Training and Support for Early Identification of Autism in Early

Intervention Systems

URLEND LEADERSHIP PROJECT 2015

RAD

KAT

BABYCATCHERS

Dallin Burgon, Athena Carolan, Kayci Lynam, Ashley Stevens, Rebecca West

Faculty Mentor: Terisa Gabrielson

What we already know:• Autism may be detected as young

as 18 months of age• Utah had the lowest rate (33%) of

early identification of ASD (ADDM; Biao, 2014)

• A diagnosis of ASD at age 2 is generally stable into the school age years (Guthrie et al., 2013).

• There are many benefits to early intervention

• Many children do not receive a diagnosis until they are older (Median age=48 months)

• Diagnosis is a two step process: screening and a comprehensive diagnostic evaluation

So where do we go???

AAP Screening Guidelines• All children should be screened for

developmental delays and disabilities during their regular well-child visits at: 9, 18, and 24 or 30 months

• In addition, all children should be screened for ASD during their regular well-child visits at 18 and 24 months or if the child is at high risk for ASD (sibling with an ASD; parent expresses concern)

• Screening is to be conducted using a standardized developmental tool and should be completed whether or not concern has been expressed

Modified Checklist for Autism in Toddlers (M-CHAT-R)(Robins et al., 2014)

• Reliable and valid measure• Adequate sensitivity and specificity • One of the most widely used screening measures in

U.S. and internationally• Available to clinicians, researchers, educators, and

parents free of cost• 20 yes/no questions• Takes 5-10 minutes to complete• Children are classified into one of three risk ranges

(low, medium, high)• Follow up questions for those in the medium risk range

We were curious…what are current screening practices like in Utah’s Early Intervention Program?

Fall 2014: Developed an informal survey for EI

providers

Winter 2014: Expanded the survey to fit a

broader audience

Spring 2015: Survey was sent out to EI providers

across the state

Sample Questionnaire Items

• What training have you received on using the M-CHAT or other autism screening tools?

• Does your E.I. program currently use any autism screeners?

• What concerns do you have about screening for autism?

• What does your program do well in terms of early identification of autism?

• What kind of local resources are available for evaluation and treatment of autism?

• What do you consider to be the most reliable signs that a child may have autism?

Results• Total surveys completed: 117

Results

0% 1% to 25% 26% to 50% 51% to 75% 76% to 100%0

5

10

15

20

25

Percentage of clients currently screened

• Inconsistency of autism symptoms in the early years was rated as impacting the providers ability to identify autism the most

• On a scale of 1 to 5, the mean response to the question “I would like more training around early identification of autism” was 4.11.

• Locating follow up resources, identifying signs and symptoms, talking to parents about autism, and using an autism screening tool were identified as the areas in which interest in additional training were requested most frequently.

Project Aims

Aim 1: Develop a statewide network of partners for on-going support of this project

Aim 2: Evaluate current screening practices for ASD within EI in the state of Utah

Aim 3: Design a training program to address training needs to increase early identification of ASD in children 3 years and younger

Utah Network for Early Autism Response (UNEAR)

URLEND Team’s Accomplishments

• Updated Fast Start Checklist for Autism Council of Utah• Developed advertising material for UNEAR training• Identified 6 locations and coordinated dates for UNEAR

trainings • Identified multiple sources of financial and resource

support for the trainings• Coordinated CME credit• Arranged and coordinated speakers for the UNEAR

training• Developed training materials• Will present UNEAR training at the International Meeting

for Autism Research Preconference on May 13th

UNEAR Training Target Participants

• EI Professionals• Pediatricians• Family Physicians• Physician assistants• Nurses• Social workers• Psychologists• Speech-language pathologists• Preschool professionals