40 Chapter 2 Table 2. Selective codes representing strategies, accompanied by illustrative quotes. 1. Training needs “We have shown the CoSoS to some colleagues. We held a presentation about it within our own organization. But then, everybody has to do it on its own. You have to know what you are doing, why you are asking these questions. And I think, as long as this isn’t clear to people, they don’t use it [CoSoS] often. – Participant 5 2. Closer collaboration between healthcare organizations “I believe that we have to ease the access to child and adolescent psychiatry centers. I know that there is a shortage of child psychiatrists, that everybody has a lot on their plate and that there is almost no money. In our region, they pilot tested a great workaround: general practitioners are getting support from a specialized child psychologist. But, in the end, I believe that it is important that we have an easy access again to child and adolescent psychiatry centers.” – Participant 10 “A good collaboration? That I receive confirmation when I refer a child. Or that they give me a sign when diagnostic assessment or treatment will start. Maybe an update halfway. And a letter or report when treatment has ended, with results. And if it is possible, maybe more consultation possibilities between professionals. If an external professional notice that parents need more pedagogical guidance, that they will give us a sign or talk to us.” – Participant 4 1. Training needs Most PCPs stated their need for additional training in recognizing the importance of early detection of ASD, what early risk signals are and how to administer the CoSoS. One PCP suggests that training in motivational interviewing could possibly help in discussing concerns with parents. Additionally, PCPs recommend extra training not only for themselves, but also for their colleagues and collaboration partners in preschool and kindergarten. 2. Closer collaboration between healthcare organizations The majority of PCPs emphasized a closer collaboration between preventive care and more specialized healthcare centers as a strategy to improve early detection of ASD. PCPs who worked in an organization where there is a close collaboration between healthcare organizations expressed more confidence in identifying young at risk children. When asked what a good collaboration would look like, almost all PCPs agreed upon the following: receiving a confirmation after a child is referred, receiving a sign when diagnostic assessment or treatment has started, receiving a letter or report when treatment has ended and more consultation between different healthcare professionals.
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