1. REAL-START : Risk Evaluation of Autism in Latinos (Screening Tools and Referral Training) Assuring No Child Enters Kindergarten With an Undetected Developmental Delay For Primary Care Providers Caring for Children in Oregon’s Diverse Communities

2. A Project of: The Oregon Pediatric Society The Oregon Chapter of the American Academy of Pediatrics Funded by: Autism Speaks

3. Goals & Objectives The goal of this research project is to help primary care practices that serve many Latino patients to implement developmental screening for all of their patients in a sustainable and culturally-appropriate way. This project is a cooperative effort between Oregon Health & Science University (OHSU), Oregon Pediatric Society, and the Oregon Pediatric Improvement Partnership.

4. Did you know? 20% of all visits to the pediatric clinician’s office are developmental or behavioral in nature. 1 in 8 children has a developmental condition 1 in 68 has autism spectrum disorder 80% of parental developmental concerns are correct and accurate.

5. Health Care Disparities Pediatric providers may not feel prepared to identify risk for autism and other developmental disorders in minority children. As a result… –Minority children are diagnosed at older ages and at the point of more severe symptoms. –Minority children are less likely to be diagnosed with autism. REAL-START IS DESIGNED FOR PRACTICES THAT FACE THESE CHALLENGES!

6. Better identification of developmental delays Patient/family satisfaction Improved child/family outcomes Cost effective Reimbursable CCO and medical home metric Screening for Developmental Delays EARLY INTERVENTION IS PREVENTION

7. What do we get for participating in REAL-START ? An in-person training session for the entire clinic about conducting general developmental and autism screening and referral. Three follow-up webinars to help with implementation Access to a practice facilitator to help your practice with problems or issues that arise. Free screening materials and a $500 honorarium.

8.  Implement standardized screening for developmental delays and autism, in accordance with AAP policy statements and Bright Futures guidelines  Increase cultural competency and improve techniques for communication and referral for families with limited English proficiency  Improve proper documentation, coding and billing of screening tools  Increase referrals and enhance care coordination with local community resources The training will help your clinic:

9. Benefits of Participation Improved developmental care within your practice Free copies of the Ages and Stages Questionnaire – 3 (ASQ) and the Modified Checklist for Autism in Toddlers – Revised (MCHAT- R). $500 Honorarium for your practice Option to receive Continuing Medical Education (CME) credit and/or American Board of Pediatrics Part 4 Maintenance of Certification (MOC) credits. Participation will help the practice attain the benchmarck for Medicaid Coordinated Care Organization Incentive Measure #8 (Developmental Screening by 36 months).

10. Obligations of Participation Participate in training events, including attending one educational session and three follow up webinars. Practice leaders need to participate in monthly in-person or phone meetings with a practice facilitator. At least one clinical staff member and one administrative staff member are needed to collect research data, including a limited amount of chart reviews, once every 2 months. The practice will need to collect information on Early Intervention referrals and parent surveys throughout the project. Providers will have to complete a 5-minute survey pre- and post- intervention. We have designed data collection to have minimal impacts on your daily clinical work.

11. To find out more about the Risk Evaluation of Autism in Latinos-Screening Tools and Referral Training please visit: www.oregonstart.org Contact: Katharine Zuckerman MD MPH at zuckerma@ohsu.edu