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Autism Speaks & The Early Access to Care Initiative Jamitha Fields Autism Speaks Collaborators: Rosa Avila, Christina Bethell, Amy Daniels AUCD 2014 November 11, 2014 The power of early intervention • The bottom line: the earlier we can intervene in a child’s life, the better • How? – Intensive behavioral interventions: trained therapist working 1:1 w/ child, multiple hours/week • Evidence-based behavioral interventions can significantly impact a child’s – – – – Cognition Adaptive behavior Social interaction Language • Mounting evidence of long term benefits The path to early intervention Surveillance Screening Diagnosis Early Intervention The main challenges Delayed diagnosis Large gap between age at which reliable diagnosis of autism can be made (24 months) and average age at diagnosis (4-5 years) Ethnic disparities in identification and diagnosis Racial and ethnic minorities are identified less frequently and diagnosed later than white counterparts. Culturally-specific barriers may compound structural barriers to care Early Access to Care Organization-wide initiative to lower the age at diagnosis and increase access to EI services Focus on underserved populations Awareness campaign with the Ad Council (PSA Central) Early Access to Care Early Access to Care Early Access to Care Resources for professionals http://www.autismspeaks.org/earl y-access-care/professionals Screening events Research to understand/address barriers to diagnosis/services in underserved communities with focus on culturally adapted: Screening in primary care Early intervention Early Access to Care Outcomes to date: • Over 10K individuals access MCHAT-R/month • Three community screening events • Increase in inquiries by linguistic minority communities – Spanish M-CHAT-R – Calls to autism response team – Targeted community initiatives (NYC Korea Community Autism Project) Data Resource Center (DRC) Goals The DRC is a Child & Adolescent Health Measurements Initiative (CAHMI) project that aims to: 1) Provide centralized, user-friendly, interactive access to standardized national, regional and state-level findings from national surveys on child and adolescent health and well-being. 2) Build shared knowledge, capacity, and inspiration for using data to stimulate and inform system change locally and nationally—especially among state health agency leaders and staff, family advocates and policy leaders. Leveraging national data to advance Early Access to Care CAHMI & Autism Speaks are collaborating to: • Develop an easy to use web-based data query of the Survey of Pathways to Diagnosis & Services by April 2015 – “Point-and-click” interactive access to Pathways data – Quick-glance “Learn about the Survey” resources – Data and methods reports • Develop an ASD web portal by April 2016 – Provide resources & information on ASD for families, policy makers, advocates, and researchers – Provide data briefs and a chartbook on ASD among US children The Survey of Pathways to Diagnosis and Services, 2011 Goal: To help researchers & policymakers understand the processes by which learning and developmental conditions are diagnosed and treated Design: Follow-up survey of the 2009 -2010 National Survey of Children with Special Health Care Needs Mode: Telephone survey followed by a mailed SelfAdministered Questionnaire Eligibility: CSHCN aged 6-17 years identified as having ever been diagnosed with ASD, ID and/or DD Sample: 4,032 completed telephone interviews Results from Pathways Children Ages 6-17 Years Old Diagnosed with ASD by Race/Ethnicity 10.1% 13.0% Hispanic (N=118) 10.7% NH-Black (N=89) NH-White (N=1056) NH-Other (N=145) 66.2% Note: The Pathways survey was not administered in Spanish. Hispanic children with ASD from homes where Spanish is the primary language may be under-represented. Results from Pathways Age of ASD Diagnosis by Race/Ethnicity NH-Other 21.7 NH-White 63.5 28.9 NH-Black 64.8 29.7 Hispanic 66.9 25.4 0% 20% < 1 Yrs Old 1 to <2 Yrs Old 2 to <3 Yrs Old 4 Yrs or Older 61.2 40% 60% 80% 100% Results from Pathways Had Early Intervention Services before age 3 by Race/Ethnicity 70.0 61.9 56.2 60.0 Percent 50.0 42.7 40.2 40.0 30.0 20.0 10.0 0.0 Hispanic (N=118) NH-Black (N=89) NH-White (N=1053) NH-Other (N=142) Early Access to Care Connecting with the community: • Facebook: EarlyAccessToCare • Twitter: @AutismSpeaksEAC • Instagram: @AutismSpeaksEAC • Email: [email protected] Collaborators Child and Adolescent Health Measurement Initiative, JHSPH Christina Bethell, PI Rosa Avila Narangerel Gombojav Scott Stumbo Elsa Sweek Autism Speaks Amy Daniels Nicole Jones Families CDC Team Cathy Rice Brian Barger Thank you! www.autismspeaks.org