Knowledge-to-practice gaps in early diagnosis of autism spectrum disorder: a cross-sectional study of Palestinian paediatricians

Early diagnosis of autism spectrum disorder (ASD) is essential for timely intervention and improved developmental outcomes. This study assessed pediatricians' knowledge, attitudes, practices (KAP), and perceived barriers regarding early ASD identification in Palestine. Methods A cross-sectional survey was conducted among 123 pediatricians practicing in hospitals, primary healthcare centers, and private clinics across the West Bank, including East Jerusalem. Data were collected using a structured questionnaire comprising demographic characteristics, the validated Knowledge about Childhood Autism among Health Workers (KCAHW) scale, and sections assessing attitudes, clinical practices, and perceived barriers related to early ASD diagnosis. Descriptive and inferential statistical analyses were performed. Results Participants showed strong overall ASD knowledge (mean KCAHW score: 14.69 ± 2.50/19), scoring highest in social/communication domains but lower in etiology, comorbidities, and onset age. Attitudes were overwhelmingly positive, with 98.4% valuing provider awareness and 95.9% supporting multidisciplinary assessments. Clinically, 93.5% routine-referred suspected cases and 91.1% counseled families, but only 32.5% routinely used standardized screening tools (e.g., M-CHAT). Key barriers included high perceived lack of parental awareness (88.6%), absence of standardized diagnostic protocols (72.4%), social stigma (61.8%), and insufficient ASD-specific training (59.3%). Conclusions Palestinian physicians exhibit good foundational knowledge and positive attitudes toward early ASD detection. However, low standardized screening rates, training gaps, and systemic and sociocultural barriers delay timely diagnosis. Enhancing professional training, implementing standardized screening pathways, and improving community awareness are vital to accelerate early intervention.