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Key elements

A multidisciplinary training clinic

The multidisciplinary approach was central to the ASD LEND Training Clinic I created within the Regional Autism Center (RAC) at CHOP, in collaboration with Dr Susan Levy. The Training Clinic was a multidisciplinary assessment team for young children referred for an ASD diagnosis, operating one day each week for 11 months of the LEND annual cycle.  Over the LEND year, ASD LEND Fellows assumed more and more responsibility for all aspects of assessment: within 6 months, they were responsible for assessment, report-writing, and family feedback for one case, and by the end of the year assumed this responsibility for up to 3 cases each week. The weekly clinic helped to reduce the waiting list for assessments at RAC (as long as 18 months prior to my tenure) and provided an opportunity for other LEND trainees to observe diagnostic assessments from start to finish.

Introductory ASD postgraduate training

Too many workshops are one-size-fits-all, failing to adapt the content and intensity to the specific role a professional might play.  I extended the tiered and tailored model I had relied on in Delaware (Doehring, 2013) in the design of LEND. For example, I created an 18-hour training (Autism I) for all LEND fellows to include:  4 hours of traditional workshops on assessment and intervention; A 1 hour workshop co-taught with the parent of a child with ASD on the experience of families with ASD; A 1 hour workshop on the administration and interpretation of ASD screening measures (as part of a program requiring that trainees conduct or participate in ASD screening described elsewhere), and; 12 hours observing actual assessments conducted in the LEND ASD Training Clinic (see above).

Advanced ASD postgraduate training

I created an intensive, Autism II cycle for 4 ASD LEND Fellows who focused their LEND experience on ASD to include: 45 hours of advanced training in assessment, intervention, research, and policy; Supervision from myself and from their discipline advisor for their work in the LEND ASD Training Clinic described earlier, and; Participation in the NextSteps workshops to prepare them to provide such training in the future (Doehring, 2011). Over the course of their LEND training, they gradually assumed a greater role until the final workshop during which they assumed full responsibility for delivering content and answering questions pertaining to their discipline. The development of this advanced training served as the base for the addition of a new position at CHOP, a specialized predoctoral psychology internship.  This advanced training also served as the base for the creation of a new role for Practicing Nurse Practitioners (PNPs), who began to play a more active role in the diagnosis of ASD in certain types of cases (Ott, Levy, & Doehring, 2010).

Parent and professional workshops

I included LEND II Trainees in the NextSteps workshops, to expose them to the challenges faced by parents of newly diagnosed young children, and to prepare them to provide such training in the future (Doehring, 2011). Over the course of their LEND training, they gradually assumed a greater role until the final workshop during which they assumed full responsibility for delivering content and answering questions pertaining to their discipline.

Community-based action research

I helped to develop community-based research projects focused on ASD and culminating in a conference presentation. Examples included aligning treatment recommendations  between hospital and community providers (Manfredi, Folsom, & Doehring, 2010), defining a role for Nurse Practitioner in ASD diagnosis (Ott, Levy, & Doehring, 2010), and assessing the knowledge of parents and professionals before and after an autism workshop (Pucci, Berry, & Doehring, 2010).

ASD Screening in the homeless shelters

A program to offer ASD screening within the Homeless Health Initiative. The Homeless Health Initiative (HHI) is a volunteer outreach program providing medical and dental services to children in area shelters and assist families in accessing important health care services including health insurance, primary care and specialty care. I created a program to offer ASD screening within HHI. LEND fellows participated in regular visits with of CHOP professionals in the homeless shelters of West Philadelphia.  They conducted ASD screening for young children using the Modified Checklist for Autism in Toddlers (M-CHAT) and the Social Communication Questionnaire (SCQ).