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Dell Children’s (S)TAAR Model of Early Autism Assessment

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Interprofessional Care Coordination for Pediatric Autism Spectrum Disorder

Abstract

Here, we describe a transdisciplinary effort to efficiently and equitably improve access to comprehensive evaluations for young children at-risk for autism and related neurodevelopmental disorders in the Austin, Texas community. What emerged from this collaboration between Dell Children’s Medical Group and The University of Texas at Austin is a flexible clinical approach that emphasizes patient-centered care, community partnerships, best practices, and provider satisfaction. This chapter outlines integral components of our (Sin Exclusión) Transdisciplinary Autism Assessment & Resources (S)TAAR model, with the hope of providing an example of early autism assessment that can be implemented in medically underserved communities through pediatric specialty clinics. Future iterations of the model are aimed at increasing professional training opportunities for students and early career clinicians and further increasing post-diagnostic family supports. The benefits and limitations of the current model are discussed and avenues for expansion are considered in greater detail.

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References

  • Akshoomoff, N. (2006). Use of the mullen scales of Early Learning for the assessment of young children with autism spectrum disorders. Child Neuropsychology, 12(4–5), 269–277.

    Article  Google Scholar 

  • Alpern, G. D. (2007). Developmental profile 3 (DP-3). Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Altiere, M. J., & von Kluge, S. (2009). Family functioning and coping behaviors in parents of children with autism. Journal of Child and Family Studies, 18(1), 83.

    Google Scholar 

  • American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association, 2013.

    Google Scholar 

  • Bargiela, S., Steward, R., & Mandy, W. (2016). The experiences of late-diagnosed women with autism spectrum conditions: An investigation of the female autism phenotype. Journal of Autism and Developmental Disorders, 46(10), 3281–3294.

    Article  Google Scholar 

  • Bisgaier, J., Levinson, D., Cutts, D. B., & Rhodes, K. V. (2011). Access to autism evaluation appointments with developmental-behavioral and neurodevelopmental subspecialists. Archives of Pediatrics and Adolescent Medicine, 165, 673–674.

    Article  Google Scholar 

  • Blacher, J., & McIntyre, L. L. (2006). Syndrome specificity and behavioural disorders in young adults with intellectual disability: Cultural differences in family impact. Journal of Intellectual Disability Research, 50(3), 184–198.

    Google Scholar 

  • Blair, I. V., Steiner, J. F., Fairclough, D. L., Hanratty, R., Price, D. W., Hirsh, H. K., et al. (2013). Clinicians’ implicit ethnic/racial bias and perceptions of care among Black and Latino patients. The Annals of Family Medicine, 11(1), 43–52.

    Article  Google Scholar 

  • Carlsson, E., Miniscalco, C., Kadesjö, B., & Laakso, K. (2016). Negotiating knowledge: Parents’ experience of the neuropsychiatric diagnostic process for children with autism: Negotiating knowledge. International Journal of Language & Communication Disorders, 3, 328–338.

    Google Scholar 

  • Chamak, B., Bonniau, B., Oudaya, L., & Ehrenberg, A. (2011). The autism diagnostic experiences of French parents. Autism, 15(1), 83–97.

    Article  Google Scholar 

  • Chapman, E. N., Kaatz, A., & Carnes, M. (2013). Physicians and implicit bias: How doctors may unwittingly perpetuate health care disparities. Journal of General Internal Medicine, 28(11), 1504–1510.

    Article  Google Scholar 

  • Chiri, G., & Warfield, M. E. (2012). Unmet need and problems accessing core health care services for children with autism spectrum disorder. Maternal and Child Health Journal, 16(5), 1081–1091.

    Article  Google Scholar 

  • Crane, L., Chester, J. W., Goddard, L., Henry, L. A., & Hill, E. (2016). Experiences of autism diagnosis: A survey of over 1000 parents in the United Kingdom. Autism, 20(2), 153–162.

    Article  Google Scholar 

  • Divan, G., Vajaratkar, V., Desai, M. U., Strik-Lievers, L., & Patel, V. (2012). Challenges, coping strategies, and unmet needs of families with a child with autism spectrum disorder in Goa, India. Autism Research, 5, 190–200.

    Google Scholar 

  • Ennis-Cole, D., Durodoye, B. A., & Harris, H. L. (2013). The impact of culture on autism diagnosis and treatment: Considerations for counselors and other professionals. The Family Journal, 21(3), 279–287.

    Article  Google Scholar 

  • Fountain, C., King, M. D., & Bearman, P. S. (2011). Age of diagnosis for autism: individual and community factors across 10 birth cohorts. Journal of Epidemiology and Community Health, 65(6), 503–510.

    Article  Google Scholar 

  • Fuss, J., Briken, P., & Klein, V. (2018). Gender bias in clinicians’ pathologization of atypical sexuality: A randomized controlled trial with mental health professionals. Scientific Reports, 8(1), 3715–3719.

    Article  Google Scholar 

  • Gerdts, J., Mancini, J., Fox, E., Rhoads, C., Ward, T., Easley, E., et al. (2018). Interdisciplinary team evaluation: An effective method for the diagnostic assessment of autism spectrum disorder. Journal of Developmental and Behavioral Pediatrics, 39(4), 271–281.

    Article  Google Scholar 

  • Gona, J. K., Newton, C. R., Rimba, K., Mapenzi, R., Kihara, M., van de Vijver, F., & Ali, A. (2015). Parents’ and professionals’ perceptions on causes and treatment options for autism spectrum disorders (ASD) in a multicultural context on the Kenyan coast. PLoS One, 10(8), e0132729.

    Google Scholar 

  • Gordon-Lipkin, E., Foster, J., & Peacock, G. (2016). Whittling down the wait time: exploring models to minimize the delay from initial concern to diagnosis and treatment of autism spectrum disorder. Pediatric Clinics, 63(5), 851–859.

    PubMed  Google Scholar 

  • Gould, J., & Ashton-Smith, J. (2011). Missed diagnosis or misdiagnosis? Girls and women on the autism spectrum. Good Autism Practice (GAP), 12(1), 34–41.

    Google Scholar 

  • Hansen, R. L., Blum, N. J., Gaham, A., Shults, J., & DBPNet Steering Committee. (2016). Diagnosis of autism spectrum disorder by developmental-behavioral pediatricians in academic centers: a DBPNet study. Pediatrics, 137(Supplement 2), S79–S89.

    Google Scholar 

  • Harper, A., Dyches, T. T., Harper, J., Roper, S. O., & South, M. (2013). Respite care, marital quality, and stress in parents of children with autism spectrum disorders. Journal of autism and developmental disorders, 43(11), 2604–2616.

    Google Scholar 

  • Hodgetts, S., Zwaigenbaum, L., & Nicholas, D. (2015). Profile and predictors of service needs for families of children with autism spectrum disorders. Autism, 19(6), 673–683.

    Google Scholar 

  • Jackson, R., Baird, W., Davis‐Reynolds, L., Smith, C., Blackburn, S., & Allsebrook, J. (2008). Qualitative analysis of parents’ information needs and psychosocial experiences when supporting children with health care needs. Health Information & Libraries Journal, (1), 31–37.

    Google Scholar 

  • Jo, H., Schieve, L. A., Rice, C. E., Yeargin-Allsopp, M., Tian, L. H., Blumberg, S. J., Boyle, C. A. (2015). Age at Autism Spectrum Disorder (ASD) diagnosis by race, ethnicity, and primary household language among children with special health care needs, United States, 2009/2010. Maternal and Child Health Journal, 1687–1697.

    Google Scholar 

  • Kai, J. (1996). Parents’ difficulties and information needs in coping with acute illness in preschool children: A qualitative study. BMJ, 313(7063), 987–990.

    Google Scholar 

  • Keen, D., Couzens, D., Muspratt, S., & Rodger, S. (2010). The effects of a parent-focused intervention for children with a recent diagnosis of autism spectrum disorder on parenting stress and competence. Research in Autism Spectrum Disorders, 4(2), 229–241.

    Google Scholar 

  • Kogan, M. D., Strickland, B. B., Blumberg, S. J., Singh, G. K., Perrin, J. M., & van Dyck, P. C. (2008). A national profile of the health care experiences and family impact of autism spectrum disorder among children in the United States, 2005–2006. Pediatrics, 122(6), e1149–e1158.

    Article  Google Scholar 

  • Kohler, F. W. (1999). Examining the services received by young children with autism and their families: A survey of parent responses. Focus on autism and other developmental disabilities, 14(3), 150–158.

    Article  Google Scholar 

  • Magaña, S., Parish, S., Rose, R., Timberlake, M., & Swaine, J. (2012). Racial and ethnic disparities in quality of health care among children with autism and other developmental disabilities. Intellectual and Developmental Disabilities, 50(4), 287–299.

    Google Scholar 

  • Magaña, S., Lopez, K., Aguinaga, A., & Morton, H. (2013). Access to diagnosis and treatment services among Latino children with autism spectrum disorders. Intellectual and Developmental Disabilities, 51(3), 141–153.

    Article  Google Scholar 

  • Mandell, D. S., Listerud, J., Levy, S. E., & Pinto-Martin, J. A. (2002). Race differences in the age at diagnosis among Medicaid-eligible children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 41(12), 1447–1453.

    Article  Google Scholar 

  • Mandell, D. S., Novak, M. M., & Zubritsky, C. D. (2005). Factors associated with age of diagnosis among children with autism spectrum disorders. Pediatrics, 116(6), 1480–1486.

    Google Scholar 

  • Mandell, D. S., Ittenbach, R. F., Levy, S. E., & Pinto-Martin, J. A. (2007). Disparities in diagnoses received prior to a diagnosis of autism spectrum disorder. Journal of Autism and Developmental Disorders, 37(9), 1795–1802.

    Google Scholar 

  • Mansell, W., & Morris, K. (2004). A survey of parents’ reactions to the diagnosis of an autistic spectrum disorder by a local service: Access to information and use of services. Autism, 4, 387–407.

    Google Scholar 

  • Mayer, M. L., & Skinner, A. C. (2009). Influence of changes in supply on the distribution of pediatric subspecialty care. Archives of Pediatrics and Adolescent Medicine, 163(12), 1087–1091.

    Article  Google Scholar 

  • Meadan, H., Halle, J. W., & Ebata, A. T. (2010). Families with children who have autism spectrum disorders: Stress and support. Exceptional children, 77(1), 7–36.

    Google Scholar 

  • Miller, A. R., Armstrong, R. W., Mâsse, L. C., Klassen, A. F., Shen, J., & O’Donnell, M. E. (2008). Waiting for child developmental and rehabilitation services: An overview of issues and needs. Developmental Medicine and Child Neurology, 50(11), 815–821.

    Article  Google Scholar 

  • Moodie-Dyer, A., Joyce, H. D., Anderson-Butcher, D., & Hoffman, J. (2014). Parent–caregiver experiences with the autism spectrum disorder service delivery system. Journal of Family Social Work, 17(4), 344–362.

    Article  Google Scholar 

  • Mullen, E. (1989). Mullen scales of early learning. Cranston, RI: TOTAL Child.

    Google Scholar 

  • Mullen, E. M. (1995). Mullen scales of early learning (pp. 58–64). Circle Pines, MN: AGS.

    Google Scholar 

  • Mungo, D., Ruta, L., Arrigo, V., & Mazzona, L. (2007). Impairment of quality of life in parents of children and adolescents with pervasive developmental disorder. Health and Quality of Life Outcomes, 5(22), 1–9.

    Google Scholar 

  • Olsson, M. B., & Hwang, C. P. (2001). Depression in mothers and fathers of children with intellectual disability. Journal of Intellectual Disability Research, 45(6), 535–543.

    Article  Google Scholar 

  • Peris, T. S., Teachman, B. A., & Nosek, B. A. (2008). Implicit and explicit stigma of mental illness: Links to clinical care. The Journal of Nervous and Mental Disease, 196(10), 752–760.

    Article  Google Scholar 

  • Pickard, K. E., & Ingersoll, B. R. (2016). The role of socioeconomic status on parent-reported service knowledge, service use, unmet service needs, and barriers to service use. Autism, 20(1), 106–115.

    Article  Google Scholar 

  • Robins, D. L., Fein, D., & Barton, M. L. (1999). Modified checklist for autism in toddlers (M-CHAT) follow-up interview. Author: Publisher.

    Google Scholar 

  • Robins, D. L., Casagrande, K., Barton, M., Chen, C. M. A., Dumont-Mathieu, T., & Fein, D. (2014). Validation of the modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 133(1), 37–45.

    Article  Google Scholar 

  • Rutter, M., Le Couteur, A., & Lord, C. (2003). Autism diagnostic interview-revised. Los Angeles, CA: Western Psychological Services, 29(2003), 30.

    Google Scholar 

  • Schopler, E., Van Bourgondien, M. E., Wellman, G. J., & Love, S. R. (2010). Childhood Autism rating scale (2nd ed.). Los Angeles: Western Psychological Services.

    Google Scholar 

  • Shattuck, P. T., Durkin, M., Maenner, M., Newschaffer, C., Mandell, D. S., Wiggins, L., ... & Baio, J. (2009). Timing of identification among children with an autism spectrum disorder: findings from a population-based surveillance study. Journal of the American Academy of Child & Adolescent Psychiatry, 48(5), 474–483.

    Google Scholar 

  • Siklos, S., & Kerns, K. A. (2007). Assessing the diagnostic experiences of a small sample of parents of children with autism spectrum disorders. Research in Developmental Disabilities, 28(1), 9–22.

    Article  Google Scholar 

  • Soares, N. S., Baum, R. A., & Frick, K. D. (2015). Improving developmental-behavioral pediatric care workflow. Journal of Developmental and Behavioral Pediatrics, 36(1), 45–52.

    Article  Google Scholar 

  • Sperry, L. A., Whaley, K. T., Shawn, E., & Brame, K. (1999). Services for young children with autism spectrum disorders: Voices of parents/caregivers and providers. Infants and Young Children, 11(4), 17–33.

    Article  Google Scholar 

  • Stoner, J. B., Bock, S. J., Thompson, J. R., Angell, M. E., Heyl, B. S., & Crowley, E. P. (2005). Welcome to our world: Parent perceptions of interactions between parents of young children with ASD and education professionals. Focus on Autism and Other Developmental Disabilities, 20(1), 39–51.

    Google Scholar 

  • Stuart, M., & McGrew, J. H. (2009). Caregiver burden after receiving a diagnosis of an autism spectrum disorder. Research in Autism Spectrum Disorders, 3(1), 86–97.

    Google Scholar 

  • Thomas, K. C., Parish, S. L., Rose, R. A., & Kilany, M. (2012). Access to care for children with autism in the context of state Medicaid reimbursement. Maternal and Child Health Journal, 16(8), 1636–1644.

    Article  Google Scholar 

  • U.S. Census Bureau. (2018). 2013–2017 ACS 5-year estimates. Retrieved from https://www.census.gov/quickfacts/TX.

  • Wang, L., Mandell, D. S., Lawer, L., Cidav, Z., & Leslie, D. L. (2013). Healthcare service use and costs for autism spectrum disorder: a comparison between Medicaid and private insurance. Journal of Autism and Developmental Disorders, 43(5), 1057–1064.

    Article  Google Scholar 

  • Weiss, J. A., Wingsiong, A., & Lunsky, Y. (2014). Defining crisis in families of individuals with autism spectrum disorders. Autism, 18(8), 985–995.

    Google Scholar 

  • Werling, D. M., & Geschwind, D. H. (2013). Sex differences in autism spectrum disorders. Current Opinion in Neurology, 26(2), 146.

    Article  Google Scholar 

  • Williams-Arya, P., Anixt, J., Kuan, L., Johnson, H., Kent, B., Bing, N., et al. (2019). Improving access to diagnostic assessments for Autism spectrum disorder using an arena model. Journal of Developmental and Behavioral Pediatrics, 40(3), 161–169.

    PubMed  Google Scholar 

  • Zwaigenbaum, L., Bauman, M. L., Fein, D., Pierce, K., Buie, T., Davis, P. A., et al. (2015). Early screening of autism spectrum disorder: Recommendations for practice and research. Pediatrics, 136(Supplement 1), S41–S59.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Psychiatry, The University of Texas at Austin, Austin, TX, USA

    Meredith I. Holley

  2. Developmental-Behavioral Pediatrics, Dell Children’s Medical Group, Austin, TX, USA

    Sheri Ravenscroft

  3. Department of Educational Psychology, The University of Texas at Austin, Austin, TX, USA

    Briana Brukilacchio, Morgan Engelmann & Autumn Fikki

Authors
  1. Meredith I. Holley
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  2. Sheri Ravenscroft
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  3. Briana Brukilacchio
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  4. Morgan Engelmann
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  5. Autumn Fikki
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Corresponding author

Correspondence to Meredith I. Holley .

Editor information

Editors and Affiliations

  1. Department of Psychology, Utah State University, Logan, UT, USA

    Maryellen Brunson McClain

  2. Department of Psychiatry, University of Texas at Austin Dell Medical School, Austin, TX, USA

    Jeffrey D. Shahidullah

  3. Department of Educational Psychology, Miami University, Oxford, OH, USA

    Katherine R. Mezher

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Holley, M.I., Ravenscroft, S., Brukilacchio, B., Engelmann, M., Fikki, A. (2020). Dell Children’s (S)TAAR Model of Early Autism Assessment. In: McClain, M., Shahidullah, J., Mezher, K. (eds) Interprofessional Care Coordination for Pediatric Autism Spectrum Disorder. Springer, Cham. https://doi.org/10.1007/978-3-030-46295-6_6

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