access to timely ASD diagnostic evaluations delay enrollment in interventions
known to improve developmental outcomes. As such, developing and testing
streamlined methods for ASD diagnosis is a public health and research
priority. In this report, we describe the Early Autism Evaluation (EAE) Hub
system, a statewide initiative for ASD screening and diagnosis in the primary
care setting. Development of the EAE Hub system involved geographically
targeted provision of developmental screening technical assistance to
primary care, community outreach, and training primary care clinicians in
ASD evaluation. At the EAE Hubs, a standard clinical pathway was
implemented for evaluation of children, ages 18 to 48 months, at risk for ASD.
From 2012 to 2018, 2076 children were evaluated (mean age: 30 months;
median evaluation wait time: 62 days), and 33% of children received
a diagnosis of ASD. Our findings suggest that developing a tiered system of
developmental screening and early ASD evaluation is feasible in a geographic
region facing health care access problems. Through targeted delivery of
education, outreach, and intensive practice-based training, large numbers of
young children at risk for ASD can be identified, referred, and evaluated in the
local primary care setting. The EAE Hub model has potential for
dissemination to other states facing similar neurodevelopmental health care
system burdens. Implementation lessons learned and key system successes,
challenges, and future directions are reviewed.