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Ann T. Cutler, MD acutler@uic.edu Department of Disability and Human Development College of Applied Health Sciences Univ

Supports and Gaps for Children with Autism Disability Rights Consortium 7-22-09. Ann T. Cutler, MD acutler@uic.edu Department of Disability and Human Development College of Applied Health Sciences University of Illinois at Chicago. Disclosure Information.

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Ann T. Cutler, MD acutler@uic.edu Department of Disability and Human Development College of Applied Health Sciences Univ

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  1. Supports and Gaps for Children with Autism Disability Rights Consortium 7-22-09 Ann T. Cutler, MD acutler@uic.edu Department of Disability and Human Development College of Applied Health Sciences University of Illinois at Chicago

  2. Disclosure Information • I have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider of commercial services discussed in this presentation. • I do not intend to discuss commercial products or services and unapproved/investigative uses of a commercial product/device in my presentation

  3. Building Capacity Screening Diagnostic Services Treatment Family Support

  4. The Combating Autism Act • Authorizes approximately $920 million for expanded activities related to autism spectrum disorders over a five-year period (FY2007-FY 2011). • Activities covered under the act include screening, surveillance, education, early intervention, prompt referrals for treatment and services, and research. • For more information: http://mchb.hrsa.gov/autism/default.htm

  5. Combating Autism Act Initiative Programs • Leadership Education in Neuro-developmental & Related Disorders (LEND) Training programs • Developmental-Behavioral Pediatrics Training Grants • Resource Centers • State Demonstration Grants • Research Networks and Nodes

  6. What is LEND? LeadershipEducation inNeurodevelopmentalDisabilities • Overarching Goal:Provide continuing education, consultation and technical assistance geared to the needs of MCH Health professionals, policymakers and families • Funded by Maternal and Child Health Bureau (MCH) • Based on the Combating Autism Act • A national network of LENDs (www.aucd.org)

  7. Illinois LEND: A Partnership • University of Illinois at Chicago: • IDHD Family Clinics and Units • UIC Autism Center of Excellence • The Autism Program (TAP) of Illinois • Children’s Mental Health and Developmental Neuroscience Center • University of Chicago: Developmental and Behavioral Pediatrics • Rush University: Speech and Hearing • Collaboration with community agencies and Illinois Title Five Maternal and Child Health (MCH) Programs

  8. LEND Disciplines • Child Psychiatry • Disability Studies • Family • Nursing • Nutrition • Occupational Therapy • Pediatrics • Physical Therapy • Psychology • Public Health • Social Work • Speech and Hearing

  9. What’s Happening In Medicine???

  10. American Academy of Pediatrics Policy • It is important that pediatricians be able to recognize the signs and symptoms of autism spectrum disorders and have a strategy for assessing them systematically. Pediatricians also must be aware of local resources that can assist in the diagnosis of and the management of ASD. • Pediatrics Vol. 120 No. 5 Nov. 2007

  11. Screening and Surveillance Algorithm

  12. Language Delay:Absolute indications for immediate evaluationAmerican Academy of Child Neurology 2006

  13. Illinois Chapter of AAP (ICAAP): Enhancing Developmentally Oriented Primary Care

  14. EDOPC at a Glance Goals • Improve delivery and financing of preventive health and developmental services for children birth to three • Build on existing programs to develop a range of strategies for primary care settings

  15. EDOPC at a Glance • Collaborative project • Advocate Health Care Healthy Steps Program • Illinois Chapter, American Academy of Pediatrics (ICAAP) • Illinois Academy of Family Physicians (IAFP) • 2005 through 2010 • Multiple funders

  16. EDOPC at a Glance:Who Has Been Trained

  17. EDOPC Tools • Training • Academic detailing in the practice for all staff • Peer-to-peer faculty • Resource Toolkits • Technical Assistance • Monthly conference calls • Face to face consulting • Phone consultation • EDOPC Web site

  18. ICAAP/TAP Collaboration • Primary care physician training on early identification; especially in rural areas • Establishing a network of interdisciplinary diagnostic teams • Establishing autism medical homes for family partnerships regarding coordination of supports • Transition • Funding!!

  19. Autism Advocacy Initiative • A network of IL physicians to represent physicians at the local and state level on issues related to autism • The primary mission is to advocate for evidence based treatments • To reach out and provide support to adult medical providers

  20. Access to Treatment for All • Current evidence-based practices for autism: • Applied Behavior Analysis (ABA)1, [i], [ii] • Discrete Trial Teaching1 • Pivotal Response Training1 • Learning Experiences: An Alternative Program for Preschoolers and Parents (LEAP)1 • Treatments Considered “Promising Practices”: • Picture Exchange Communication System (PECS)Incidental TeachingStructured Teaching (TEACHH)Augmentative/Alternative CommunicationAssistive TechnologyJoint Action RoutinesCognitive Behavioral ModificationCognitive Learning Strategies Social StoriesSocial Decision-Making StrategiesSensory Integration [i] Rogers, S. J. & Vismara, L. A. (2008). Journal of Clinical Child & Adolescent Behaviors, 37 (1), 8-38. • [ii] New York State Department of Public Health Early Intervention Program (2005). Report of the Recommendations: Autism/Pervasive Developmental Disorders. New York: Department of Public Health.

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