Date of Paper/Work


Type of Paper/Work

Doctor of Nursing Practice Project

Degree Name

Doctor of Nursing Practice



First Advisor

Nanette Hoerr


Doctor of Nursing Practice


Purpose: Autism spectrum disorder (ASD) is a developmental disorder that oftentimes results in significant social, communication, and behavioral challenges. In 2014, the CDC reported that one in 68 children were diagnosed with autism. Hewitt et al. (2013) reported that in Minneapolis, Minnesota, 1 in 32 Somali children ages 7-9 had ASD, a rate higher than any other immigrant population. Early diagnosis and immediate implementation of intensive treatment leads to improved outcomes for children with autism (Carakovac et al., 2016). The purpose of this DNP project is to develop a standardized process for increasing completion and documentation rates of the MCHAT-R for Somali children between ages 16 months to 30 months in a pediatric clinic serving a significant population of Somali children and families.

Problem: The practice problem surrounding this DNP project centers on a pediatric primary care clinic where a standardized process for toddler autism screening does not exist. Screening procedures are inconsistently applied, leaving some children at risk for undiagnosed ASD.

Approach: The DNP student developed a standardized process for increasing completion and documentation rates of the MCHAT-R form for Somali children between ages of 16 months and 30 months. The DNP student and quality improvement (QI) team made incremental changes utilizing the PDSA cycle model as a framework.

Results: Twenty charts were reviewed for pre-intervention and post-intervention. Of the 20 charts reviewed pre-intervention, autism screening was documented in the electronic health records of 35% of 18-month-old and 65% of 24-month-old toddlers. Post intervention, the screening rate rose to 95% of 18-month-old and 85% of 24-month-old toddlers.

Conclusion: Implementing a quality improvement process led by this DNP student resulted increase in autism screening and documentation rate within the pediatric clinic.