Identifying Autism in Primary Care: Screening Tool for Toddlers and Young Children (STAT) • Hilary Duckworth, PsyD, Behavioral Health Consultant • Kate Christian, LCSW, Behavioral Health Consultant • Eboni Winford, Ph.D., Behavioral Health Consultant Cherokee Health Systems Session # A2 CFHA 20 th Annual Conference October 18-20, 2018 • Rochester, New York
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Identifying Autism in Primary Care: Screening Tool …...Identifying Autism in Primary Care: Screening Tool for Toddlers and Young Children (STAT) • Hilary Duckworth, PsyD, Behavioral
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Identifying Autism in Primary Care: Screening Tool for Toddlers and Young Children (STAT)
• Hilary Duckworth, PsyD, Behavioral Health Consultant• Kate Christian, LCSW, Behavioral Health Consultant• Eboni Winford, Ph.D., Behavioral Health Consultant
Cherokee Health Systems
Session # A2
CFHA 20th Annual ConferenceOctober 18-20, 2018 • Rochester, New York
Presenter
Presentation Notes
Please insert the assigned session number (track letter, period number), i.e., A2a Please insert the TITLE of your presentation. List EACH PRESENTER who will ATTEND the CFHA Conference to make this presentation. You may acknowledge other authors who are not attending the Conference in subsequent slides.
Faculty DisclosureThe presenters of this session have NOT had any relevant financial relationships during the past 12 months.
Presenter
Presentation Notes
You must include ONE of the statements above for this session. CFHA requires that your presentation be FREE FROM COMMERCIAL BIAS. Educational materials that are a part of a continuing education activity such as slides, abstracts and handouts CANNOT contain any advertising or product‐group message. The content or format of a continuing education activity or its related materials must promote improvements or quality in health care and not a specific propriety business interest of a commercial interest. Presentations must give a balanced view of therapeutic options. Use of generic names will contribute to this impartiality. If the educational material or content includes trade names, where available trade names for products of multiple commercial entities should be used, not just trade names from a single commercial entity. Faculty must be responsible for the scientific integrity of their presentations. Any information regarding commercial products/services must be based on scientific (evidence‐based) methods generally accepted by the medical community.
Conference ResourcesSlides and handouts shared in advance by our Conference Presenters are available on the CFHA website at http://www.cfha.net/?page=Resources_2018
Slides and handouts are also available on the mobile app.
Learning ObjectivesAt the conclusion of this session, the participant will be able to:
•List two advantages of embedding BHCs into pediatric Well Child Check exams.
•Describe the rationale for implementing the STAT-BHC within Well Child Check exams.
•Describe two ways to utilize community health workers as extenders of the primary care team to reinforce autism spectrum interventions.
Presenter
Presentation Notes
Include the behavioral learning objectives you identified for this session
1. Stone, WL, McMahon, CR, Henderson, LM. (2008). Use of the Screening Tool for Autism in Two-Year-Olds (STAT) for children under 24 months: an exploratory study. Autism: International Journal of Research Practice, 12(5), 557-573.
2. Zwaigenbaum, L et al. (2015). Early screening of autism spectrum disorder: Recommendations for practice and research. Pediatrics, 136, S41-S59.
3. Pinto-Martin, J., Young, L., Mandell, D., Poghosyan, L., Giarelli, E., & Levy, S. (2008). Screening strategies for autism spectrum disorders in pediatric primary care. Journal of Developmental and Behavioral Pediatrics, 5, 345-350.
4. Chlebowski, C., Robins, D. L., Barton, M. L., & Fein, D. (2013). Large-scale use of the modified checklist for autism in low-risk toddlers. Pediatrics, 131(4), e1121-e1127.
5. Guevara, J.P., et al. (2013). Effectiveness of developmental screening in an urban setting. Pediatrics, 131(1), 30-37.6. Robins, D., et al. (2016). Universal autism screening for toddlers: Recommendations at odds. Journal of Autism and
Developmental Disorders, 46(5), 1880-1882.7. Glascoe, F. P. (2015). Evidence-based early detection of developmental behavioral problems in primary care: What
to expect and how to do it. Journal of Pediatric Health Care, 29(1), 46-53.
Bibliography / Reference
Presenter
Presentation Notes
Continuing education approval now requires that each presentation include five references within the last 5 years. Please list at least FIVE (5) references for this presentation that are no older than 5 years. Without these references, your session may NOT be approved for CE credit.
Learning AssessmentA learning assessment is required for CE credit.
A question and answer period will be conducted at the end of this presentation.
Presenter
Presentation Notes
Please incorporate audience interaction through a brief Question & Answer period during or at the conclusion of your presentation. This component MUST be done in lieu of a written pre- or post-test based on your learning objectives to satisfy accreditation requirements.
Greetings from East Tennessee!
Our Mission…To improve the quality of life
for our patients through the blending of primary care and behavioral health.
CherokeePediatric Behavioral HealthINTEGRATED CARE
Training Academy
Why WCCs?
• Routine points in medical/physical care • Wellness promotion, broad screening, further engagement of children
and families
• Appropriately matched assessment of wellness goals and health education at each stage of development
• BHC enhances visits with PCP • Generates awareness of our greater role within the primary care team,
services available, and critical tasks in healthy biopsychosocial development.
Presenter
Presentation Notes
Talking Points: Developmental screening tools are an invaluable component of identifying psychoeducational needs, deficits in health literacy, delayed or atypical developmental milestones (or markers for further assessment), as well as trauma, distress, and/or risks/safety concerns. Behavioral health in WCC often allows for ongoing surveillance of subclinical symptoms and this secondary prevention may prevention more chronic clinical concerns.
CherokeePediatric Behavioral HealthINTEGRATED CARE
Training Academy
Results: Using a rapid diagnostic model, diagnostic clarity (i.e., ASD vs. no ASD) determined within the initial consult session for 59% of the children. Latency to diagnosis was less than two months, compared with a minimum of 6 months for tertiary clinic assessment. The median age at diagnosis (32 months) was considerably lower than the national average of approximately 50 months.
“A Pilot Model for Embedding ASD Diagnosis within the Medical Home”, Unpublished Manuscript, Hine et. al.
CherokeePediatric Behavioral HealthINTEGRATED CARE
Training Academy
BHCs• 3-hour training on autism• Periodic half hour training sessions on specific issues, like
sleep, behavior management, and feeding• Two-day training specific to the STAT • Periodic email updates on experience with the STAT• Access to the Developmental Psychology Team• Developmental psychologists consult on unclear STATs
CherokeePediatric Behavioral HealthINTEGRATED CARE
Training Academy
Community Health Coordinators:• 3-hour training on Autism• 3-hour training on the STAT process and community resources• Assist parents as indicated with completion of developmental
questionnaire• Active involvement in the “next steps” discussion• Meet with the parents to review next steps• Collaborate with parents to refine topics for discussion with
CherokeePediatric Behavioral HealthINTEGRATED CARE
Training Academy
• Continue to collect data• Ongoing training and research• Expand to all pediatric clinic sites within our system• Continue to shorten the diagnostic delay