Innovating ASD Assessments in Primary Care Settings
Moving ASD assessments from specialty to primary care settings involved creative strategies like reducing multidisciplinary teams, embedding psychologists in pediatric practices, and providing early identification and support. Data from embedded testing showed successful outcomes with high referral rates and accurate ASD diagnoses, guiding further comprehensive evaluations. The approach aims to streamline services, reduce wait times, and enhance patient care in pediatric settings.
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Programs of Evaluation, Development And Learning or PEDAL A story of moving ASD assessments from a specialty setting to a primary care setting
30,000 Foot View 2010-NICU Follow up clinic 2011-Multidisciplinary Clinic for children and youth with complex health conditions (wait list 9-12 months) 2012-2015-Added Behavior Clinic, Feeding Clinic, Concussion Clinic 2016-Lost space so lost clinics
Needed to get Creative! 2016 Reduced multidisciplinary team to DVP, Psychology, Speech and Social Work. In April began our Birth to Five Clinic with DVP/Psychology in Primary Care Setting Patients are primarily under 5 with complex special health care needs. Approximately 50-70% have ASD as referral diagnosis. Rate of false positives for this clinic is very high. Of the children who are referred for ASD, I estimate only about 30% have ASD. Wait list quickly grows to 8 months.
Needed to Get Creative! 2013 St. Charles and Central Oregon Pediatrics Associates forged a partnership to embed Psychologists as integrated behavioral health providers. 2016-worked with Pacific Source to provide developmental screening/evaluation as an integrated provider in Primary Care allowing us to practice at the highest end of our license, reduce PEDAL wait time, and offer early identification for children with developmental concerns including ASD.
DATA for our Embedded Testing Between October-December 2016 we (2 psychologists; 2 days/week dedicated to evaluation) have seen approximately: 23 patients 16 were referred due to ASD concerns Approximately 5 were diagnosed with ASD Referrals made to ABA, Speech, OT, DD and 4 patients were recommended to return for a more comprehensive evaluation in a year due to complex presentation. Parents provided support and parenting guidance.
