South Carolina Autism Treatment Network: Bridging the Communication Gap Between Community Pediatricians and School-Based Clinicians to Increase Service Coordination

Background:  In SC, and many states, a two-tiered system for diagnosis and treatment of individuals with an Autism Spectrum Disorders(ASD) exists. First are the community providers offering early intervention services.Second are the local school systems that provide services to ensure that students of all ages achieve the highest level of learning potential. In the best circumstances, the school collaborates with community providers to provide the best long-term outcome for children with ASD and enhance scarce resources. In reality many children in SC only access services through their pediatrician or the local school districts. Most children with ASD are diagnosed and served by school resources alone; only three percent of children with ASD are diagnosed solely by non-school resources. Of the three percent diagnosed in the community, about half (57%) are served by a combination of school and non-school resources.The other 40% are served by school resources alone (Yeargin-Allsopp et al., 2003). Thus the SCATN believed bridging the communication gap between the two major stakeholders in the diagnosis and treatment of ASD was critical.

Objectives:  To create a consensus paper by SCATN pediatricians and school personnel as a road map for  best approaches to screening, referral, diagnosis, education services, and treatment of children with ASD to improve student-outcomes in SC.

Methods:  Two meetings were held in SC to both provide ASD education and to develop a consensus among health care providers, educators, and child advocates regarding assessment and treatment of children with ASD. Communication continued between meetings and via email and Google documents. At the second meeting, this process produced a consensus paper that was discussed, approved, and disseminated.

Results:  The consensus paper provides a roadmap to increase communication between pediatric offices, parents, and local school districts. Many SCATN pediatricians did not understand the process of communicating with a school. The following consensus was reached between school personnel and community health care providers representing part of the roadmap: 1) School Psychologists are the personnel best equipped to communicate with pediatricians; 2) Pediatricians understand that a medical diagnosis of ASD will not always lead to a school diagnosis of ASD or necessitate school based intervention; and 3) All communications should be brief and only relevant information should be exchanged. Important to the consensus process was the educational component. Survey results indicated participants increased their knowledge about ASD and its treatment, with the greatest gains made by pediatricians in the areas of behavioral therapies, community resources, and use of technology, hopefully increasing the likelihood of appropriate referrals and coordination of interventions among school personnel, physicians, and parents.

Conclusions:  Crucial to improving the outcome of students with ASD is community collaboration in care, particularly collaboration of pediatric practices with the educational system. Such collaboration addresses other barriers to good care, such as pressures from parents and schools to prescribe medications, cultural biases that may prevent schools from assessing children for ASD or may prevent families from seeking health care, and inconsistencies in recognition and referral among schools in the same system.