Beginning in 2012, the Department of Pediatrics at Indiana University School of Medicine created a network of Early Evaluation Hubs throughout the state, stretching from South Bend to Evansville. In 2018, community-based providers at these hubs evaluated more than 900 children. Notably, children seen in the hubs are receiving their diagnoses of autism and/or developmental delay before age three. The goal is to continue to expand this hub model and to further develop a navigation system for families to access evidence-based interventions in a timely manner after their child’s diagnosis.
Early Evaluation Hubs
The Neurodevelopmental Behavioral System of Care is a statewide effort in Indiana to improve early detection and intervention for children ages 1-4 years old with autism or developmental delay. By training primary care physicians throughout the state to recognize the signs and perform an evaluation for autism and other neurodevelopmental conditions, the program addresses the long-standing nationwide problem of long wait times for families who are seeking evaluation for a developmental concern. At Riley Hospital for Children in Indianapolis, prior to the start of this project, the average wait time from referral to patient visit was over a year, meaning many children missed the early-detection window.
After a positive screen by their local pediatrician, children at risk for developmental delay can receive further evaluation and diagnosis at an Early Evaluation Hub within their own communities. The hubs also facilitate referral to Riley Hospital for Children for those who need additional assessments after the hub visit. The system has reduced the wait time for evaluation from one year to less than three months, resulting in reduced age of diagnosis.
The Early Evaluation Hub program has trained and coached 14 practices throughout Indiana to perform early evaluations of young children with developmental concerns. This has decreased the age of diagnosis of developmental delays and autism spectrum disorder among participants to under age three, but there is still additional outreach needed to drop the average age across the whole state.