Cutting-Edge Practice

Virtual Autism Diagnostic Clinic

State/Jurisdiction: Pennsylvania
Setting: Home-Based
Population: Child Health, CYSHCN,
Topic Area: Health Equity, Health Screening & Promotion, Access to Health Care/Insurance, Service Coordination & Integration, Telehealth,
NPMs: NPM 6: Developmental Screening NPM 11: Medical Home NPM 15: Adequate Insurance

In 2018, the Autism Diagnostic Clinic (ADC) was a pilot program conducted as a hybrid telehealth model. Caregivers and their toddler arrived in-person at our clinic in Reading, PA where a trained examiner administered a play-based assessment called the ADOS (Autism Diagnostic Observation Schedule). Offsite, using an advanced camera system, a developmental nurse practitioner and a developmental pediatrician observed child and clinician interactions as well as caregiver and child interactions. Clinicians then discussed the intricate scoring based on each other’s shared conclusions. This model reduced cost and travel time and created an easily accessible alternative to our community. In 2020, the COVID-19 pandemic interrupted services and necessitated the implementation of a fully virtual model, which resulted in a dramatic improvement in delivery and effectiveness. It is now our preferred method of operation. Easterseals Eastern Pennsylvania primarily serves families with lower incomes and provides its specialty medical clinics at no cost. We partner with three different county Birth to Three Early Intervention systems to provide early autism identification. Toddlers in the Early Intervention system have already been identified with a developmental delay or disability. The child is further assessed using the M-CHAT autism screening tool to determine his/her risk factor for Autism Spectrum Disorder. Children who score 8 or higher are referred to Easterseals Autism Diagnostic Clinic (ADC) for an evaluation. The ADC provides a virtual, home-based model so that families do not have to travel for services, the child is evaluated in familiar surroundings, and geographic barriers are eliminated. The wait time for an evaluation with Easterseals ADC is less than six months while wait time through other clinics and hospitals is over one year. The average age of children diagnosed through Easterseals is age 2, while the national average is age 4. Easterseals contracts with diagnosticians from Children’s Hospital of Pennsylvania (CHOP) and St. Christopher’s Hospital for Children to conduct the evaluation virtually in partnership with its clinicians. Both the St. Christopher’s psychologist and Easterseals autism program manager are bilingual in Spanish. This allows us to effectively reach a wider audience of people who are underserved. The psychologist provides an educational classification, reducing the need for an additional evaluation through the local intermediate unit (ages 3-5 Early Intervention). A written order for behavioral health services is also provided, reducing the need for an additional evaluation through the behavioral health system. As appropriate, we can conduct the Vineland Adaptive Behavioral Scale, sometimes required for IDD (Intellectual and Developmental Disabilities) case management services.

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Implementation Handout
Diagnostic Clinic Intake Checklist

Easterseals Eastern PA
Jill R. Glose, M.A. VP Clinical Services
Practice Website
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