ECHO autism adult healthcare: Training community clinicians to provide quality care for autistic adults

Beth A Malow; Micah Mazurek; Gary Stobbe; Mavara M Agrawal; Rachel Loftin; David Caudel; Amy Hess; Alexander Westphal; Joshua Smith; Janet Shouse; Nancy Cheak-Zamora; Kristin Sohl

doi:10.1002/aur.2996

ECHO autism adult healthcare: Training community clinicians to provide quality care for autistic adults

Autism Res. 2023 Aug;16(8):1619-1629. doi: 10.1002/aur.2996. Epub 2023 Jul 31.

Authors

Beth A Malow^{1

2}, Micah Mazurek³, Gary Stobbe⁴, Mavara M Agrawal⁵, Rachel Loftin⁶, David Caudel⁷, Amy Hess⁸, Alexander Westphal⁹, Joshua Smith¹⁰, Janet Shouse², Nancy Cheak-Zamora¹¹, Kristin Sohl¹²

Affiliations

¹ Sleep Disorders Division, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
² Vanderbilt Kennedy Center for Excellence in Developmental Disabilities, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
³ Department of Human Services, University of Virginia, Charlottesville, Virginia, USA.
⁴ Center on Human Development and Disability, Department of Neurology, University of Washington, Seattle, Washington, USA.
⁵ Department of Humanities, Health and Society, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA.
⁶ Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois, USA.
⁷ Frist Center for Autism and Innovation, Department of Engineering, Vanderbilt University, Nashville, Tennessee, USA.
⁸ Behavioral Health, Child Development Center, Nationwide Children's Hospital, Columbus, Ohio, USA.
⁹ Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.
¹⁰ Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
¹¹ Department of Health Sciences, University of Missouri, Columbia, Missouri, USA.
¹² Department of Child Health, University of Missouri School of Medicine, Columbia, Missouri, USA.

PMID: 37519223
DOI: 10.1002/aur.2996

Abstract

Autistic adults experience significant unmet healthcare needs, with opportunities for improvement in both the systems and the practitioners who serve this population. Primary care physicians/practitioners (PCPs) are a natural choice to provide comprehensive care to autistic adults but often lack experience in serving this population. This pilot study developed and tested an Extension for Community Healthcare Outcomes (ECHO) Autism model adapted from our previous work, focused specifically on training PCPs in best-practice care for autistic adults. The project was informed directly by the perspectives and preferences of autistic adults, caregivers, and PCPs. Two consecutive cohorts of PCPs participated in ECHO Autism Adult Healthcare sessions. Each cohort met 1 h twice a month for 6 months, with 37 PCPs (n = 20 in Cohort 1, and n = 17 in Cohort 2) participating. Based on findings from the first cohort, adjustments were made to refine the session preparation, curriculum, conduct of the ECHO, resources, and evaluation. After participation in the ECHO Autism program, PCP self-efficacy and satisfaction improved, while the number of perceived barriers did not change. Knowledge did not improve significantly in Cohort 1, but after adjustments to the training model, participants in Cohort 2 showed significant knowledge gains. While attention to systems of care is critical to addressing barriers in healthcare in the autistic population, the ECHO Autism Adult Healthcare model is feasible and holds promise for improving PCP satisfaction and self-efficacy in working with autistic adults.

Keywords: adults; autism; cases; education; self-efficacy.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adult
Autism Spectrum Disorder* / therapy
Autistic Disorder* / therapy
Delivery of Health Care
Humans
Pilot Projects
Self Efficacy