Early Detection and Screening Program at Children s Hospital of the King s Daughters

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1 Early Detection and Screening Program at Children s Hospital of the King s Daughters COLLABORATION BETWEEN DEVELOPMENTAL PEDIATRICS Amy Newmeyer, MD Janice Keener, PsyD & GENERAL ACADEMIC PEDIATRICS John Harrington, MD

2 Virginia Department of Health Service Contract VDH is in the process of consolidating services from the Child Development Centers (CDC) throughout Virginia into regional centers The CDC at the Norfolk Department of Health closed in 2013 Contract with CSG started Dec 2013 Provides support for additional staff needs: Psychology SW Administrative staff

3 Developmental Pediatrics Clinic Composition FTE Dev Peds 0.8 FTE Ed Specialist 0.8 FTE SW FTE Dev Peds 3.0 FTE Ed Specialist 2.0 FTE SW 2.7 FTE Psychology (as of Summer 2015)

4 Referral Process Referrals are from general pediatricians or from community agencies Patients are seen first by SW or Dev Pediatrician and then referred for other services SW intake may be required for older or more complex patients, with the goal of providing referrals to community services for those most at need

5 Patient Composition Developmental Pediatrics sees approximately 1400 new patients per year; and approximately 2000 followup visits Diagnoses: Autism spectrum disorders Developmental Delay Speech Disorders Motor Coordination Disorders ADHD Learning disabilities (dyslexia, etc.)

6 Current wait times Social Work Developmental Pediatrics Psychology Educational Consultant 1 to 2 months 3 to 4 months 6 to 8 months 2 to 3 months Wait time for psychology should decrease once our new psychologist starts in the fall and speech therapists have been fully trained; however, need will continue to be high as our division is one of the few places in the community for autism evaluations

7 Follow Up After Assessment Referrals are made to the following depending on patient needs: School special education programs Early Intervention Counseling services Applied Behavior Analysis therapy Parent support groups Tidewater Autism Society of America Family to Family Network Medication management

8 Assessment Program Locations Princess Anne SW Psychology Developmental Pediatrician Medical Tower Developmental Pediatrician Psychology Social Work Educational Consultant Harborview Developmental Pediatrician Educational consultant Oyster Point Developmental Pediatrician Educational Consultant Oakbrooke Developmental Pediatrician Social Work

9 Applied Behavioral Analysis Support Patients with autism spectrum disorder have difficulty participating in therapy sessions ABA therapist on staff could consult with families and multiple clinics to achieve the best outcomes It would allow patients to stay in therapy services for a longer period of time

10 Autism Services In 2014 Developmental Pediatrics had approximately 3000 patient visits for children with ASD Currently no focused service line at CHKD for children with ASD, leading to confusion about referrals and community resources Collaborating with General Academic Pediatrics and other hospital divisions to develop a focused service line for ASD services at CHKD

11 COMMENTS ABOUT EARLY STEP PROGRAM PARTICIPATION What were the key activities you found to be of greatest value (professional development, family support, bringing community team together quarterly, tracking impact/change) as a result of being involved with project? I think it was very helpful to meet as a team to discuss things that were working and things that weren't via the referral cycle. I think it also highlighted that we are actively pursuing answers to our delays in processing children for an evaluation for a diagnosis. The development of three active diagnostic teams with the potential growth of training more teams is outstanding. I think our Richmond counterparts really came to know our huge need for resources and that services and support for autism likely should be flowing at higher rate through SE VA versus Richmond, especially access to ABA based on the number of children we are evaluating and subsequently diagnosing with autism. What are the most important benefits to your surrounding community in terms of early identification, diagnosis, and support The development of 3 diagnostic teams in our catchment areas. The idea that we still have delays, but we are starting to get a handle on these and it appears we are making real headway What are 1-2 words of advice you would offer to another community? Identify system needs and champions: (improved screening, targeted referral, access to diagnostic services, access to therapy)