Multi-Faceted Autism Initiative Implemented with the Help of GAFP

Implementation of the Georgia Department of Public Health’s (DPH) Autism Initiative’s strategic plan includes a triad of projects that aim to improve autism developmental screening and referrals among physicians and early intervention coordinators.  The plan also includes a family support and training component foundational to help improve care, positive behavior and visual support skills at home.

The need for autism screening and early intervention is great.  According to the Centers for Disease Control and Prevention (CDC), autism spectrum disorders are among the fastest growing developmental disorders in the United States, affecting one out of every 150 children.  Autism, as defined by Individuals with Disabilities Education Act (IDEA), refers to “a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, which adversely affects a child’s educational performance.”

Partners in the DPH Autism Initiative include the Georgia Academy of Family Physicians (GAFP), Centers for Disease Control and Prevention (CDC), Georgia Chapter of the American Academy of Pediatrics (GAAAP), and Georgia State University/ Center for Leadership in Disability (GSU/CLD).

These partners have joined forces to implement the following projects outlined in the DPH Autism Initiative’s strategic plan:

PROJECT 1

PHYSICIAN DEVELOPMENTAL SCREENING  (closed)

Goal:  To improve developmental screenings and referrals for further evaluation and/or early intervention services.

Tactics:  Distribute a Pediatric Primary Care Physician’s Developmental Screening Survey (surveying closed on June 15) and compile results for a four-part autism and developmental webinar training series.

Community providers considered to be experts in the field of autism collaborated with Georgia Autism Initiative partners on the survey designed to help gain a better understanding of the barriers associated with performing developmental screening, as outlined in the American Academy of Pediatrics (AAP) periodicity schedule and referral to IDEA’s Part C program.

Collaborators on the developmental screening survey included representatives from the DPH Autism Initiative’s partnering organizations, the Marcus Autism Center, Diana Robin, PhD (developer of M-CHAT), and developmental and general pediatricians.  The survey targets family physicians, pediatricians, physician assistants, and nurse managers and was reviewed by the  chair of the AAP’s Autism Task Force, Susan Levy, MD,  as well as the GAFP’s Public Health Chair David Westfall, MD.

The information gathered from the survey will be integrated with best practices to create a Developmental Screening Training and Toolkit for pediatric primary care providers, physician assistants, and nurse managers on the importance of developmental screening, using screening tools, screening practices, and linking families to early intervention services and family supports.

CMEs will be offered for the four-part autism and development webinar training series starting early fall. Look for an announcement from the GAFP when the four-part webinar series is available.  The webinars will cover the following topics:

    • Importance of Developmental and Autism Screening
    • Developmental and Autism Screening Tools Overview
    • Imbedding Screening as a Standard of Care in Pediatric Practices
    • Referring Families to DPH Child Health Programs and Community Services and Supports

PROJECT 2

EARLY INTERVENTION PROVIDERS (EIP) DEVELOPMENTAL SCREENING   (ongoing)

Goal: To provide training to 125 Part C EIPs throughout Georgia on 1) early detection; 2) collaboration and family support; 3) developmental perspectives, 4) evidence-based intervention strategies and supports, and  5) intervention outcomes prioritization.

Tactics: Educate EIPs through a series of online modules (deadline is July 30) and provide face-to-face coaching for 25 EIPs designed to help families engage and optimize their day-to-day activities with their child (ongoing).

DPH is utilizing the Atlanta-based Marcus Autism Center’s to help train Georgia EIPs to cast a wider developmental screening net.  Marcus Autism Center is a not-for-profit organization and subsidiary of Children’s Healthcare of Atlanta that treats more than 5,500 children with autism and related disorders a year.  As one of the largest autism centers in the United States and one of only three National Institutes of Health (NIH) Autism Centers of Excellence, Marcus Autism Center offers families access to the latest research, comprehensive evaluations and intensive behavior treatments.

Learn about the signs of autism and the early social communication milestones that are important for family physicians and parents to observe.  Many signs often exist before a child’s second birthday.

The EIPs represent several disciplines within the DPH’s Babies Can’t Wait program.* The providers include speech language pathologists, occupational therapists, physical therapists, special instructors, service coordinators, and behavior therapists.

*Babies Can’t Wait is a statewide early intervention program for children (birth to 3 years of age) with developmental delays and their families. The program is established by Part C of the Individuals with Disabilities Education Act (IDEA) which guarantees all eligible children, regardless of their disability, access to services that will enhance their development.  Babies Can’t Wait assists families in identifying needed resources and services within our community to meet a child’s developmental needs.

PROJECT 3

FAMILY SUPPORT AND TRAINING ON POSITIVE BEHAVIOR AND VISUAL SUPPORT  (Pilot – ends September 2015)

Goal:   To provide Positive Behavior and Visual Support training to 150 Georgia families of children with a diagnosis of autism or combined delays of social emotional and communication. 

Tactics:  Identify participating families through Part C/Babies Can’t Wait program and equip them via five two-hour one-on-one sessions with supportive materials on implementing Positive Behavior and Visual Support.

Identified through the Babies Can’t Wait program, families receiving the Positive Behavior and Visual Support training will be equipped to help develop communication and self-regulation skills, improve behaviors and cooperation and enhance their self-efficacy.

The Positive Behavior Support model has 30 years of research supporting its effectiveness at preventing and reducing challenging behavior.  It’s widely recognized by professionals and specialist as an effective process for reducing challenging behavior and increasing positive behavior.  The model is currently being used and implemented across Georgia by Bright from the Start – Georgia Department of Early Care and Learning (DECAL) and the Georgia Department of Education (DOE), which will support continuity of services as children transition between home and childcare centers as well as between Part C and Part B programs.

Any GAFP member who serves a child in need of services for developmental delay or a related disability, including suspected Autism Spectrum Disorders (ASD), can refer a child to Babies Can’t Wait for services through Children First the first point of entry into DPH’s Child Health Programs.   Family physicians can refer children who are between the ages of birth to three years old who have ASD or combined social emotional/language delay to benefit from these services.

Projected results of family support and training include:

  • Empowered families with more knowledge and skills to support their children’s positive behavior and decrease their challenging behavior.
  • Equipped children with the skills to communicate their wants and needs to help decrease their level of stress and increase positive interactions with others.

The DPH is currently identifying funding opportunities and strategy to continue the program and/or embed the services within the Babies Can’t Wait program so any families enrolled in the program will be able to receive this Positive Behavior and Visual Support training.