Extension for Community Health Outcome (ECHO) Autism - Uruguay: A Coordinated Strategy to Improve Access to Health Care for Children with Autism Spectrum Disorders.
Objectives: To share the experience of the ECHO Autism program in Uruguay during the first three years of implementation, including analysis of case presentations and participates self-perception of skills and knowledge gained.
Methods: Analysis of ECHO Autism clinics from June 12, 2015 to June 8, 2018 including clinical cases presented and participant’s self-perception of changes in skills and competences. The following skills and competencies were assessed: identifying developmental delay including autism before age 3, autism diagnosis, support family needs, comorbidity management, psychopharmacology, resource attainment and interprofessional communication.
Results: 30 ECHO Autism clinics were conducted during the study period. Thirty clinical cases were presented: mean age 4.5 years old (range 1– 12); most of them were male (n=25). Twenty patients presented with medical and psychiatric comorbidities, eight of them with two or more. Reasons for presentation in the ECHO Autism clinic were: difficulties in therapeutic approach focused on management of comorbidities (n=22) and diagnosis (n=8). Median age at time of concern was 18th months (range 12-60). Forty-five participants were connected in at least 50% of ECHO Autism clinics. After ECHO Autism implementation, a statistically significant improvement in participant self-perception of skills and competences in all fields evaluated was observed.
Conclusions: ECHO Autism is the first ECHO project in Uruguay focused on a primarily pediatric condition. The results of this experience shows that ECHO Autism is feasible and effective in this population. Additionally, it has an important role to improve access to diagnosis and treatment of children with autism spectrum disorder. A community of practice was achieved through participation in the ECHO Autism clinics, and self-perception about skills and competences in diagnosis and treatment of ASD improved. ECHO Autism in Uruguay is a meaningful approach to autism care and offers improved access to best practice care.