Determining Presumptive Eligibility for Early Intensive Behavioral Intervention Using Two Positive Screens:
A South Carolina Act Early Work in Progress
Jane Charles, MD, Kristie Musick, MA, Kathi Lacy, PhD.
South Carolina Act Early Team
BACKGROUND
March
2012
CDC reports
Prevalence of
Autism Spectrum
Disorders is
1 in 88
It is recognized that early intensive
behavioral intervention (EIBI) provided by
Part C programs for very young children at
risk for/with ASD is crucial for the best
outcome. However, identification of children
eligible for Part C services lags due to
excessive delays from the time of parental
concern to the time of diagnosis. Often, by
the time of definitive diagnosis, the child has
aged out of Part C services.
OBJECTIVES
RESULTS
METHODS
• The South Carolina Act Early Team used a grant from the
Association of Maternal and Child Health (AMCHP), “Act
Early State Systems Grant” to pilot the STAT-MD
program.
• The program trained interested medical and allied health
professionals from around the state to use the Screening
Tool for Autism in Toddlers (STAT) as a second level
screening for children with a positive M-CHAT
ADDITIONAL ISSUES
AND FUTURE EFORTS
EIBI services for children
who failed the STAT
started in October 2012. In
one year, 204 children
total were approved for
EIBI, 104 from a failed
STAT. Three children who
received EIBI who went on
to have a definitive ASD
evaluation were found not
to have an ASD.
To address concerns regarding reliability and
experience of medical providers and other
allied health professionals in accurately
administering a standardized screening tool,
future training for providers will include:
Instruction on administering standardized tools.
Commitment to a specified number of evaluations to remain reliable.
Commitment to routine “re-training” for reliability.
This may reduce the number of primary care
I providers available but will assure the integrity
of the program. Providers must be agency
approved. Currently, the list includes:
• As a result of policy changes at the state level, children
found “at risk” using the STAT are presumed to have an
ASD and are referred for EIBI services through the Part C
program.
Number of Individuals Eligible for EIBI
Create a framework for performing ASD evaluation in
community-based practices that could:
Reduce waits between screening concerns and
service delivery
Meet time demands for Part C eligibility.
• Children receive EIBI until a definitive diagnostic
evaluation using the Autism Diagnostic Observation
Schedule-Generic (ADOS-G) can be performed
Link children with appropriate early intervention
services.
120
100
Four
Development
al/
Behavioral
Pediatricians
100
75
80
Provide adequate reimbursement for screening
services performed by physicians.
This program was modeled on the STAT-MD
Program developed by Drs. Wendy Stone
and Zachary Warren of Vanderbilt University
in collaboration with the Tennessee branch of
the American Academy of Pediatrics.
119
68
Four Primary
Care
Pediatricians
Four PhD
psychologist
s
1 LPN
1 MSW
1 BSW
11 Autism
consultants
employed by
DDSN
ADOS
60
• If it is determined that a child has an ASD, the child is
eligible to participate in the state’s Pervasive
Developmental Disorder (PDD) Waiver to receive an
additional three years of EIBI services.
52
STAT
40
20
CONCLUSIONS
10
0
0
0
2010
2011
2012
Since
10/12
2013
As of
10/13
The STAT MD program is a viable tool to
increase the number of younger children
eligible for EIBI services under Part C.