University of Wyoming Echo for Autism: Leveraging Education Systems to Provide Behavioral Services in Frontier Communities.

Background: Individuals with autism who live in rural/frontier communities often face numerous challenges accessing services. For example, in Wyoming, there are only a handful of trained professionals with experience in autism to serve the whole state and most individuals with autism live hundreds of miles away from a skilled provider. Given this, most families must rely on the educational system to access even basic services. Unfortunately, many educators receive little to no training on how to support such students with autism. Therefore, professional development opportunities are critical to enhance the capacity of educators to support students with autism. Project ECHOÔ was originally developed to overcome similar challenges facing physicians. University of Wyoming has adapted ECHO to enhance educators’ knowledge and skills related to behavioral strategies for autism, and implemented it throughout the state over the last two school years.

Objectives: 1) To describe the adaptation of ECHO for Education: Autism, 2) to the describe the ability of this program to reach remote schools, 3) to describe the impact of this program on teacher knowledge and skills, and 4) describe additional adaptations being made to the model to further support families to work with their schools on behavioral supports.

Methods: Starting in the 2016-2017 school year, ECHO for Education: Autism was deployed in each of the 48 Wyoming school districts . In line with agreements with the state, each session was free and open to anyone. As a result, participants included teachers, paraprofessionals, allied health professionals, administrators, principals and family members. Attendance was tracked at each session using the iECHO platform used by all ECHO replication sites. Change in educator knowledge and skill was assessed using a traditional and retrospective pre/post design (before and after the school year) and weekly evaluation questionnaires.

Results: After two years of implementation, this program has offered a total of 68 weekly sessions and served 307 unduplicated participants (1247 duplicated participants). Participants have come from all 48 school districts in the state. Weekly evaluations revealed a large impact on participants’ self-reported skills, M_pre = 2.89 (.87), M_post = 3.37 (.78), t = 18.27, p <.001, d = .58, and knowledge, M_pre = 2.89 (.83), M_post = 3.57 (.73), t = 20.6, p <.001, d = .75. Traditional pre/post assessments revealed knowledge and skills significantly improved over the school year, M_pre = 3.06 (1.14), M_post = 3.79 (.82), t = 4.38, p <.001, d = .74; retrospective pre/post revealed a similar effect, M_pre = 2.87 (1.19), M_post = 3.40 (1.03), t = 4.49, p <.001, d = .48.

Conclusions: ECHO for Education: Autism had significant reach statewide. It also seems to have improved skills and knowledge, although it remains unclear how much this has impacted student level outcomes. Based on this success, an additional network for families of children with autism was developed and is undergoing testing. This model has the potential to improve capacity of education systems in rural settings to serve students with autism. Additional research is needed to understand student academic and behavioral outcomes.