Act Early Network News, Winter 2017 Issue

Providing full access to culturally-competent early identification practices for children from non-English speaking families has been a long-standing goal of the Massachusetts Act Early State Team. The team is pleased to announce that the Considering Culture in Autism Screening kit and curriculum is now available for download at no cost for pediatric providers and other early childhood professionals at http://www.maactearly.org/considering-culture-in-autism-screening.html.

The Considering Culture in Autism Screening Kit (funded by a 2012 AMCHP State Systems Grant) includes a clinician tips guide, referral resource listing, and translations of the M-CHAT-R/F autism screening tool. The Considering Culture in Autism Screening Curriculum (funded by a 2014 grant from the Deborah Monroe Noonan Memorial Research Fund) includes two cultural case studies, videotaped interviews from parents of children with ASD from four cultures, a facilitator training guide, and supplementary classroom materials. Modeled after the LTSAE Autism Case Training (ACT) curriculum, the project also received in-kind support from the CDC. To obtain access to the videos for use in training, please contact [email protected].

Citation: Gabovitch, E., Blenner, S., Braden, K., Choueiri, R., Charles, J., Fernandez-Pastrana, I., Helm, D.,& Travers, J. (2016). Considering Culture in Autism Screening: A Cultural & Linguistic Competence Training Curriculum for Pediatric Providers. [Curriculum]. Massachusetts Act Early Program, UMASS Medical School-Eunice Kennedy Shriver Center.

If you have questions, please contact the Principal Investigator/former CDC Act Early Ambassador to Massachusetts at [email protected].

In 2013, the Massachusetts Autism Commission issued a call to "determine the number of people with autism ... and their support needs by implementing a plan for consistent statewide data collection." In response, the University of Massachusetts Medical School-Eunice Kennedy Shriver Center and Massachusetts Act Early conducted a comprehensive 3-year state autism needs assessment using the framework of the six "Healthy People 2020" MCHB core outcome indicators for CYSHCN. As a result, the project's Massachusetts Healthy People 2020 Autism Roadmap Report provides recommendations for state autism data collection including future progress monitoring strategies and resources.

One of the indicators, Early Identification & Screening, is discussed at length and shares activities and outcomes from the MA Act Early state team's and related LTSAE efforts. The report includes several factors related to underserved children and youth: race, culture, language, immigrant status, region, level of function, and mental health. The report is available for download at: http://shriver.umassmed.edu/research/population-health/healthy-people-2020-roadmap.

Citation: Gabovitch, E., Lauer, E. & Dutra, C. (2016). Massachusetts Healthy People 2020 Autism Roadmap for Children & Youth with ASD/DD: Understanding Needs & Measuring Outcomes. [Report]. Worcester, MA: UMass Medical School-E.K. Shriver Center. If you have questions please feel free to contact the Principal Investigator/former CDC Act Early Ambassador to Massachusetts at [email protected].

The statewide system change work of the South Carolina Act Early Team was published in the most recent issue of the journal Pediatrics. This article provides "an example of a successful, novel statewide effort to increase early identification of young children at risk for Autism Spectrum Disorder using a two-tiered screening process with enhanced quality assessment, interagency policy collaboration and coordination. It demonstrated that improvements in early identification and intervention are feasible through collaborative policy change in a manner that should be replicable in other states for the benefit of young children with ASD. For access to the full article, click here.

OBJECTIVES: To provide and example of a successful, novel statewide effort to increase early identification of young children at risk for autism spectrum disorder (ASD) using a 2-tiered screening process with enhanced quality assessment, interagency policy collaboration and coordination.

METHODS: The South Carolina Act Early Team (SCAET) provided focused collaboration among leaders representing state agencies, universities, health care systems, private organizations, and families to improve quality of life for children with ASD. Specific focus was on implementing policy changes and training to result in earlier identification and home-based behavioral intervention for young children at risk for ASD.

RESULTS: Policy changes, training, and modified state agency practices were accomplished. Presumptive eligibility, on the basis of a 2-tiered screening process was implemented by BabyNet (South Carolina's Early Intervention Program) in collaboration with the lead agency for developmental disability services. There was a fivefold increase in children eligible for early intensive behavioral intervention without waiting for a diagnosis of ASD, avoiding long waits for diagnostic evaluations. Only 16 children (2.5%) were later found not to have ASD from a comprehensive evaluation.

CONCLUSIONS: Improvements in early identification and intervention are feasible through collaborative policy change. The South Carolina Act Early Team and its key stakeholders committed to improving outcomes for this population used existing tools and methods in new ways to improve early identification of children with ASD and to make available evidence-based intervention services. This example should be replicable in other states with key stakeholders working collaboratively for the benefit of young children with ASD.

Citation: Rotholz DA, Kinsman AM, Lacy KK, et al. Improving Early Identifi cation and Intervention for Children at Risk for Autism Spectrum Disorder. Pediatrics.2017;139(2):e20161061

Improving the Early Identification and Intervention of Neurodevelopmental Disorders and Autism in Underserved and Culturally Diverse Children on Friday April 21, 2017 UMass Medical School Worcester, MA Faculty Conference Room Sponsored by: MA Act Early; CDC Act Early campaign; UMass Memorial Children Medical Center (CMC) and Division of Developmental and Behavioral Pediatrics at the CMC

DESCRIPTION: This is a one-day conference and summit of the MA Act Early State Team for early childhood providers, advocates and healthcare providers. The conference will share important information about the CDC Act Early campaign and Learn the Signs Act Early materials (LTSAE), resources and important information about screening and monitoring of developmental milestones and early identification and treatment in young children from underserved communities. The conference will include keynote presentations by experts in autism screening and autism screening in minorities, as well as a language access attorney. MA,RI and NJ CDC Act Early Ambassadors will share their programs and updates and a panel including early childhood providers from Early Intervention, Women Infants and Children, Early Education and Care, and Head Start will highlight difficulties and strategies developed to reach underserved children.

TARGET AUDIENCE: This conference is designed for and will benefit early childhood educators, early childhood providers, health care providers and allied health care professionals working with young children.

REGISTRATION FEE: $25 Registration fee includes: admission to the day long symposium and activities, a light breakfast, lunch, morning and afternoon snacks; a parking voucher is also included. A certificate of attendance will be provided. Registration deadline: Wednesday April 10, 2017. For more information and to register, please read the registration form.pdf.

A committee that advises the U.S. secretary of health and human services said Thursday it would study inconsistencies in newborn screening throughout the country, with the intent to give state public health labs guidance on how to better test newborns for genetic disorders.

The action was prompted by a Milwaukee Journal Sentinel investigation late last year that found lab policies and protocols for newborn screening vary widely from state to state. As a result, babies can die or suffer brain damage when treatable genetic conditions aren't detected soon after birth.

The lack of uniformity means a child who suffers permanent brain damage in one state might have been diagnosed and treated in another, the investigation found. Each state runs its own program and sets its own standards to detect the disorders. To read the full article, please click here.

In Oregon, the Act Early Milestone Moments Booklet has been introduced into the Coffee Creek Head Start program. This along with Vroom activities and implementation of Circle of Security--Parenting sessions is a component of the Nurturing Healthy Attachment project at the Coffee Creek Women's Correctional Facility. The Coffee Creek Head Start is co-located at this women's correctional facility. Incarcerated mothers of infant, toddler and preschool age children attend the blended Early Head Start and Head Start classroom with their children.The Milestone Moments Booklet provides the mothers with a tool for learning about typical early childhood development and heightens their awareness of their child's developmental progress.

Vroom provides a variety of activities promoting mother-child interaction. Circle of Security--Parenting builds the mother's capacity to interpret her child's behavior as an expression of emotional needs and respond appropriately. The Nurturing Healthy Attachment project pulls together these approaches to collectively promote secure attachment in this highly vulnerable population. Preliminary findings suggest that NHA may cultivate an empathic shift and further mother-child emotional engagement. For questions and further information please feel free to contact Sherri Alderman, CDC Act Early Ambassador to Oregon at [email protected].

The Screening in Practices Initiative is designed to improve the health, wellness, and life course of children through practice and system-based interventions for early childhood screening, referral, and follow-up. One of the major components of the Initiative is the National Technical Assistance Resource Center on Screening, which provides evidence-informed technical assistance and resources to assist practices in implementing effective screening, referral, and follow-up for developmental milestones, maternal depression, and social determinants of health. Technical assistance is provided through a toll-free hotline, in-person and web-based trainings, and an online resource center.

The U.S. Departments of Education and Health and Human Services joined with Too Small to Fail to release a Fostering Healthy Social and Emotional Development in Young Children Toolkit on social and emotional development.
This set of resources on healthy social and emotional development includes:
• A tip sheet for parents and families of infants, toddlers, and preschoolers
• A tip sheet for infant, toddler, and preschool providers and educators
• A milestones chart with key information on social and emotional development from birth to age 5
• A fact sheet on the research behind social and emotional development in early childhood and lifelong outcomes
• A "Let's Talk About Feelings" poster

Joint HHS-ED Policy Statement to Support the Alignment of Health and Early Learning Systems. This statement provides policy and program recommendations from HHS and ED to improve young children's access to needed services and transform delivery systems to improve health and early learning outcomes for all children.