August 2021

Vanderbilt Adult Program

Every year, approximately 50,000 people with autism turn 18-years-old and transition to adult health care. In an effort to increase access to community-based primary care physicians and practitioners (PCPs), who are well-equipped to deliver best-practice autism care, Vanderbilt University, the University of Virginia, and the University of Missouri developed a program that enhances provider expertise to meet the unique needs of this population.
With funding from a Department of Defense grant, ECHO Autism: Adult Healthcare launched a six-month pilot study in November 2020 with 20 participating PCPs across the United States. An interdisciplinary panel of world-renowned autism experts, including a Neurologist & Autism Specialist, Vanderbilt University; Med-Peds Physician & Autism Medical Specialist, Florida International University College of Medicine; private practice Clinical Psychologist & Autism Behavior Specialist, Chicago, Illinois; Neurologist & Autism Specialist, University of Washington Medicine; Psychiatrist & Autism Behavior Specialist, Yale School of Medicine; and the mother of a child with autism & Family Navigator, Nationwide Children’s Hospital came together twice, monthly with community-based PCPs to discuss de-identified patient cases. By utilizing the ECHO model®, expert panelists mentored and coached PCPs on how to manage the medical and psychiatric conditions of their autistic patients and how to connect them to evidence-based autism resources, services, and supports. Two additional experts served on the team, adding an invaluable perspective- lived experience of being a person with autism. One of the self-advocates is a Professor of Special Education at Adelphi University. The other expert is a Physicist & Associate Director at Vanderbilt Center for Autism and Innovation and brings a dual perspective, as he is also a father to children with autism. Having an autistic person and/or a family member of child with autism represented on each ECHO Autism expert hub team is a hallmark of the program.
Currently, pilot study results are being analyzed and the team is gearing up for the launch of a new cohort in November 2021. Recruitment is open to PCPs who serve adults, including physicians (family practice, internal medicine, osteopathic or naturopathic doctors), advanced practice nurses, or physician assistants. TeleECHO sessions will be held on the 1st and 3rd Thursday of each month at 1:00 eastern time, starting November 4 and will run through April 2022. If you are interested in joining, contact Janet Shouse, study coordinator, at janet.shouse@vumc.org.
August 2021

Encircle Technologies

Address: 16 Hitt St, Columbia, MO 65203
Phone:(573) 514-5226
EnCircle Technologies, a program of Mid-Missouri’s non-profit group Woodhaven, is a center fortraining and educating people on the autism spectrum. Columbia, Missouri is a hub for families with autism, due to the local access to autism specialists and research facilities. Founded by Teri Walden and Becky Llorens, this program offers three types of classes- social skills, tech skills, therapeutic recreation- to anyone neurodiverse from school age and older. The first EnCircle class was taught to three students by one instructor in Lloren’s basement and has been growing since then. Popular classes include “Make Your First Video Game,” “Improv For Fun & Self Expression,” and “Intro to C++ Programming.” While many classes have been taughtvia Zoom during the COVID-19 pandemic, classes are typically held at the program’s downtown Columbia location.EnCircle has helped over a hundred students hone their technology skills, they also help students who just want to increase their social and communication skills, such as Alex. Alex enrolled in Improv for Fun & Self-Expression, an innovative class created by EnCircle’s Instructional Specialist, Jamie Bolyard. Alex showed up to each class with a smile and an eagerness to learn and connect with her classmates. Alex’s self-confidence increased, and she freely shared her creativity and enthusiasm. She also expressed her curiosity, often initiating questions and conversation topics that fostered class connection. About her experience with EnCircle, Alex said, “my classes and experiences with EnCircle Technologies program has allowed me to develop more self-confidence and focus on my strengths.”EnCircle’s funding comes from a variety of public and private sources, which allows students to apply for scholarships and enroll in classes at no cost to them. Student satisfaction rates are quite high, with 84.6% of students agreeing that classes are useful for reaching future personal goals, and 96.7% of students reporting skill gain in Spring 2020. A key component to this success is EnCircle’s co-teaching model, which brings together a content expert, such as a full-time computer programmer, with a staff member trained in best practices for instructing neurodiverse students. This team-teaching approach gives students the opportunity to learn directly from professionals in the field while also having the stability and expertise of an instructional specialist.The COVID-19 pandemic initially posed a challenge to the program, but it was able to pivot to virtual instruction quickly according to Lukin Murphy, Director of EnCircle Tech. “Actually, the switch to virtual classes has created the exciting opportunity to expand the geographic reach of the program and has allowed students with transportation barriers the ability to participate in more classes.” says Lukin. According to Lukin and the rest of the staff, the social connections between students has always been an important component of the program but has become even more crucial due to the isolation experienced by many during COVID. To learn more about EnCircle Technologies and Woodhaven, visitwww.woodhaventeam.org/encircle-technologies
August 2021

ECHO Autism: Mental Health

Since the pandemic, mental health awareness has increased across the globe. Clinicians in the autism field have had a heightened awareness of mental health concerns long before the pandemic due to the high prevalence of co-occurring psychiatric conditions associated with autism. Despite this fact, there are very few clinicians who have the expertise to adapt evidence-based mental health interventions for people with autism. In September 2020, ECHO Autism Communities, the Missouri Department of Mental Health, and Autism Speaks partnered to launch ECHO Autism: Mental Health. The overarching goal of this program is to increase access to community-based clinicians who are well-equipped to deliver best-practice therapeutic modalities modified for individuals with autism. The program focuses on increasing clinician self-efficacy in identifying the need for and implementing Cognitive Behavioral Therapy (CBT) as one component of a comprehensive treatment plan for people with autism and co-occurring psychiatric conditions.
This program is spearheaded by an interdisciplinary panel of leading experts in the autism field, including Brenna Maddox, Ph.D., Clinical Psychologist, University of North Carolina Chapel Hill; Rachel Brown, MBBS, Child & Adolescent Psychiatrist & Department Chair, University of Kansas; Melinda Odum, MSW, LCSW, University of Missouri; and Ellie Madigan, a mother of a child with autism and co-occurring mental health concerns who lives in Missouri.
During the summer of 2020, the University of Missouri ECHO Autism Communities team recruited 28 licensed therapists across the state of Missouri and 2 from Illinois who were committed to learn more about autism and how to modify therapeutic interventions to meet the needs of their autistic clients. Recruitment was focused on mental health clinicians in rural parts of the state, in an effort to create better access to community-based care where autism expertise is limited, and in many places, non-existent. Another key recruitment consideration was to engage mental health clinicians in the geographical proximity of clinicians participating in the ECHO Autism: Primary Care and ECHO Autism: Psychology programs. This continues to grow already established communities of physicians and clinicians who evaluate and provide care for people with autism across Missouri.
Program participants came together for a one-day virtual training, hosted by the expert panelists, prior to the program’s launch. Covered topics included Autism Across the Lifespan, Common Co-Occurring Psychiatric Conditions in Autism, Modifying CBT, and Community Resources. The highlight of the training included a parent panel and self-advocate presentation.
Program teleECHO sessions were held for 90 minutes each on the 2nd and 4th Monday of each month from October through May 2021. During each teleECHO session, a de-identified patient case was presented by a community-based clinician, followed by a rich discussion among the expert panel and the other clinicians. Everyone had an opportunity to ask clarifying questions and provide best-practice recommendations. Additionally, one of the expert panelists gave a brief 20-minute lecture on a specific topic during each session. These two knowledge-sharing components are the core elements of the ECHO model®.
Clinicians who participated in the program reported high satisfaction and improved confidence in their ability to best serve their clients with autism. ECHO Autism Communities is excited to announce another opportunity for licensed therapists to join the program in the fall of 2021! To sign up, contact Robin Wilcox at WilcoxR@health.missouri.edu.