HJAR Mar/Apr 2025

14 MAR / APR 2025 I  HEALTHCARE JOURNAL OF ARKANSAS Program, created a clinical program called Community Based Autism Liaison Treat- ment Project (CoBALT) to help mitigate the bottleneck in obtaining an evaluation arising from a large volume of referrals. A second program to help provide evidence- based, autism-specific information to medi- cal providers was also created. Both of these programs will be described below. Community Based Autism Liaison Treatment Project (CoBALT) CoBALT teams are trained to conduct Tier II screenings on children referred for developmental and autism concerns. The CoBALT teams serve in a consultative role to the child’s PCP in their area of the state. These teams are led by pediatricians and pediatric nurse practitioners who are selected because of their experience caring for children with developmental concerns. These teams go through extensive training and ongoing educational support by the CoBALT leadership team, comprised of fac- ulty at the James L. Dennis Developmental Center. CoBALT teams are located around the state so that teams can evaluate a child closer to home. Some children may be found to have diagnoses other than autism (e.g., speech delay, motor delay, behavior challenges), and the team expeditiously redirects fami- lies to appropriate therapies and services in their area. If a child needs a formal evalua- tion for autism or more complex develop- mental issues, CoBALT teams refer the child to either the Dennis Developmental Cen- ter (DDC) in central Arkansas, Schmieding Center in the northwest region of the state, or other subspecialty clinicians for further evaluation as deemed appropriate. The CoBALT program, initially developed by Eldon Schulz, MD, has been in practice since 2010. Data collected since 2016 show Fiscal Year CoBALT DDC Seen DNKA Seen DNKA 2016 2 0 0 0 2017 64 16 13 1 2018 87 11 27 5 2019 139 85 56 16 2020 249 67 86 35 2021 327 97 121 49 2022 341 68 199 49 2023 389 104 147 26 2024 329 94 151 23 2025 (6 mos data) 185 32 73 12 Total 2112 574 873 216 Table 1: Total Number of Children Referred to CoBALT since Fall 2016 (Cumulative Total: 2,686) Age at Evaluation (in years) 2.8 years Wait time from PCP Referral to CoBALT eval 85.5 days Distance to CoBALT center 28.3 miles PCP referrals about possible ASD 83% CoBALT suspected ASD 59.2% Percentage referred to DDC 51.5%% Agreement rate between CoBALT and DDC 96.1% Table 2: CoBALT demographic/clinic data September 2016 – December 2024