The ECHO Effect

August 7, 2020

The University Center for Excellence in Developmental Disabilities at the Waisman Center, University of Wisconsin-Madison, recently launched two new initiatives - ECHO AAC and ECHO Autism WI. Both programs are targeted to help improve and expand teletraining services using the Project ECHO® (Extension for Community Healthcare Outcomes) platform. Project ECHO (the mantra for which is "All teach, all learn") uses video-conferencing technology to provide education and case consultation on best practice clinical services, training, and resources for individuals with specific healthcare needs that are difficult to meet locally.

The Waisman Center ECHO platform will serve as a diagnostic and treatment training hub to share the center's expertise on intellectual and developmental disabilities, such as autism, Down syndrome, and cerebral palsy, throughout the state and beyond. This is especially important when access to specialized care and resources are as limited as they are in communication disorders and autism.

ECHO AAC launched in spring 2020 through the center's Communication Aids & Systems Clinic (CASC), one of 11 specialty clinics at the Waisman Center. CASC provides highly specialized, cutting-edge augmentative and alternative communication (AAC) for children and adults experiencing significant communication difficulties.

"What lacks across the state are centers that house all of the tech that the Waisman Center has access to," says Sarah Marshall, a Waisman speech-language pathologist. She adds that such an "access crisis for individuals who need AAC services" inspired her and fellow speech-language pathologist Cat Kanter to seek out a way to make Waisman resources and expertise more accessible to people all around the state. In their search, they came upon Project ECHO. The program was pioneered at the University of New Mexico in 2003 and, since its inception, has expanded to 400 networks and more than 800 ECHO programs in 40 countries.

Marshall says that ECHO AAC was created in response to an increased desire for AAC-related resources and support by community providers, family members, and individuals who use AAC. "The ECHO model provided the opportunity for providers across disciplines to learn new information from experts as well as to engage in case-based collaborative problem solving," she says. "Communication is not just something that happens during speech therapy, and thus training and support for the entire team and family is crucial to success."

ECHO Autism WI launched at the end of July 2020 and is a collaboration between content experts and practicing clinicians all around the state, where the Waisman Center serves as the hub of experts for sharing research and knowledge. An important part of the ECHO Autism hub team is a parent of a child with autism. "And then as we develop all these experts in different areas throughout the state, those individuals can continue to spread that knowledge," says Lindsay McCary, PhD, director of the Autism and Developmental Disabilities Clinic and the psychology training coordinator of the WI LEND program.

ECHO Autism WI focuses on educating physicians on the early identification of autism in children and on providing specialized care. "ECHO is able to help empower physicians to feel like they have the skills and knowledge to be able to talk about those daily issues with families," McCary says.

Physicians participate in biweekly ECHO Autism WI sessions to help develop their knowledge and self-efficacy to care for patients with autism who are already on their caseload. "They're basically going through an entire training program," McCary says. Topics for these modules vary widely based on the specific needs for individuals with autism on topics such as screening and early identification practices, sleep issues, anxiety and ADHD, safety, and supporting families - to name a few things.

As ECHO AAC and ECHO Autism WI take root at Waisman, they pave the way for future ECHO programs in other Waisman clinics as well as a way to branch out and make new research and information more public-facing.

To read the full article, please go to