Wait lists for a specialist to confirm an autism diagnosis can be agonizing and last months. As the prevalence of autism and autism spectrum disorders increase, so does the demand for a health care system that is fully equipped to respond to the complex needs associated with autism. Now, Extension for Community Healthcare Outcomes (ECHO) Autism, a new program from the University of Missouri, is training primary care providers in best-practice care for autism spectrum disorders. Initial results of the pilot program found significant improvements in primary care provider confidence in screening and management of autism and in utilization of specific tools and resources.
"We are very excited about the initial results from the ECHO Autism model," said Kristin Sohl, associate professor of child health and the director of ECHO Autism. "Children with autism can show symptoms as early as 12 months; however, in too many cases children may not receive a diagnosis until they are 5 years old. Early diagnosis is critical for children with autism, and primary care providers play an important role in that initial process."
The ECHO model connects primary care providers to academic medical centers using videoconferencing technology. This allows one-on-one training in diagnosis, screenings, treatment protocols and care management. The ECHO model was created by Sanjeev Arora, MD, from the University of New Mexico and first demonstrated effectiveness in improving outcomes for hepatitis C and has expanded to address other complex medical conditions such as rheumatoid arthritis, diabetes and addiction. Now, MU researchers have developed the first ECHO model to be applied to the care of children with autism in an effort to reduce disparities for underserved and rural children and their families.
"Currently there are not enough specialists to manage the number of children with autism who need health care," said Micah Mazurek, assistant professor of health psychology in the School of Health Professions and lead author of the study. "A real need exists to assist community-based health care providers as they help families get the answers they need without traveling or waiting to see a specialist. Preliminary data from the pilot program suggests ECHO Autism can help with that issue."
ECHO Autism clinics are conducted using high-quality secure video conferencing technology to connect participating primary care clinics to a panel of experts based at the MU Thompson Center for Autism and Neurodevelopmental Disorders. The panel includes a pediatrician specializing in ASD, a clinical psychologist, a child and adolescent psychiatrist, a dietician, a social worker, and a parent of a child with autism. The primary care providers maintain responsibility for care of their patients using the expert panel to build skills and discuss issues.
In testing the pilot, researchers found that participating primary care providers demonstrated significant improvements in confidence across all domains of health care for children with autism--screening and identification, assessment and treatment of medical and psychiatric conditions, and knowledge of and referral to available resources. Future research on ECHO Autism is being conducted through the Autism Intervention Research Network for Physical Health and will expand the reach of the program to 10 additional academic centers connecting with primary care providers across the US and Canada.
Standardized screening leads to earlier autism diagnoses in pediatric care