Physician Training and Education
Dr. Seay, a developmental pediatrician and stakeholder on the ESI project, provides a link to the medical community and Early Intervention through Children’s Medical Services (CMS). This allows for the education and training of area pediatricians on the importance of early identification and intervention for children with autism spectrum disorders. Dr. Seay shares her perspective with the medical community in this interview:
"One of the things that I have learned over time to pay a lot of attention to is parent report because I may not see the abnormality in a ten or fifteen minute office visit…I think sometimes physicians make the mistake of if you don’t see it yourself in the very brief office visit, then it’s not there and it’s not really true.
So my plea would be to expose yourself to this [autism spectrum] diagnosis, to update yourself on this diagnosis and this spectrum and the current thinking about it, and to be willing to work as a participant in a multidisciplinary approach in trying to get these children services in all they can benefit from services in. That means we’ve got to learn and talk to occupational and physical therapists, speech therapists, and sometimes counselors and educators, as well as other medical professionals, in order to really find out what this child needs and how to make sure all the bases are getting covered appropriately.
I think that if there’s any suspicion on either the family’s part or the professional’s part you have nothing to lose by doing some early intervention. If the red flags turn out to be correct, then you’re ahead of the game for the child. If the red flags turn out to be incorrect, you’ve lost nothing except a little bit of your time, which I don’t think is lost because time spent working with a child is going to be supportive of development, whether it’s normal or problematic levels of development.
We may want to reassure pediatricians that they’re not out there by themselves in trying to deal with children on the spectrum. There are a lot of resources, a lot of people who are willing to help. You just have to learn to network with those people and identify the resources in your area.
I think early intervention is really critical. The long-term outcomes, the long-term results in terms of functionality, are directly correlated with how early the interventions are begun and how intensively they are carried out."
The key to early identification of children with ASD is working closely with the medical community. Most children obtain health care on an ongoing basis from birth, giving physicians an opportunity to develop ongoing, trusting, confidential relationships with families. Many parents consider their physician a trusted advisor on the health and development of their child, an ideal position for identifying and referring children with developmental delays.
It is essential for physicians to be able to identify young children at risk for ASD, refer the children for appropriate assessment, and assist the family with information and resources. Training and education in the Tallahassee area include the following activities:
- Visits by the Project Coordinator were scheduled to local pediatricians’ offices. The “First Signs Screening Kit” was provided to local pediatricians, nurses and office staff. This kit contains an informational video that highlights the developmental differences of typical children as compared to those with autism spectrum disorders. The kit also includes developmental screening tools and a listing of early intervention services in the Tallahassee area (provide link www.firstsigns.org).
- Area physicians are provided with information on the First Words Project to screen for communication delays in children younger than 24 months of age (provide link http://firstwords.fsu.edu). The CSBS-DP Infant/Toddler Checklist, completed by parents, can identify children in need of further evaluation. Some physicians’ offices have chosen to screen all children in their practice at 12 or 18 months of age. Others use the checklist when families express concerns or when the physician observes red flags for delays in social communication development.
- A parent of a child diagnosed with autism, participating in ESI, visits
pediatrician’s offices and offers information the importance of early
identification of children at risk for developing autism spectrum disorders
from the parent’s perspective.
Collaboration with Community Providers
ESI project staff work in collaboration with community providers to better meet the needs of the children being served through the Project. We strive to plan and provide cohesive, coordinated and integrated intervention and evaluation activities. Collaborations are wrapped around the child and family and include information sharing, joint planning, and program monitoring with:
- Speech pathologists
- Physical therapists
- Occupational therapists
- Family service coordinators through Children’s Home Society
- Early intervention providers
- Physicians
Collaboration with Child Care Providers
Many children enrolled in the ESI Project are enrolled in community child care programs. We work closely with the teachers in those programs to identify the child’s strengths and needs in their classroom, share developmental information, and provide training and technical assistance for embedding intervention in classroom routines. We listen carefully to their observations, questions, and suggestions to provide support and work together to meet the child’s needs.
- Project staff shares information and intervention support with child care providers on issues related to early social communication and challenging behavior.
- Child care providers are encouraged to use the CSBS-DP Infant/Toddler Checklist, a screening instrument for children who may have or may be at-risk for developing a communication impairment.
- ESI project staff consults directly with child care providers serving children enrolled in the ESI project, provide visual supports, embed intervention into child care routines and activities, and monitor programs.
Community Training on Early Intervention
- Community trained on Autism Diagnostic Observation Schedule (ADOS)
- Training provided to the diagnostic teams and Family Service Coordinators at Children’s Home Society (CHS) on the early identification of ASD.