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• Early identification and intervention has been shown to improve outcomes across domains for
children diagnosed with ASD (Warren et al., 2011)
• However, children in rural and underserved areas are less likely to be diagnosed before school age
and often do not have access to appropriate autism-specific services (Daniels & Mandell, 2014)
• Extended wait times after initial concerns have also impacted the early diagnosis of young children
and contribute to negative family experiences (Zablotsky et al., 2014)
Autism in Delaware
Medical Diagnosis of Autism
• Primary resource for diagnostic services in Delaware has historically been Nemours/A.I. duPont
• Families located in rural areas (e.g., Sussex county) are often required to travel long distances
and overcome additional barriers in order to access these services
• Average age of ASD diagnosis in Delaware was recently shown to be 5.2 years
(Ekbladh & Rhoton, 2013)
• When concerns for autism arise, families have the right to evaluations through both Part B and
Part C, but may only receive services from one
Understanding Educational Eligibility and
Medical Diagnosis of Autism
Building Bridges
• Streamlining the Process
• Collaboration between Part C and Nemours
• DOE development of guidance for autism referrals
• CDW North
• Serves families in New Castle County
• CDW South
• Serves families in Kent and Sussex Counties
Support at CDW South
Building Bridges grant funds a Nemours post-doctoral psychologist and LEND trainee to conduct
comprehensive diagnostic autism evaluations at CDW South two days per week
• Focus on medically underserved regions of the state
• Kent and Sussex Counties
Social-
Adaptive
emotional
Concerns for Autism
• When concerns for autism arise during the MDA or from parent or provider concern, referral
for comprehensive autism evaluation is required
Referral to:
120
104 (80.6%)
100
80
60
40
20
0 1 2 3 4 5 6
Average Wait Time for Evaluation
4-6 weeks
Diagnosis Totals by County
80
70 67 (64.6%)
60
50
40 37 (35.6%)
30
20
10
60
50
40
30 64 (80%)
20
10
0
“People that live in Dover and Smyrna can come right to Dover. People that live in
Milford, Georgetown, Sussex County can go to Milford. It's easier, more convenient for
those families. And I think it's a more cohesive process when they can be here with [an
autism expert] on staff.”
“There are huge benefits to having the medical. Without the medical diagnosis, I can’t
get the kid stable child’s Medicaid, I can’t get this child SSI, and I can’t get them ABA
therapy services outside of the school setting.”
Next Steps & Sustainability
Statewide Commitment
Regular meetings with Delaware Division of Public Health (DPH) and CDW leadership
Collaboration between CDW, UD, Nemours, and Delaware Network for Excellence in Autism for
ongoing technical assistance
Collaboration between Part B and Part C to ensure streamlined processes for referrals and
evaluations for autism
Meetings with school districts statewide to inform of the new service and processes
Considerations
CDW South and CDW North will have very different training needs
CDW South will have two years completed with this process
CDW North will be launching an entirely new process