Funded Projects

Problem:

About 70% of counties in NC are medically underserved, with NC having the 3rd highest rate of ASD nationally. The number of professionals trained to work with ASD and other I/DD and their families is below national standards. Unidiscipline models are inadequate to address these public health needs.

Goals and Objectives:

Goal 1: Provide exemplary interdisciplinary leadership training to health care professionals who focus on prevention, early detection, assessment, medical home, and health promotion. Objective 1: Recruit and provide interdisciplinary clinical training to 22 Long-Term interdisciplinary trainees (300+ hours) per year to increase their experience in the screening, assessment, diagnosis, and evidence-based intervention for ASD and related I/DD. Objective 2: We aim to provide training to 6-7 minority Long-Term trainees during each of the next 5 years, with the goal of increasing the percentage of Long-Term leadership trainees from approximately 24% for the 2006-2011 time period to approximately 34% over the next 5 years. Objective 3: Using a hybrid model of web-based, didactic, and clinical activities, provide at least 25 hours of dedicated cultural competency training to all trainees each year, with a particular focus on ASD and related I/DD issues. Goal 2: Provide exemplary clinical and community-based interdisciplinary services which are family based and culturally appropriate, for populations with or at risk for neurodevelopmental disabilities. Objective 1: Provide model interdisciplinary diagnostic and intervention planning services in the CIDD Clinic, Hospital/Dental School, and community for at least 1000 children and adolescents each year who are at risk for or have ASD or related I/DD. Objective 2: In accordance with Bright Futures, provide dental screenings to at least 100 consumers with ASD and related I/DD each year as part of interdisciplinary services within the NC-LEND. Objective 3: Provide at least 4 interdisciplinary clinics on-site at the CIDD that focus specifically on the screening, assessment, and treatment of individuals across the lifespan who have or are suspected of having an ASD as a basis for modeling evidence-based practices. Goal 3: Provide CE that fosters family-centered, coordinated care and improves systems-of-care and advocacy skills for populations with ASD and other I/DD at the state and national levels. Objective 1: Conduct 3 regional statewide workshops each year targeting community professionals (e.g., pediatricians) to increase the number of trained professionals who can screen, assess, diagnose, and provide evidence-based interventions for individuals with ASD and related I/DD and their families. Objective 2: Working within the Southeast Regional Consortium, that includes other LEND and UCEDD programs within Region IV, we will offer 1 CE program each year on CSHCNs, including individuals with ASD and related I/DD, to professionals and LEND trainees in the southeast region and nationally. Objective 3: NC-LEND faculty and trainees will present a minimum of 25 seminars, workshops, and institutes on ASD and I/DD-related topics, including self-advocacy by our Youth Consumers, to be attended collectively by at least 1,500 individuals annually. Goal 4: Provide TA to Title V and other local, state and national partners to improve community-based services and supports for children with ASD and other neurodevelopmental disabilities and their families. Objective 1: Provide a minimum of 500 hours of TA/C on issues pertinent to CSHCNs, including ASD and related I/DD, to state and national Title V and other MCH-related partners annually by serving on task forces, committees, policy forums, and work groups. Objective 2: Provide a minimum of 500 hours of TA/C in evidence-based practice and policy to teachers, special educators, school administrators, and related educational personnel with respect to the development of a knowledge base for working with CSHCNs, including those with ASD and related I/DD. Objective 3: Each year, at least 1 Long-Term trainee will work in a leadership capacity with 1 or more of the following organizations, UNC MCH Leadership Consortium, NC Autism Alliance, NC Postsecondary Education Alliance, ASNC, NC Early Detection of Hearing Impairment, and NC MCH Children and Youth Branch. Goal 5: Provide leadership experiences related to the application and dissemination of research findings into community programs and the larger arena of population-based services and infrastructure building. Objective 1: Long-Term trainees will attend monthly research presentations on ASD and other developmental disabilities-related topics via the UNC IDDRC. Objective 2: NC-LEND faculty and trainees will produce a minimum of 25 peer reviewed journal articles, books, chapters, or educational products each year that are relevant, evidence-based, or tied to emerging health related issues pertaining to individuals with ASD and related I/DD. Objective 3: All Long-Term trainees will present their research efforts at the Annual NC-LEND Trainee Research Conference conducted in the spring of each year.

Methodology:

To accomplish our targeted goals and objectives, we have evolved a comprehensive, competency-based interdisciplinary training curriculum that consists of didactic and clinical/community components. Additionally, the NC-LEND curriculum is built upon the MCH leadership competencies and is designed to develop the future leaders of MCH. Trainees are mentored by faculty advisors in developing their individual Interdisciplinary Training Activity Plan, with experiences extending across Educational, Clinical, Research, and Systems Change tracks. Follow-up evaluations occur at least 3 times per year. An innovative leadership training model, including single discipline and interdisciplinary mentoring within the ID setting, a hybrid cultural competency training curriculum , and our year-long Interdisciplinary Training Across the Lifespan Problem-Based Learning Course are employed. NC-LEND faculty also will engage in technical assistance, continuing education, and research activities, particularly as these activities may influence systems and policy change for I/DD and ASD disorders. All of these leadership activities have been designed to be cultural competent, family-based, and population-oriented, and applicable for individuals with intellectual and developmental disabilities, with a special focus on increasing awareness of ASD as well as the number of professionals trained to conduct screening, assessment, and evidence-based interventions for individuals with ASD and their families.

Coordination:

The NC-LEND is closely coordinated with medical school departments, university departments, and nearly every major division in the NC Department of Health and Human Services, particularly our Division of Public Health and Title V agencies. We have established local, state (Autism Alliance, Postsecondary Alliance), and national (Southeast Region Consortium) networks. This strong coordination facilitates our interdisciplinary training, technical assistance, and continuing education initiatives.

Evaluation:

Using the logic model, the evaluation components pertain to (1) trainee progress in the competency-based curriculum, (2) curriculum needs, (3) TA activities, (4) CE activities, and (5) research and dissemination of products to address the overarching goals and objectives of the NC-LEND. The NC-LEND Program employs quantitative and qualitative strategies to assess progress on the goals/objectives. A self-assessment and the required National Performance Measures also are completed annually.