HJAR Mar/Apr 2025

HEALTHCARE JOURNAL OF ARKANSAS I  MAR / APR 2025 15 developmental concerns, medical comor- bidities of ASD, and medical management of ASD and comorbid conditions. The last 13 lectures help elucidate evi- dence-based treatments, as well as both statewide and national resources for developmental and autism concerns. Top- ics addressed here include Arkansas state programs that assist families navigate the health system, avail of appropriate services, and address insurance matters; applied behavioral analysis (ABA) intervention; technology resources; and tools for tran- sitioning into adult services. State leaders on these topics have graciously volunteered their time for these lectures. Leaders from national level Autism Speaks also presented for this series. These lectures are now archived as enduring medical information on the UAMS Learning on Demand website and can be accessed for CEU credit as well. Much still needs to be undertaken to pro- vide quality care for children with develop- mental concerns in our state. It is hoped that these CoBALT initiatives will bring children closer to timely evaluations and appropri- ate services. It is also CoBALT’s directive to empower our state’s healthcare profession- als as the first line of support for families by sharing knowledge relevant to their compe- tencies of caring for children with develop- mental concerns. To access the lecture series, “Autism Spectrum Disorder: Moving the Needle for Children and Families in Arkansas,” please visit the following link: https://learnonde- mand.org/lms/asd To see locations of CoBALT teams and those practitioners, please visit the CoBALT website at CoBALTAR.org. n that over 2,600 children have been referred to CoBALT teams inArkansas (refer to Table 1). The agreement rate of diagnosis given between CoBALT team evaluations and DDC evaluations has been consistently optimal at 96.1% (refer to Table 2). The CoBALT pro- gram is now led by Jayne Bellando, PhD, and Jaimie Flor, MD. Autism Spectrum Disorder: Moving the Needle for children and families in Arkansas Though PCPs are often the “first point of contact” for caregivers voicing autism concerns, research has shown that PCPs have a low comfort level and perceive low self-competence in providing ongoing care for patients with ASD. 6,7,8,9 While PCPs may be aware of the need to enhance care for ASD individuals within the primary medi- cal home setting, they also have to contend with time constraints, a paucity of diagnos- tic and treatment services, limited access to resources, and a lack of focused training. 8,9 CoBALT has collected quality improve- ment data that has shown that while most CoBALT referrals from primary care pro- viders are for autism (97.2%), our CoBALT teams are finding the actual number of autism concerns after a Tier II screening to be less (79.4%). This data is consistent with studies at other sites who measure similar information. An autism screening initia- tive in Indiana showed that primary care physicians trained to do Tier II screenings found that of 858 children referred for these services, 80% had autism as the PCP pri- mary concern, but 40%were actually diag- nosed with autism. 10 Aprospective study at Montreal Children’s Hospital looked at 224 children referred to either developmental pediatrics or pediatric neurology for devel- opmental concerns. 11 The final diagnosis for the patients showed that 35.3% of the final diagnosis differed from the referral question by the medical provider. 11 These studies and the CoBALT internal data underscore the need for available train- ing opportunities for healthcare provid- ers in the state to help them hone a sense of self efficacy as well as a robust knowl- edge base regarding ASD. PCPs need to be adept at recognizing ASD signs, conduct- ing a good developmental history, setting up their office to accommodate developmental screenings, and giving feedback to families about their ASD concerns. While PCPs may refer a child to an autism diagnostic center, the child returns to their PCPs for followup care. Therefore, it is crit- ical that PCPs know how to access edu- cational, community, state, and national resources; guide families to pursue evi- dence-based interventions; as well as have the skills to manage medical and behav- ioral conditions that co-occur with ASD. 6 Current research suggests that even short term or brief training workshops resulted in physicians perceiving themselves as bet- ter equipped to address the needs of their patients with ASD. 8 With these goals in mind, the two-year, web-based series entitled “Autism Spectrum Disorder: Moving the Needle for Children and Families in Arkansas” was created by CoBALT. Each didactic session is about an hour long in duration, and the virtual plat- form affords clinicians the convenience to learn on their own time and the ease to learn at their own pace. Clinicians also have the option to access sessions on particular top- ics to focus on specific knowledge gaps. The first 12 lectures highlight a medical review of autism. Topics discussed include DSM-5 autism spectrum disorder crite- ria, how to identify behavioral features of autism, debunking myths and misconcep- tions about autism, talking to families about