Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 21, 2025
Date Accepted: Jan 21, 2026
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Rising to the Challenge of Early Screening in Primary Health Care: A Qualitative Study on Win4ASD – Web Italian Network for Autism Spectrum Disorder in the paediatric population
ABSTRACT
Background:
Early identification of Autism Spectrum Disorder and, more generally, 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 18-24 months. Telemedicine, namely healthcare 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 Win4ASD platform is a telemedicine-based screening tool designed to detect Autism Spectrum Disorder early within the paediatric healthcare system in Italy.
Objective:
The clinical goal, in terms of preventive medicine, is to develop early screening for Autism Spectrum Disorder across the (Lombardy) region and connect pediatricians with specific regional autism services through a network. The Win4ASD platform, through the CHAT checklist, is the tool that has enabled the development of this objective. In light of this, the clinical effectiveness of the platform for early autism screening is discussed.
Methods:
The Win4ASD platform, which is active in the Lombardy Region, helps paediatricians to screen toddlers for autism at an early age (18-24 months) using the CHAT checklist. Furthermore, children identified as at-risk are referred for further diagnostic evaluation to ASU – a specialist team composed of 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 paediatricians' commitment and effectiveness in identifying children at risk of autism.
Results:
The first key finding is the commitment of paediatricians from the Regional Public Health Services in Lombardy to use the platform. A total of 909 paediatricians were actively using the platform, making up 72% of all paediatricians working for the Regional Public Health Services. The platform enabled the screening of 58,419 infants from the general population in Lombardy. A total of 596 children, who were identified as "at risk", were referred for fast-track diagnostic evaluation. They make up approximately 1.02% of the screened population, 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.
Conclusions:
Early identification of risk and timely intervention can prevent the progressive development of behavioural atypicalities, have a significant impact on the quality of life of the child and family, and ultimately allow for a cut in healthcare costs and a consequent improvement in the organisation of the healthcare system.
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