Date

11-11-2026

Department

School of Behavioral Sciences

Degree

Doctor of Philosophy in Psychology (PhD)

Chair

Margaret Gopaul

Keywords

Down Syndrome, Autism Spectrum Disorder, primary care providers, behavioral phenotype, co-occurring medical conditions, parental stress, symptoms

Disciplines

Psychology

Abstract

The purpose of this survey research study was to examine whether primary care providers (PCPs) could identify early symptoms of autism spectrum disorder (ASD) in children with Down syndrome (DS). The literature indicates that the prevalence of ASD in the DS population is significantly higher than in the general population, and receiving an ASD diagnosis is often delayed. Overlapping symptomatology due to cognitive impairments and developmental delays creates challenges in distinguishing the differences between ASD and DS symptomatology. PCPs play an essential role in the initial ASD screening process by providing referrals for ASD diagnostic evaluations. It is unknown if currently practicing PCPs are aware of research-indicated early symptoms of ASD specific to the DS population. Research indicates there are differences in behavioral phenotypes, co-occurring medical conditions, and reported parent stress levels in children with a comorbid diagnosis of DS+ASD. A 20-question online survey was used to assess PCPs’ knowledge of research-indicated early symptoms of ASD in children with DS. The results indicated that PCPs in this study were knowledgeable about behavioral symptoms and parental stress but were not knowledgeable about co-occurring medical conditions. Knowledge and medical experience were positively correlated, but the sample size was too small to determine a statistically significant correlation. This study contributes data that can be used in future studies to determine if training interventions are needed to support PCPs in early identification of ASD symptoms in children with DS.

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