic Disorder vs. Asperger disorder vs Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). In addition, it will be determined which alternative diagnoses were most common amongst patients who did not receive an Autism Spectrum diagnosis. Prevalence of True Autism Spectrum Disorders in Children Referred to a Regional Autism Clinic Sonia Monteiro MD, Adiaha Franklin MD, MPH, Diane Treadwell-Deering, MD; Sherry Sellers-Vinson, MD; Lane Strathearn, MD; Eboni Smith, MD Leandra Berry, PHD; Monica Proud, MD; Robert Voigt, MD Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas Results 348 children with a mean age of 6 years 7 months ± 3 years 5 months (83% [N = 289] male; 17% [N = 59] female) completed a diagnostic autism evaluation. Only 61% of those evaluated (N = 214) received a diagnosis of an ASD (autistic disorder, N = 162; Asperger disorder, N = 13; pervasive developmental disorder, not otherwise specified, N = 39. Of those who received an autism specific screen, 63% (N = 180) received an ASD diagnosis and 37% (N = 107) did not. Of those who were not screened 56% (N=34) received an ASD diagnosis and 44% (N = 27) did not. Of those who were not found to have an ASD, the most frequent alternative diagnoses were: language disorder, attention- deficit/hyperactive disorder, disruptive behavior disorder, intellectual disability and anxiety disorder, with most patients having multiple diagnoses.. Abstract Background: Increased public and provider awareness of Autism Spectrum Disorders along with recommended implementation of autism screening in primary care have both led to increased wait times for an autism evaluation and may cause a delay in receipt of essential autism services. This may in fact be a case of overreferral of children who do not have an autism spectrum disorder. Objective: To determine the prevalence of true ASD diagnoses in children referred to a regional autism diagnostic clinic who were diagnostically evaluated for the presence of a possible ASD. Methods: Retrospective Chart Review of all patients evaluated between April of 2011 and August of 2012 using the electronic medical record. Demographic information and clinical diagnoses were abstracted. Results: 348 children with a mean age of 6 years 7 months ± 3 years 5 months (83% [N = 289] male; 17% [N = 59] female) completed a diagnostic autism evaluation. Of those evaluated, only 214 (61%) received a diagnosis of an ASD (autistic disorder = 162 [47%]; Asperger disorder = 13 [4%]; pervasive developmental disorder, not otherwise specified = 39 [11%]. Conclusion: Increasing public and health care provider awareness of ASD’s and increased use of standardized screening measures likely contribute to the current epidemic of concerns about possible autism; however our data indicate that concerns about autism are not confirmed by an ASD diagnosis in a significant number of children referred for an autism diagnostic evaluation, Description of intervention/study Between April 2011 and August 2012, all patients referred to our regional autism diagnostic clinic due to suspicion of a possible ASD underwent a diagnostic evaluation. This group included both patients who had failed an autism screen (N = 287; either the Modified Checklist for Autism or the Social Communication Questionnaire) as well as children who did not receive a screen or who passed the screen [n=61]. We retrospectively reviewed the electronic medical records of all patients who were evaluated and abstracted demographic information and clinical diagnoses made for each patient Conclusions 1.Concerns about autism are not confirmed by an ASD diagnosis in a significant number of children referred for an autism diagnostic evaluation, regardless of whether or not they failed autism specific screening. 2. Increased education for both the public and providers is needed regarding the differential diagnosis of ASD’s. 3. The specificity of referrals needs to be improved to help decrease waiting time for children who truly have an ASD. 4. Improved specificity of referrals and decreased wait times will allow for evidence-based ASD-specific interventions to begin at the earliest age possible References 1.Blumberg S, Bramlett M, et al. Changes in Prevalence of Parent-reported Autism Spectrum Disorder in School-aged U.S. Children: 2007 to 2011–2012. National Health Statistics Report. 2013; Number 65. 2. AAP Council on Children with Disabilities, Section on Developmental Pediatrics, Bright Futures Steering Committee, Medical Home Initiatives for Children with Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home; an algorithm for developmental surveillance and screening. Pediatrics 2006; 118: 405-420. 3.Johnson CP, Myers SM; American Academy of Pediatrics Council on Children with Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007; 120: 1183-1215. Texas Pediatric Society Electronic Poster Contest N=348 Patients referred for ASD Evaluation Failed Screen N=287 ASD Diagnosis N= 180 (63%) Autism N= 142 Aspergers N= 7 PDD-NOS N= 31 No ASD N= 107 (37%) No Screen N=61 ASD Diagnosis N= 34 (56%) Autism N= 20 Aspergers N= 6 PDD-NOS N= 8 No ASD N= 27 (44%) Age (months) RangeMeanMedianModeStd Dev 15-23879655841 GenderMaleFemale N= 289 (83%) N= 59 (17%) RaceCaucasianAfrican American HispanicAsianOther N= 147 (42%) N=49 (14%) N=124 (36%) N=25 (7%) N=3 (1%) Demographics 