Increasing Access to Diagnostic Evaluations and Ongoing Care for Autism Across Washington State

April 28, 2021

University of Washington LEND is excited to report initial outcomes of ECHO Autism Washington: our new ECHO program supporting primary care providers (PCPs) in Washington State in diagnosing and managing autism spectrum disorder (ASD). ECHO Autism Washington is supported by UW LEND in collaboration with the Washington State legislature and Washington State Health Care Authority. We launched our first cohort of 28 PCPs from 15 counties in Washington in December 2019 (see Map). PCPs completed a questionnaire before ECHO participation, after 6 months, and at the end of the year-long program. The questionnaire asked PCPs about practice patterns and barriers to diagnosing and caring for individuals with ASD and contained a modified version of the Primary Care Autism Self-Efficacy (PCASE) survey developed at the University of Missouri (Mazurek et al., 2017). The PCASE yields a total self-efficacy score and six subscale scores: diagnosis across age groups, diagnostic criteria, referrals and resources, medical comorbidities, psychiatric symptoms, and additional aspects of care. 68% of participants completed both pre- and post-questionnaires.

An analysis of pre- and post-ECHO questionnaires revealed a significant increase in self-efficacy related to ASD diagnosis and care in ECHO Autism Washington PCPs, p < .001. Additionally, PCPs reported less frequently that ASD knowledge and training were significant barriers to completing ASD diagnostic evaluations in their practice. The percentage of PCPs who endorsed barriers of (1) a lack of prior training in ASD, (2) a lack of knowledge about ASD symptoms, or (3) a lack of confidence managing behaviors decreased substantially from (1) 42.11% to 10.52%, (2) 31.58% to 10.52%, and (3) 47.37% to 21.05%, respectively. We are pleased about our initial results suggesting that telementoring models such as Project ECHO are one way to build PCP capacity and expand ASD expertise-with the goal of increasing access to diagnostic evaluations and ongoing care for individuals with ASD.

Please visit our UW LEND ECHO website for more information on our ECHO programs:


Mazurek, M. O., Brown, R., Curran, A., & Sohl, K. (2017). ECHO Autism: A new model for training primary care providers in best- practice care for children with autism. Clinical Pediatrics, 56(3), 247-256.