A study published in the Journal of Research in Childhood Education showed that a novel autism training program among early education providers was feasible and well-received. The program, facilitated by specialists at Children's National Hospital and community agencies, also successfully improved the providers' knowledge of autism and how to navigate resources to support children with autism.

What it means

Specialists at Children's National hypothesized that with appropriate training delivered by specialists, providers at community agencies could also train early childhood education care providers to recognize autism in young children and help families access resources to support them.

With 13 million children under age 5 attending an early childhood education program in the United States, early childhood education providers are well positioned to identify early developmental concerns such as autism and support access to early intervention services. Increased knowledge of autism and resource navigation can help ensure quick and equitable access to care.

What's been the hold-up in the field?

Early childhood education providers themselves have identified several barriers to their support of children with an increased likelihood of autism. These include:

• Limited knowledge about autism
• Hesitancy among providers to discuss developmental concerns with families
• Limitations in knowing how best to engage parents in the diagnostic referral process

Moving the field forward

The study findings demonstrate a successful model that depends on and expands community-based partnerships between hospital specialists and child-serving community agencies. The findings also demonstrate that the program's train-the-trainer model provides a sustainable approach that increases autism knowledge and improves resource navigation.

While the training was well-received and succeeded in meeting study goals, participants noted that some barriers still exist, and a system for continued training would be needed to maintain the program's efficacy.

What is exciting about this work?

"It was exciting to co-develop this research with our community partners, who helped ensure that the work is relevant and timely," says study lead author Serene Habayeb, PhD, a psychologist at Children's National. "It has been wonderful to see the work sustained by community partners."

As just one example, DC Public School's Early Stages evaluation center is now providing regular training workshops with the materials developed through the project.

Children's National leads the way

This is just one example of the many impactful behavioral health initiatives led by Children's National. Partnerships created as part of this training program effort were leveraged to expand the reach of other hospital initiatives that aim to increase access to autism-related knowledge. This includes the work of ECHO (Extension of Community Health Outcomes) Autism, a program at Children's National hosted through the Center for Autism Spectrum (CASD). ECHO Autism at Children's National offers an innovative tele-mentoring model that creates virtual learning communities between multidisciplinary autism specialists and community professionals, including early childhood education providers. The early childhood education-focused ECHO at Children's National has been highly successful, as shown by high attendance at training sessions and participant-reported gains in autism-related knowledge. The program's success reflects both the need and interest of community professionals to improve care for children with autism or related developmental needs.

As a result of the identification of ongoing challenges and needs, a city-wide collaborative, the DC Autism Collaborative (DC-AC), was formed in 2020. More than 90 members from more than 45 different organizations regularly participate in the DC-AC. These members continue working toward increasing early and equitable access to high-quality autism care for all children.

A number of hospital teams are represented in the DC-AC collaborative, including CASD, the Divisions of Psychology and Behavioral Health, Neurodevelopmental Pediatrics, Primary Care, as well as the Community Mental Health CORE (Collaboration, Outreach, Research and Equity). The Community Mental Health CORE leads infrastructure building activities, develops enabling services to connect families to high quality care and launches innovative models to deliver direct services, all anchored in the mission of promoting equal access to health care for all children and families in Washington, D.C.

Read the study, Expanding Autism Knowledge and Access in Early Childhood Education Community-Based Settings, in the Journal of Research in Childhood Education.

Additional authors from Children's National include: Amanda Hastings, PsyD, Anne Inge, PhD, Olivia Soutullo, PhD, Renee Williams, CHES, MSHEP, Melissa Long, MD, Leandra Godoy, PhD