Abstract
Problem:
Due to the unique qualities of Northern California (NorCal), services for individuals with autism spectrum disorders or other developmental disabilities (ASD/DD) and their families are extremely limited. The area, covering approximately 66,000 square miles and 14.5 million people, is largely rural and agricultural and characterized by a culturally diverse population, significant poverty, and marked health disparities. There is no ethnic majority group, and large numbers of residents are immigrants or migrant workers for whom the primary language of the family is not English. Health services for children and youth with ASD/DD are clustered in children's hospitals in the urban areas that make up the southern border of this region - San Francisco, Oakland, and Sacramento. The COVID-19 pandemic has increased disparities for under-resourced families in areas where children are already inadequately diagnosed and treated, who often must travel hundreds of miles to find specialists. The NorCal LEND is the primary multidisciplinary, interprofessional training program in the region that provides training in the core disciplines that support children with ASD/DD and their families - PT, Education, SLP, clinical and behavioral psychology, child psychiatry, developmental and behavioral pediatrics, and social work among others. The NorCal LEND is housed at the UCD MIND Institute - a research, clinical, and training setting focused on ASD/DD, which serves the Northern California region. A highly experienced, diverse interdisciplinary faculty from UCD and California State University Sacramento (CSUS) have successfully implemented an innovative training program for short, medium, and long-term trainees to develop their leadership skills and better meet the health and treatment needs of children with ASD/DD and their families. In the first 5 years of funding, the NorCal LEND program trained 49 long-term, 21 advanced medium, 65 medium-term and over 6,500 short-term trainees in its effort to prepare the next generation of practitioners in current best practices in diagnosis, treatment, and collaborative interdisciplinary, family-centered, culturally competent care. To meet the health and intervention needs of northern CA children with ASD/DD and their families, this next generation of practitioners has also received training and practice in leadership skills that will both increase capacity of community and state care delivery systems and develop new approaches to care. Seventy percent of the long-term trainees in our first five years came from historically underrepresented groups, a demonstration of our commitment to address these groups and our success at recruitment. With this renewal, the NorCal LEND Program proposes to continue and further develop our goal to recruit and prepare new leaders in ASD/DD by providing a balance of culturally competent academic, clinical, and community opportunities focused on evidence-based screening, diagnosis, treatment, and community support for children with ASD/DD and their families, particularly those from ethnically diverse and under-resourced communities.