Psychologist University of Colorado School of Medicine University of Colorado School of Medicine Aurora, Colorado, United States
Background: The impact of COVID-19 challenged traditional models of provider training, screening, and care designed to diagnose and manage children with Autism Spectrum Disorders (ASD). Project ACCESS was developed prior to COVID 19 to improve autism outreach and respond to the needs of community PCPs.
Objective: Compared prior to COVID-19, Project ACCESS was adapted and expanded during COVID-19 to address the needs for children with ASD, particularly for rural, remote, and underserved families through a multiple pathway model of care.
Design/Methods: Project ACCESS training and care pathways were modified and delivered during 2020. Results from 2020 were compared to prior years of ACCESS to evaluate the impact of COVID-19, and the success of implemented adaptations in response to the pandemic. Pathways comprised of: 1) initial assessments, 2) expanded assessment team, 3) Screening Tool for Autism in Toddlers (STAT) training for primary care providers, 4) ASD education via Extension for Community Health Outcomes (ECHO), 5) mentoring providers through monthly ongoing ECHO Community of Practice, 6) provider training/observation during outreach visits to rural/frontier communities, 7) Pediatric Care Network (PCN) training/collaboration model, 8) Telehealth, and 9) Electronic-consultations. Outcome variables included (1) provider involvement, training attendance, satisfaction, and knowledge; (2) frequency of initial assessments, telehealth visits, and (3) waitlist time and referrals. Statistical analyses were based on t-tests and chi-square tests.
Results: Similar to pre-COVID period of assessment, Project ACCESS training pathways (ECHO, STAT, and PCN) all showed statistically significant improvements in ASD knowledge, high satisfaction ratings (9.05/10), and maintained or increased provider attendance. The frequency of initial assessments and telehealth visits during 2020 all showed significant increases compared to prior evaluations while the number of referrals increased using electronic medical records with no change in overall time on waitlist. Conclusion(s): During COVID-19, a multiple pathway model was successfully adapted to continue to meet the needs of patients and community partners. This included leveraging the use of telehealth, virtual educational platforms and information technology to not only significantly expand the existing care pathways, but also to improve the ACCESS model as an efficient and successful model of care.
Authors/Institutions: Rebecca Wilson, University of Colorado School of Medicine, Aurora, Colorado, United States; Richard Boles, University of Colorado School of Medicine, Aurora, Colorado, United States; Ann Reynolds, University of Colorado School of Medicine, Aurora, Colorado, United States; Elizabeth Coan, University of Colorado; Children's Hospital Colorado, Aurora, Colorado, United States; Sandra L. Friedman, University of Colorado, Aurora, Colorado, United States