Efforts to Improve Autism Spectrum Disorder Service Delivery Under the Autism CARES
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The publication was produced for the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, under contract number HHSH250201500010C. This publication lists non-federal resources in order to provide additional information to consumers. The views and content in these resources have not been formally approved by the U.S. Department of Health and Human Services (HHS) or the Health Resources and Services Administration (HRSA). Listing these resources is not an endorsement by HHS or HRSA. Efforts to improve autism spectrum disorder service delivery under the Autism CARES Act: Research, training, and State systems grants for FY 2014–17 is not copyrighted. Readers are free to duplicate and use all or part of the information contained in this publication; however the photographs are copyrighted and may not be used without permission. Pursuant to 42 U.S.C. § 1320b-10, this publication may not be reproduced, reprinted, or redistributed for a fee without specific written authorization from HHS. Suggested Citation: U.S. Department of Health and Human Services, Health Resources and Services Administration, Efforts to improve autism spectrum disorder service delivery under the Autism CARES Act: Research, training, and State systems grants for FY 2014–17. Rockville, MD: U.S. Department of Health and Human Services, Health Resources and Services Administration. Photography Credits: iStock.com/mixetto; iStock.com/FatCamera; ESB Professional/Shutterstock.com Acknowledgements Insight Policy Research thanks the Autism CARES grantees for participating in the range of activities needed to complete this evaluation. Efforts To Improve Autism Spectrum Disorder Service Delivery Under The Autism CARES Act, Final Report Contents Executive Summary .................................................................................................................................. i Chapter 1. Introduction ........................................................................................................................... 1 A. Overview of ASD and the Changing Healthcare Landscape .......................................................... 1 B. HRSA’s Implementation of the Autism CARES Act of 2014 ........................................................... 2 C. Report Overview ......................................................................................................................... 3 Chapter 2. Overview of Grant Programs .................................................................................................. 4 A. Training Programs ....................................................................................................................... 5 B. Research Programs ..................................................................................................................... 7 C. State Implementation Grants and Innovation in Care Integration Grants................................... 11 D. National Resource Centers ........................................................................................................ 12 Chapter 3. Study Design and Methods ................................................................................................... 14 A. Research Questions .................................................................................................................. 14 B. Data Sources ............................................................................................................................. 15 C. Analysis..................................................................................................................................... 16 D. Considerations .......................................................................................................................... 16 Chapter 4. Increasing Awareness of Developmental Milestones and ASD/DD Interventions and Resources ................................................................................................................. 18 A. The Need for Building Awareness of ASD .................................................................................. 19 B. Promoting Awareness of ASD Among Professionals .................................................................. 19 C. Promoting Awareness of ASD Among Community Members ..................................................... 22 Chapter 5. Training Professionals in ASD/DD Service Delivery ................................................................ 29 A. The Need To Train Professionals in ASD/DD Service Delivery ..................................................... 30 B. Increasing the Number of Professionals Trained To Provide ASD/DD Services ........................... 30 C. Enhancing Didactic Instruction About ASD/DDs ......................................................................... 33 D. Ensuring Access to Clinical Training Opportunities..................................................................... 36 E. Building a Cadre of Strong Leaders ............................................................................................ 39 Chapter 6. Building the Evidence Base for ASD/DD Care and Services .................................................... 42 A. The Need for Research on ASD/DDs .......................................................................................... 43 B. Conducting Research on ASD and Translating Research Into Practice ........................................ 43 C. Mentoring New Investigators .................................................................................................... 50 D. Developing Manuscripts and Presentations............................................................................... 51 E. Developing Medical and Behavioral Treatment Guidelines ........................................................ 53 Efforts To Improve Autism Spectrum Disorder Service Delivery Under The Autism CARES Act, Final Report F. Developing Assessment Measures and Toolkits ......................................................................... 54 G. Collaborating With Grantees and Other Stakeholders ............................................................... 56 Chapter 7. Building and Improving Systems of Care for Individuals With ASD/DDs ................................. 57 A. The Need for Improving Systems of Care for Individuals With ASD/DDs .................................... 58 B. Improving Access to Early Developmental Screening, Diagnostic Evaluation, and Intervention Services ..................................................................................................................... 58 C. Building More Comprehensive, Coordinated Systems of Care ................................................... 64 D. Engaging Families and Self-Advocates ....................................................................................... 66 Chapter 8. Improving Services for Youth With ASD as They Transition to Adulthood .............................. 74 A. The Need for Focus on the Transition to Adulthood .................................................................. 75 B. Building Awareness About Transition Issues .............................................................................. 75 C. Training Providers To Deliver Transition Services ...................................................................... 78 D. Building the Evidence Base on the Needs of Transition-Aged Youth .......................................... 80 E. Improving Systems of Care for Youth as They Transition to Adulthood ...................................... 81 Chapter 9. Supporting Collaboration and Coordination Through the National Resource Centers ............ 85 A. The Need for Supporting Collaboration and Coordination Among Grantees .............................. 86 B. Engaging Grantees in Collaborative Technical Assistance .......................................................... 86 C. Supporting the Annual Autism CARES Grantee Meetings ........................................................... 90 D. Providing Informational and Training Resources ....................................................................... 90 Chapter 10. Autism CARES Grantees’ Progress, Remaining Challenges, and Opportunities ..................... 92 A. HRSA’s Progress, 2008 to 2018 .................................................................................................. 92 B. Remaining Challenges and Opportunities .................................................................................. 93 Abbreviations and Acronyms ................................................................................................................. 95 References ............................................................................................................................................ 98 Appendix A. Data Sources Included in Evaluation..................................................................................A-1 Appendix B. Autism CARES Grantees .................................................................................................... B-1 Appendix C. Logic Model ...................................................................................................................... C-1 Appendix D. Evaluation Research Questions by Data Source ................................................................ D-1 Appendix E. Research Program Studies ................................................................................................