The Autism Society Event and Education Recordings Archive

This session will provide an overview of Pennsylvania’s statewide implementation using First Signs and their approach to training primary care providers and other professionals to improve early identification in Pennsylvania. Current practice will be discussed, along with the PA First Signs model for training will be reviewed. Pennsylvania is currently addressing Autism through the Department of Public Welfare. Last year, in August, over 250 professionals and parents came together to start to develop the Pennsylvania Autism Task Force Report. As the Early Intervention Subcommittee Facilitator, I was involved in finding information and bringing others information together to develop the Report that has become a part of the final document that will be available in the near future.

Early Identification was a lead concern in the report. With review and discussion, it was recommended that First Signs be implemented on a statewide level to improve the rate of identification. Who is First Signs? First Signs is a National Non-profit with a mission to promote the best social, emotional, communication, and behavioral outcome for every child's development through public awareness and education. First Signs is cutting edge in working with an extensive clinical advisory board, the National American Academy of Pediatrics, the Center for Disease Control, and others addressing this important issue for the most up-to-date information for early identification.

With many pediatricians lacking the time to detect autism, they also may not have the proper tools or training. In fact, primary care providers do not detect 70% of children with developmental disorders. (Palfrey et al. J PEDS. 1994)) Some of the common reasons are; screening tests are too long, many difficult to administer, children uncooperative, reimbursement is limited from the insurance company, and don't want to alarm parents.

Current mandates and policies in our country from lead agencies such as the American Academy of Neurology, and American Academy of Pediatrics have recommended standards such as the need for developmental screenings at every well visit. Practice of these recommendations is not enforced and may be difficult, based on the reasons listed above.

The rationale for screening is obvious, better long-term outcomes. If our medical professionals are more skilled in developmental screening and referring to early intervention- and for further identification, outcomes will be better for the child, family and community. Current rates of detection using validated screening tools are 70% to 80% of children with developmental disabilities are correctly identified.(Squires et al, JDBP. 1996;17:420-427)

Professionals need to know and understand the key social/ emotional and communication milestones for typical development in comparison with atypical development- and to know the subtle differences. Pennsylvania's goals are to improve screening and referral practices of young children at risk for autism and other developmental disorders, and to lower the age at which children are identified with autism and other developmental disorders.

In addition to learning objectives of current practice and perceived barriers, and why to screen, how Pennsylvania is looking to improve their rate of identification will be discussed. The presentation will include information about the First Signs Model for PA. Program objectives include Physician awareness and education. The target audience will be discussed as well as the strategy to be used including implementing best practices. The program tactics of 6 regional trainings and related train-the-trainer and other training venues will be highlighted. And finally, discussion of the evaluation process that will look at outcomes, the challenges, accomplishments, positive results, and areas needing improvement.

First Signs has several pilot programs, New Jersey, Florida, Minnesota, Wisconsin, Delaware, and Pennsylvania. Other pilot program outcomes will be highlighted along with implementation in other states.

Note: Statistical information provided by First Signs Inc.

Content Area: Early Intervention