Early Autism Evaluation

During the 2023 calendar year, 1,026 children with an average age of under 32 months were served across the EAE Hubs. Fifty-seven percent of evaluated children received a diagnosis of autism. In children not diagnosed with autism, other diagnoses included speech delay, developmental delay, and other conditions. The hub system’s average wait time for evaluation of under four months is dramatically lower than typically reported waits, thereby reducing the age of diagnosis and referral to intervention services.

Early Autism Evaluation System Outcomes for 2023

The goal of this initiative continues to be to improve localized access to early diagnostic evaluations for young children who are found to be at increased likelihood of autism and/or developmental delay based on developmental screening and/or parental caregiver or clinician concerns. Regardless of their diagnoses, eligible children are referred to receive subsequent evidence-based interventions at the earliest age possible.

Early Evaluation Hubs

The EAE Hub system has trained and coached over 25 primary care practices and 85 clinicians and their teams since its launch in 2012, building advanced skills in screening, diagnosis, and management of young children with autism for over 60 primary care clinicians. Currently we have 18 teams across Indiana who perform evaluations and participate in the monthly learning collaborative group activities, which include content on challenging case presentations, updated autism diagnosis and care management practice standards, billing and coding guidance, and information on statewide autism resources.

Trained clinicians throughout the state receive referrals from local and regional primary care offices to provide structured diagnostic evaluations and deliver detailed clinical reports which qualify children for needed next step interventions. In cases where the child’s diagnosis is not definitively determined during the EAE Hub evaluation (under 20% of cases), families are assisted in a referral for further subspecialty evaluation, including through Riley Hospital for Children’s Developmental Medicine and/or Child Psychiatry services.

Clinical Pathway

The following is an algorithm representing the evaluation procedure used during an EAE hub clinical evaluation. It incorporates a review of developmental screening results, a diagnostic interview including assessment of DSM-5 criteria for autism and a medical and developmental history, the administration of a structured observational assessment for autism (i.e., Screening Tool for Autism in Toddlers and Young Children; STAT), and  physical examination, followed by integration of the data to formulate and present a clinical diagnosis to the family, and then the creation and dissemination of a clinical report which includes recommended next steps for care management.