early identification & linkage for autism and other developmental disabilities
TRANSCRIPT
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Welcome to the USC UCEDD Parent/Consumer Webinar Series
funded by grant #90DD0695 from
the Administration on Intellectual and Developmental Disabilities (AIDD) Administration on Community Living
January 28, 2016
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Your Moderator
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Susan Kanegawa USC UCEDD Family Support Coordinator [email protected] www.uscucedd.org
The USC University Center of Excellence in Developmental Disabilities at Children’s Hospital Los Angeles (USC UCEDD) is one of 68 UCEDDs funded to promote systemic change, advocacy, and capacity building in states on behalf of individuals with, or at risk for, developmental, behavioral and/or special health care needs and their families. The USC UCEDD Webinar series is designed to educate the community about current policy issues which impact the lives of people we serve and their families. Our primary audience is individuals with special needs and their families. However, service providers, program managers, students in training and others are welcome as space allows. At this time, our webinars are in English only. We are exploring methods to make this series available in other languages in the future.
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Structure and Logistics
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Early Identification and Linkage for Autism
and other Developmental Disabilities
Marian E. Williams, PhD Associate Professor of Clinical Pediatrics
Program Area Lead, Early Childhood Mental Health Programs
January 28, 2016
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About Marian Williams, PhD Marian Williams is at the USC UCEDD as an Associate Professor of Clinical Pediatrics and is Program Area Lead in Early Childhood Mental Health Programs, as well as Co-Director of Interdisciplinary Training. www.uscucedd.org [email protected]
Marian Williams is a licensed psychologist specializing in infant-family and early childhood mental health and developmental disabilities in children. She heads the Training and Technical Assistance project for First Connections, a three-year project funded by First 5 LA to enhance developmental screening and linkage for young children from underserved communities. She conducts research on diagnosis and assessment of autism spectrum disorders, access to care for young children with disabilities, and development of bilingual children.
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Overview of the Webinar
About the Early ID Program,
First Connections
Screening Red Flags Recommended
Services
How to keep children from
falling through the cracks
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About the Early ID Program,
First Connections
Screening Red Flags Recommended
Services
How to keep children from
falling through the cracks
First Connections is 3-year project funded by First 5 LA
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First Connections Objectives
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1. Community agencies learn to screen young children and link families to community services
2. Underserved young children and families have better access to developmental screenings and early intervention services.
3. Parents learn about healthy development and developmental delays
4. Parents get support in parenting children who have developmental delays.
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First Connections Partnership
• USC University Center for Excellence in Developmental Disabilities (Training and Technical Assistance Lead)
• Three Federally Qualified Health Centers: • AltaMed Health Services
• Eisner Pediatric and Family Medical Center
• Northeast Valley Health Corporation
• Two family service agencies: • Foothill Family Service
• Westside Children’s Center
• Family Resource Center: • South Central Los Angeles Regional Center Family Resource Center
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First Connections Activities
• Train community providers in developmental screening and linkage
• Screen children ages birth to 5
• Educate parents about developmental milestones and services
• Link families to early intervention, family support, special education, and more
• Do screening outreach at libraries and community events
• Task Force reviews policies to support universal developmental screening and coordinated services
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Why is developmental screening important?
What does good screening include?
About the Early ID Program,
First Connections
Screening Red Flags Recommended
Services
How to keep children from
falling through the cracks
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Infographic: A Healthy Beginning
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Why is developmental screening important?
• Nearly 85% of brain development happens in the first three years of life
• 1 in 4 young children are at risk for developmental delay
• 2 in 5 parents with children under age 6 have concerns about their child’s development
• The number of children with autism spectrum disorder is growing
• Early intervention helps children with developmental delays or autism do better in school, and later in life
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What is recommended for developmental screening?
• Pediatricians recommend that all children get routine screening between birth and age 3 years
• Parents know their children best: – Screening should focus on asking parents to share what they know about their child
• Professionals have developed screening tools that: – are completed by parents or other caregivers
– can be quickly scored
– help doctors, teachers, or other professionals to see if child is on track in development compared to other children same age
– help parents learn about developmental milestones
– include activities parents can try with their child
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What does good screening include?
• Regular use of a screening tool that is completed by a parent and has been tested on thousands of children (including from different cultures and language backgrounds)
• Covers all the key areas of development
– Gross motor and fine motor
– Language and communication
– Cognitive and problem-solving
– Social and emotional
– Signs of autism spectrum disorder
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What are red flags for autism spectrum disorder in young children?
About the Early ID Program,
First Connections
Screening Red Flags Recommended
Services
How to keep children from
falling through the cracks
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What is Autism Spectrum Disorder?
• Developmental disorder (starts very young)
• Neurodevelopmental (based in differences in the brain)
• Main difficulty is with social interactions and social communication
• Includes repetitive behaviors and interests that take the place of more functional activities
• Makes it hard for the child to function in relationships, school, family life, community
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How early can we identify autism spectrum disorder?
• We can now diagnose autism accurately by age 2
• In many children, autism can be identified as young as 12 to 18 months
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Red Flags in Toddlers: What is Missing? • Communicating with others through:
– Babbling
– Gestures
– Pointing
• Social interactions such as: – Wanting to share/show something they enjoy with others
– Trying to get others to play with them or watch them
– Showing excitement when parent comes in the room
– Imitating others (actions, sounds, faces, etc.)
– Making eye contact
– Responding when their name is called
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Red Flags in Toddlers: What do we see more of?
• Intense visual inspection of objects
• Repetitive actions such as:
– tapping objects
– spinning objects
• Negative mood
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Learn More About Red Flags and Autism
• Autism Speaks video library – www.autismspeaks.org
– Video glossary
• Autism Navigator – www.autismnavigator.com
– Web-based tools with video examples
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About the Early ID Program,
First Connections
Screening Red Flags Recommended
Services
How to keep children from
falling through the cracks
What services are recommended for young children?
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Early Intervention Services • All states have early intervention services for children ages birth to
3 years, who have developmental delays
• The earlier services start, the better
• Many children who get early intervention can go to regular school when they get to preschool or kindergarten
• Services can be offered at home and/or in a center-based program
• Parents should be involved in every aspect of services
• Services should focus on the areas of development that are delayed
• Services should be fun, play-like, child-led, and enjoyable for child and parent
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Early Intervention for Autism • There are special services designed for young children with autism.
• Some examples are:
– Applied Behavior Analysis (ABA)
– Early Start Denver Model
– Pivotal Response Treatment
• Parents can help by practicing strategies during regular routines and playtimes
• Book called An Early Start for your Child with Autism: Using Everyday Activities to Help Kids Connect, Communicate, and Learn (by Rogers, Dawson, & Vismara) has lots of ideas for parents to try at home
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About the Early ID Program,
First Connections
Screening Red Flags Recommended
Services
How to keep children from
falling through the cracks
How are we doing with identifying kids in need and linking them to services?
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Are children falling through the cracks?
• Fewer than 1 in 3 children in California are getting screenings recommended by American Academy of Pediatrics
• California ranks 30th in nation on rate of infant and toddler developmental screenings
• Parents with children with autism usually first have concerns – by age 18 to 24 months, yet
– most children are not diagnosed with autism until age 4 or 5 years
• That 2+ year gap means many children miss the window for early intervention
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Which children are most likely to miss out?
• Children from non-White ethnic backgrounds
• Children living in poverty
• Children without health insurance
– Less likely to get routine developmental screenings
– Less likely to have a medical home
– Diagnosed later if they have autism spectrum disorder
– More likely to be diagnosed with the wrong disorder, instead of autism
– Less likely to get comprehensive early intervention services
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What can be done to make sure children don’t fall through the cracks?
• Universal developmental screening
• Programs like First Connections that screen children in – Well-child visits with their medical provider
– Day care centers
– Early Head Start/Head Start/Preschools
• Education for parents about developmental milestones, red flags, importance of screening
• Public information about disparities in access for underserved populations
• Advocating for funding and fair distribution
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Poll: Do you now have a better understanding of
early identification and linkage for autism and other developmental disabilities?
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