P2.054: Improving Access to Developmental-Behavioral Pediatrics through Collaboration

Purpose/Objectives: Evidence shows that early intervention is best for children with autism spectrum disorder (ASD). However, access to developmental-behavioral pediatrics (DBP) care, including ASD diagnostic evaluation, is limited. Our DBP team sought to improve access to DBP care through a collaboration with speech-language pathologists (SLPs) within our hospital system which included an additional training opportunity for SLPs.

Design/Methods: Two SLPs completed formal Autism Diagnostic Observation Schedule-2 (ADOS-2) training with the support of the Caregiver of the Future, ASD Education Pediatric Therapy Services Grant through the Cleveland Clinic Education Institute. The SLPs subsequently completed clinical ADOS-2 training with DBP faculty members over a period of 6 months. The pilot collaboration included one DBP and one SLP forming a team to complete ASD diagnostic evaluations through the Autism Evaluation Clinic (AEC). Children less than 4 years of age who were at high risk for autism on DBP intake paperwork were eligible for the AEC (Figure 1). ASD evaluation included a medical and developmental evaluation with a DBP and an ADOS-2 and speech/language testing (if not yet performed) with the SLP within a single morning. The DBP and SLP had a brief conference to discuss the patients after their respective portions of the evaluation were completed. The family met with the DBP at a subsequent appointment to discuss results and recommendations.

Results: Using a collaborative model for ASD evaluation, DBP availability was increased by 16 hours per month. This has allowed for the DBP to see an additional 21.3 follow-up appointments per month or perform an additional 3.8 complete ASD evaluations (with ADOS-2 completed by the DBP). The DBP and SLP involved in the pilot of the collaboration reported high satisfaction with the collaborative relationship and the clinic's process and structure.

Conclusion/Discussion: Collaboration between DBP and SLP for ASD diagnostic evaluations resulted in increased access to DBP care. Steps to support further access include training additional SLPs in the ADOS-2 and expansion of the collaboration to other clinical locations and providers.