Early Childhood Autism Diagnosis Project

• Calls to MCPAP line about children 1-5 are triaged by an Early Childhood Behavioral Health Clinician.
• Cases where the primary question is Autism Diagnosis and the Primary Care Clinician (PCC) agrees to collaborative process are further triaged:
• For children <3 we require a positive ASD screen (for example, MCHAT by PCC, and encourage Early Intervention referral or sharing of evaluation if completed.
• For children 3-5, must have concerns about
  • Deficits in social communication and social interaction
  • Restricted, repetitive patterns of behavior, interest, or activities.  
• Children who meet the above criteria are referred to Autism evaluation with Early Childhood Licensed Independent Social Worker (LICSW) trained in conducting a semi-structured diagnostic interview, using the Childhood Autism Rating Scale™, Second Edition, (CARS-2).
• LICSW offers a 2-session evaluation & feedback using CARS-2 which helps to identify children with autism and determine symptom severity through quantifiable ratings based on direct observation.
• Diagnostic impressions are shared with the family.
• LICSW’s note includes CARS-2 assessment and DSM-5 criteria and is shared with PCC and family through a standardized letter.
• PCC signs off on the diagnosis using the information in the letter. 
• Family Partner help PCC/family with resources and referrals and offers added support. 
• The expectation is that the majority of children with ASD can have the diagnosis formally made by a PCC. However, some children with more complicated clinical presentations will still require a specialist evaluation.  MCPAP for Early Childhood will have sufficient specialist consultants to serve those children so they do not need to go to the “back of the line” with a referral to a specialty service.
• Currently, the early ASD Diagnosis program is only available in the Central-Western part of the state (UMASS/Baystate hubs) supported by a PMHCA HRSA grant.  With the calculation that statewide approximately 10 children per business day will need diagnosing, the expectation is to spread this service to the entire Commonwealth over the next year.

Additional Resources for Autism Evaluation and Diagnosis in Primary Care

 Autism Diagnostic Tip Sheet

The AAP Autism Pedialink CME/MOC course

Identifying Austism Spectrum Course is also a great place to start.

Other good online resources include: 

The AAP clinical report 

AAP ASD Patient Care Page

Autism Intervention Research Network on Physical Health

Autism Care Network

The AAP Council on Children with Disabilities has periodic information/education sessions regarding new developments in autism. 

ECHO Autism  is another program that can offer training and education to pediatricians looking to learn more.

The CDC Act Early  has an autism case training video series. CDC Act Early Documents.  

The Vanderbilt Kennedy Center’s Treatment and Research Institute for Autism Spectrum Disorder offers several resources for training on various assessment tools (STAT, ASD-PEDS, ADOS) and online modules through their TRIAD online learning platform.  Triad Diagnostic Trainings