C59. Introducing the Ritvo Autism Asperger Diagnostic Screening Tool – Revised in a Residential Substance Use Disorder Treatment Facility

About The Event

Learner category:

  • Expert Level

Learning objectives:

  • The purpose of this quantitative quasi-experimental project was to compare the prevalence or rate of patients identified with comorbid ASD/SUD after implementation of a validated ASD screening tool to the prevalence or rate of patients identified with no screening tool among adult patients admitted to a dual-diagnosis residential SUD treatment program in the western region of the United States within a four week period. The independent variable was the use of the RAADS-R and the dependent variable was the number or rate of patients screened positive by scoring 65 or higher on the RAADS-R, which is consistent with a diagnosis of ASD, or a prior diagnosis of ASD (Ritvo et al., 2016).
  • A second part of this quality improvement project was to show changes in staff confidence levels in diagnosis and individualized ASD interventions after provider education. An online video education was provided on the DSM-5 ASD diagnostic criteria and adaptive ASD interventions, and was intended to improve the effectiveness of increasing referrals for further ASD diagnostic work-up and providing interventions consistent with ASD/SUD comorbidity in order to possibly enhance treatment retention. Staff confidence levels were analyzed in a pre and post-                                                                                                                                                                              type of survey measure using the TCS-ID


Undiagnosed autism spectrum disorder (ASD) in residential substance use disorder (SUD) programs can lead to premature departure and increased morbidity and mortality and could be prevented using quality improvement measures. Available literature lacks sufficient evidence on the impact of screening tool implementation combined with staff education in increase of ASD diagnoses. The purpose of this quantitative, quasi-experimental quality improvement project was to investigate whether implementing the Ritvo Autism Asperger Diagnostic Scale – Revised (RAADS-R) tool with staff education increased the rate and number of ASD diagnoses pre- and post-implementation compared with prior practice where no validated tool or education were used. Staff pre- and post-ASD knowledge, experience, and comfort levels were analyzed using the Therapist Confidence Scale – Intellectual Disability (TCS-ID). The theory of diffusion of innovation framed this project by introduction of the RAADS-R and results (innovation) to generate a new practice of utilizing the tool (diffusion). Participants included all patients 18 years or older admitted to an adult residential dualdiiagnosis                                                                                                                                                                   SUD treatment facility in western California. Total data analysis time period was 12 months pre-implementation and four weeks post-implementation. A total of five ASD diagnoses occurred— zero pre-implementation and five post-implementation. The total percentage of ASD diagnoses increased significantly from 0% to 16.1% post-implementation (p <.00001). A paired-samples t test comparing pre- and post-education staff confidence levels in treating ASD revealed significant changes across time (p = .012). Patients identified were referred for further diagnostics and individualized treatment plans. Additional investigation with a longer intervention period is warranted.


Deborah Bowman
DNP, PhD, CARN-AP, NP MindTherapy Clinic
MindTherapy Clinic, California, USA Dr. Bowman is a board certified addiction nurse practitioner specializing in co-occurring disorders at the MindTherapy Clinic, a psychiatric outpatient clinic as well as the Alta Mira and Living at Reflections residential substance use disorder facilities in Marin County, California. She is EMDR certified and provides substance detoxification as well as multiple forms of MAT to include buprenorphine (sublingual, subcutaneous and implanted) and ketamine-assisted psychotherapy. Dr. Bowman has worked in substance use disorder for thirty years and graduated from the University of Michigan, Michigan State University and Grand Canyon University and is a veteran of the United States Marine Corps.

Our Speakers

Deborah Bowman
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