All Hands on Deck: Increasing Knowledge of Autism Signs and Symptoms By Evaluators in the Part C System Toward Earlier Detection and Referral for Early Intervention Services

Background:

Despite evidence that early intervention (EI) for Autism Spectrum Disorder (ASD) can improve language and behavior and optimize outcomes for children by making crucial differences in early brain development (Dawson et al, 2012), only a fraction of children with ASD are identified in early childhood (Baio et al, 2018). Standardized ASD screening procedures and knowledge are not yet in widespread practice in pediatric settings (Radecki et al 2011); however, implementation of these procedures community-wide is needed to address disparities in age of detection based on many factors (Giarelli et al 2010). In many communities, EI providers also lack sufficient training to recognize red flags for ASD (Zwaigenbaum et al, 2015; IACC, 2017).

Objectives:

Evaluators are among the first professionals to see children referred for delays and are in the pivotal position of using assessments and clinical judgment to refer children with developmental delays meeting criteria for services in the Part C system. This project aimed to increase evaluators’ knowledge and comfort with early detection of ASD in infants and toddlers by providing access to an 8 hour web-based course and conducting three webinars to support participants’ learning.

Methods:

This study examined the feasibility and impact of providing training to 20 EI evaluators on red flags for ASD in toddlers. The study utilized automated completion and mastery metrics as well as surveys on a Likert scale. Participants also provided text responses to reflect options not listed. This exploratory study examined demographics, education level, professional role, impact on knowledge and comfort with identifying ASD, willingness to discuss ASD with families, and satisfaction with the training.

Results:

• 20 EI evaluators represented 8 of 18 districts
• 3 districts served a highly populated metro area; 5 served rural areas .
• 75% MA degree; 25% BA degree
• 3 SLPS, 12 intake coordinators,13 special instructors. Several individuals held more than one role.
• 70% of participants participated in all three webinars.
  • 47% of participants completed all six modules
  • 37% of participants did not complete modules
  • 50% responded to both a pre- and post-survey.
    • From pre- to post, participants reported an increase in knowledge and confidence in:
      • describing red flags for ASD to families
      • answering questions about ASD
      • creating IFSP goals to address social communication deficits.
    • All participants reported that the webinars were relevant and engaging and that the best way to learn is through both online modules AND webinars

Conclusions:

Data gathered from participants indicated high satisfaction with the project and an overall increase in evaluators’ confidence in identifying and describing red flags for ASD in young children. This data informs future collaborations in the community with the goals of supporting EI evaluators to deepen their knowledge of ASD in toddlers, their ability to describe red flags for ASD to families during the EI evaluation process, and building the capacity in the Part C system to identify and provide evidence-based intervention for children who are at-risk for autism. This project could easily be replicated statewide and child and family outcomes measured.