Experts in autism diagnosis are close at hand: A TRIAD and Metro Nashville Public Schools partnership

Whitney Loring presenting at a TRIAD workshop for educators

Because of the limited access to autism diagnostic evaluations, which may delay access to services, TRIAD has partnered with Metro Nashville Public Schools to help them build capacity and sustainability for autism evaluation within their district. In doing so, the ultimate goal is to increase comfort across educators involved in this process and families who may be accessing services within their schools.

Although emphasis has been placed on the diagnosis of autism spectrum disorder (ASD) as early as possible so that children diagnosed with ASD can receive the benefit of early intervention, the average age in the U.S. for an ASD diagnosis is around 4 years, and many children may not be identified until they are of school age.

Wait lists for assessing school-age children has been a challenge for the diagnostic and evaluation services in Vanderbilt’s Center for Child Development where TRIAD psychologists conduct these evaluations. A delay in screening and diagnosis means a delay in needed services.

Attendees at December 2016 TRIAD Capacity Building Workshop

Attendees at December 2016 TRIAD Capacity Building Workshop

Two years ago, TRIAD began a formal partnership with Metro Nashville Public Schools (MNPS) to train K-12 psychologists and speech-language pathologists in understanding best practices in autism assessment in the schools.

“One aim of our partnership is to reduce the wait time for school-age children to access services, particularly within their school,” said TRIAD’s Whitney Loring, Psy.D., assistant professor of Pediatrics and Psychiatry & Behavioral Sciences. “It is important to help families within MNPS understand that the providers they may be waiting to see in 6 to 9 months were likely a part of this partnership in providing support to the assessment team at Metro Nashville Schools, who could provide a similar school-based evaluation within 60 school days.”

To date, TRIAD has provided ADOS-2 Clinical Training to 170 MNPS psychologists and speech-language pathologists to increase providers’ overall awareness of the characteristics of ASD and best practices for autism assessment. To further enhance training, TRIAD provided an ADOS-2 Booster session for 25 MNPS school psychologists most likely to conduct ASD evaluations. In addition, TRIAD provided four members of the MNPS Autism Assessment Team individualized coaching through a group supplemental ADOS-2 observation opportunity that involved more complex cases.

“Another goal is to work together to create a smooth ‘hand-off’ and efficient evaluation process between pediatric clinics and schools so that both families and schools are clear about resources and next steps within the school,” Loring said.

Considerable work has gone into examining the processes, beginning with a needs assessment that was completed by 28 school psychologists in order to identify specific needs related to ASD. Current assessment procedures and structural processes within MNPS were also reviewed. TRIAD provided recommendations to the MNPS Autism Assessment Team. Recommendations included revisions of forms currently used and identification of additional assessment tools that may be beneficial for ASD evaluations.

The next stage involved two case studies, which yielded additional suggestions for improving the hand-off. Finally, TRIAD has conducted a follow-up survey to assess the perceived impact of these training options in the district.

“Our collaboration is continuing,” Loring said. “Metro’s Autism Assessment Team is able to reach out to us with specific questions or concerns related to their ASD evaluation process. TRIAD educational consultants are sharing resources with the Metro team as they continue to refine their evaluation process.”

“We have been thrilled with this partnership,” said Linda Dohnal, MNPS psychologist and co-chair of its ASD assessment team. “It’s been a labor of love. It’s become so much bigger than we ever imagined. We began several years ago training just a handful of staff. In the last year, 200 special education specialists were trained by TRIAD, which not only is a huge financial savings to the district but allows us to do a better job for our students, families, and schools. We are serving the community better every single day. Metro Schools and TRIAD both had a vision that has formed a single accord. Each year, TRIAD comes with bigger ideas to try. It’s all amazing.”

“TRIAD is grateful to the Tennessee Department of Education, since TRIAD has been able to do this training through the Department’s support for training educators and other school personnel,” said Pablo Juarez, M.Ed., BCBA, TRIAD director. “Like other TRIAD research, service, and training activities, our aim involves not only sustaining the partnership with Metro Schools but also developing a replicable model that can benefit other school districts in Tennessee and beyond. There is a particular need for this model in rural counties that typically have fewer resources for autism screening, diagnosis, and interventions. TRIAD is launching a replication model in Fall 2017.”

For information about TRIAD professional development training, contact triad.doe@vanderbilt.edu, 615-875-9819.

Jan Rosemergy is VKC deputy director and director of Communications and Dissemination.

Pictured top of page: Whitney Loring presenting at a TRIAD workshop for educators

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