Clinical Training Unit

Contact: Beth Ogata (bogata@uw.edu)
Core Function: Professional Training

Assuring Pediatric Nutrition in the Hospital and Community, an intensive training program, is offered once a year to community-based registered dietitians (RDs). Other health care professionals with an interest in pediatric nutrition are also invited to attend. The training prepares RDs to screen children for nutrition problems, assess specific nutritional needs, and develop interventions for children with special health care needs.

RDs can earn up to 26 hours of continuing education credits from the Commission on Dietetic Registration for participating in the training. During the four-day intensive training program, 20 speakers cover an array of nutrition and feeding issues faced by children with special health care needs. Speakers from the University of Washington and Seattle Children’s Hospital represent a variety of disciplines. The class is limited to 40 participants to facilitate interaction and small group learning experiences and to promote development of clinical competencies. The conference was expanded in 2016, to provide training opportunities at an advanced level. Participants can select from a 3-day introduction to pediatric nutrition or a 2-day advanced topic option.

Core Function: Clinical Services

Children who are born with complex congenital heart disease (CHD) are at risk for problems with the growth and development of their brain and central nervous system. The Cardiac Neurodevelopmental Clinic evaluates and treats babies and children with complex congenital heart defects who had heart surgery before their first birthday. Clinicians provide close follow-up during their first 5 years of life and offer intermittent follow-up and consultation for children age 5-18 years. A visit to the Cardiac Neurodevelopmental Clinic can provide reassurance that a child’s brain and central nervous system are developing normally. Clinical disciplines available in the clinic include: developmental behavioral pediatrics, psychology, physical therapy, occupational therapy, speech therapy, social work, nutrition, and audiology. Clinic staff members work in interdisciplinary teams, combining expertise to evaluate each child and make recommendations for care. If clinicians find developmental issues, they can help connect families with the therapies that make a difference.

Contact: Child Development Clinic (chdevcl@uw.edu)
Core Function: Clinical Services

The Child Development Clinic provides diagnosis, assessment and management plans for children from early childhood to adolescence with or at risk for neurodevelopmental disabilities. Clinic staff members work in interdisciplinary teams, combining expertise to evaluate each child and make recommendations for care. Staff members include professionals from audiology, developmental/behavioral pediatrics, nursing, nutrition, occupational therapy, physical therapy, psychology, social work, and speech and language pathology. The clinic is the primary venue for interdisciplinary clinical training under the auspices of the Leadership Education in Neurodevelopmental Disabilities training grant awarded by the Maternal and Child Health Bureau using Combating Autism Act funds. Trainees participate in hands-on and didactic training which includes assessments, parent conferences, lectures, and report writing.

Clients are diagnosed with an array of developmental disabilities including intellectual disability, autism spectrum disorders, motor disabilities, learning disabilities, behavioral disorders, communication disorders, and attention-deficit hyperactivity disorder.

Contact: Sophie Lu (sophielu@uw.edu)
Core Function: Information Dissemination

The Child Health Notes (CHN) project provides health care providers in the community with a series of newsletters that contain current information on the early identification and management of special health and developmental concerns of infants, children and youth. The goal of the CHN project is to support community-based medical homes for children by facilitating partnerships among primary care providers, families, community early intervention providers and specialists. A medical home is a team approach to providing comprehensive primary health care services in a high-quality and cost-effective manner.

The CHN newsletters are developed for physicians, nurse practitioners, physician assistants, public health nurses, family resource coordinators, early intervention providers, childcare providers, and other community providers who participate in medical homes. Each newsletter includes information on a health or development topic, management suggestions for primary care practices, and local, state and national resources for professionals and families. The CHNs are customized and distributed electronically or in print by county medical home leadership network resource teams, local health jurisdictions, health plans or other health programs. Customized health notes include additional key resources and information for primary health care providers within their local area.

Contact: Kate Orville (orville@uw.edu)
Core Function: Technical Assistance and Outreach Training

The Community Asset Mapping (CAM) project is a collaboration between local communities and Washington State Maternal and Child Health Title V partners. These partners include the University of Washington Leadership Education in Neurodevelopmental and Related Disabilities (LEND), the Washington State Department of Health, and the Washington State Medical Home Partnerships Project (MHPP). CAM staff and a network of state partners help communities strengthen local systems to screen, evaluate, diagnose and provide timely intervention services to children with autism and other developmental disabilities. CAM is a process and forum for communities to identify issues around serving all children, but especially children with special healthcare needs and their families. This is done through a community-driven process of identifying assets and challenges in how children are currently being identified and served, prioritizing opportunities to improve care, and moving forward as a community to pilot and implement improvements. CAM staff help communities identify and address training needs, as well as examine how to improve communication and referrals to state diagnostic centers for more complicated evaluations.

The CAM project was developed by the state Washington Autism Advisory Council in 2009 and has benefited greatly from the active support of council participants. Since 2009, twelve rural Washington State communities have had facilitated community discussions and continue to work on these issues locally. The CAM process has proven to be a successful tool for igniting community coalitions and improving services for children with special health care needs, specifically children with autism and their families.

Contact: Sue Wendel (swendel@uw.edu)
Core Function: Clinical Services, Professional Training

Several clinics in the region, including Yakima Children’s Village, Northwest Autism Center in Spokane, Boyer Children’s Clinic, etc., provide services to children and adults with special needs; UCEDD faculty and trainees in professions relevant to developmental disabilities participate in a variety of ways in these specialized clinics, as described below.

Yakima Children’s Village: located in central WA and supports over 30 different specialized services for families living in Yakima County, with a high percentage of rural and native Spanish speaking population. Children’s Village has medical specialty clinics that provide developmental evaluations and diagnostic services, dental services, occupational, physical and speech therapy, mental health counseling, education services, behavioral intervention and nurse home visiting services to thousands of children annually.

Northwest Autism Center in Spokane: located in less populated eastern WA and serves families in Spokane County. Northwest Autism Center facilitates and coordinates comprehensive services for individuals with autism spectrum disorder and other developmental disabilities through the lifespan, using community-based approaches.

Boyer Children’s Clinic, a community-based clinic, is a non-profit therapy and early childhood educational facility serving children from birth to three years of age who have neuromuscular disorders such as cerebral palsy or delays in development. The mission of Boyer Children’s Clinic is to improve the quality of life of children with neuromuscular disorders or other developmental delays by providing the best solutions for each child and family. To achieve this mission, a multi-disciplinary team, including a developmental pediatrician, a nurse, speech pathologists, occupational and physical therapists, educators, family resource coordinators and a social worker, provides services. The team works closely with the family to conduct initial diagnostic assessments and plan and implement individual programs. Boyer Children’s Clinic is one of the CTU clinical sites for our pediatric fellows and residents.

Holly Ridge Development Center is a non-profit agency that provides services for children and adults with special needs. Holly Ridge Center is an outpatient center for children up to age three with a range of developmental disabilities. Located in Bremerton, WA, Holly Ridge serves clients in Kitsap County and portions of adjacent counties that are often underserved by medical specialists and far from urban tertiary centers.

The Kindering Center, a not-for-profit neurodevelopmental center, has been providing comprehensive services for children with special needs and their families since 1962. Each year thousands of infants and children receive crucial therapies, special education, and counseling. The Clinical Training Unit (CTU) of the UCEDD provides Nutrition consultation services, including chart review, evaluations, and collaboration in the development and monitoring of interventions.

Seattle Children’s Autism Center (SCAC) is a multidisciplinary clinic offering medical and mental health services to provide assessment, diagnosis, treatment and support to infants to young adulthood with ASD and their families. IHDD faculty provide patient care and facilitate clinical training for LEND fellows at SCAC. Other centers are Alyssa Burnett Adult Life Center that offers lifelong learning for people 18 & older with ASD/DD. Echo Glen Children’s Center is a medium/maximum security facility providing treatment services for younger male offenders and the only institution for female offenders. Consultation with psychologists regarding neurodevelopmental disabilities is provided.

Contact: Kate Orville (orville@uw.edu)
Core Function: Information Dissemination, Technical Assistance and Outreach Training

A ‘medical home’ is primary health care that is team-based, holistic, and centered on the patient and family. This project is funded by the Washington Department of Health (DOH) Children and Youth with Special Health Care Needs (CYSHCN) program. The Medical Home Partnerships Project helps WA Title V Program to meet their federal performance measures to improve access to medical homes, increase the percentage of children who receive early developmental and other screenings, and improve systems of care for CYSHCN, including patient/family-provider partnership.

Project activities include:

1. Provide technical assistance and support to 27+ county or clinic-based Medical Home teams, Community Asset Mapping coalitions, or county-based interdisciplinary autism diagnostic teams or networks improving care for CYSHCN across Washington. Pediatric clinics focus on improving overall ‘medical homeness,’ care coordination, and developmental screening and referral for children whose families do not have English as a main language. The CAM coalitions bring together community providers from primary care, schools, behavioral health, early intervention, family support to collectively improve early identification and evaluation of children with autism and/or other developmental disabilities. Autism Diagnostic teams and networks organize around how to build community capacity to diagnose more children closer to home and avoid the long wait lists at tertiary care centers.
2. Provide leadership and consultation on state Universal Developmental Screening initiatives, including, Help Me Grow Washington, Central Washington Help Me Grow, Essentials for Childhood, and WA Frontiers of Innovation. These efforts are working to: a) identify and mitigate social determinants of health, b) increase parental and community awareness of optimal ways to support and nurture children in the prenatal period and first years of life, c) build on local developmental screening efforts in both health care and early childhood settings ensure all children are screened, d) address gaps in and link families to services that improve community provision of needed resources, and f) address policies at the local and state level that impact these efforts.
3. Research and write Child Health Notes (CHN), a quarterly one-page newsletter for pediatric primary care providers and others caring for children with special needs. Local communities adapt the newsletter resources section to include contact information for key local resources.
4. Provide trainings to Pediatric residents, LEND Fellows, public health students, nutritionists, dentists, and parents of CYSHCN on serving children through the medical home model and how to access key community resources.
5. Disseminate information on how the Medical Home Neighborhood (primary care, families, and community partners) can support children, their families and providers in Washington State through the project website medicalhome.org as well as through the project listserv with 300 subscribers.
6. Provide technical assistance to Department of Health led initiatives including the Collaborative Improvement and Innovation Network (CoIIN) to Advance Care for Children with Medical Complexity, the Washington Statewide Family Leadership (WSLI) Coalition for family-led organizations supporting families who have children and youth with special health care needs, and the WSLI Family Navigation Workgroup.

Contact: Sarah Harsh (sbharsh@uw.edu), Mari Mazon (lilmaro@uw.edu)
Core Function: Information Dissemination, Technical Assistance and Outreach Training

The Children with Special Health Care Needs (CSHCN) Nutrition Network project is designed to improve the availability of quality, community-based nutrition services for children with special health care needs in Washington State. This objective is achieved through providing ongoing training opportunities and resources to over 200 registered dietitian nutritionists (RDNs) in Washington State who provide nutrition services to children with special health care needs. The CSHCN Nutrition Network strengthens the capacity of RDNs to effectively respond to the nutrition needs of families and children with special health care needs.

The CSHCN Nutrition Network activities include an annual one-day workshop reaching 75 network members (RDNs) for continuing education and information exchange, an annual 2.5 hour webinar for continuing education, and opportunities to participate in other webinars designed for the pediatric focused RDN.  Membership in the Nutrition Network begins with an initial two-day training; to increase workforce capacity yearly trainings are provided.  Network members come from a variety of employment settings including local health departments, community clinics, hospitals, early intervention centers and home health agencies. New members are selected based on pre-defined community needs and demographics. Learn More at: http://depts.washington.edu/cshcnnut/

Contact: Sam Zinner (szinner@uw.edu)
Core Function: Professional Training

Developmental-Behavioral Pediatrics Training Programs provide interdisciplinary custom-tailored training experiences for pediatric residents and medical students from the University of Washington and for Developmental Behavioral Pediatrics fellows from Seattle Children’s Hospital as well as from the military fellowship program at Madigan Army Medical Center. Trainees participate in a variety of clinical and didactic activities both within IHDD and at community-based clinics to gain skills in evaluating the range of neurological development and behavior in the context of psychosocial influences. Combining developmental and behavioral aspects into the interdisciplinary training approach prepares trainees to integrate both influences as part of their customary surveillance and care.

Developmental Behavioral Pediatrics Fellows spend 3-6 months in Child Development Clinic, where they participate in the pediatric evaluation as well as the interdisciplinary team conference and parent conference. They are also LEND trainees and have the opportunity to present their research at the end of their second year, either as a poster or an oral presentation. One of the current Seattle Children’s Hospital fellows is doing her fellowship research project in PKU Clinic at the IHDD. Pediatric residents spend one month of their three-year training program dedicated to Developmental-Behavioral Pediatrics. Each trainee participates in a custom-tailored experience that emphasizes interdisciplinary participation. In addition, trainees explore family-centered care in a medical home model that serves as a foundation for general pediatrics management. Pediatric residents spend time in Child Development Clinic as well as the Infant Development Follow-up Clinic. Fourth-year medical students at the University of Washington School of Medicine may opt for two-week or four-week elective rotations in Developmental-Behavioral Pediatrics. Each trainee participates in a custom-tailored experience that emphasizes interdisciplinary participation and medical home family-centered care.

Core Function: Clinical Services

The Down Syndrome Specialty Clinic was founded in 2016 with the goal to provide long-term developmental and behavioral consults and care for individuals with Down syndrome and their families. Clinicians focus on providing formal developmental assessments, consultation for behavioral concerns, and assessment for common medical problems that can contribute to behavior or development concerns. They also collaborate with schools and early intervention programs to help provide the best environment for success. In addition, clinicians can assess for the co-existence of other diagnoses such as ADHD or Autism Spectrum Disorder. The specialists available in our clinic include: developmental behavioral pediatrics, psychology, physical therapy, occupational therapy, speech therapy, social work, nutrition, genetic counseling, and audiology. Clinic staff members work in interdisciplinary teams, combining expertise to evaluate each child and make recommendations for care.

Contact: Susan Adelman (adelms@uw.edu), Megan Goldenshteyn (megolden@uw.edu)
Core Function: Professional Training

The Families as Mentors (FAM) Program enhances the trainee’s understanding of the family experience of raising a child with a neurodevelopmental disability. Typically trainees learn directly from families through extended interactions and experiences that take place in the family’s home and community.

Trainee learning objectives include:

1. To view families as teachers
2. To appreciate the realities of raising a child with a disability;
3. To develop leadership skills in promoting systems change among professional peers regarding family-centered care
4. To recognize that services or recommendations that may appear to be critically important from a professional perspective may decrease in importance when viewed within the context of the family’s daily routines
5. To recognize and acknowledge biases, beliefs, and attitudes and how these may affect the client/family-clinician relationship. Discussion sessions are also held with fellows and faculty mentors to share and reflect on the FAM Program experiences and discuss readings.

Contact: Susan J. Hemingway (astley@uw.edu)
Core Function: Clinical Services, Technical Assistance and Outreach Training

The Washington State Fetal Alcohol Syndrome Diagnostic & Prevention Network (FAS DPN) is a network of one Washington State community-based clinic and the core clinical/research/training FAS DPN clinic at IHDD. The core clinic at the IHDD was first established in 1993 through support from the Centers for Disease Control. The single clinic was expanded into the statewide FAS DPN clinical network in 1995 through legislation.

The goals of the FAS DPN are primary and secondary prevention of FASD through screening, diagnosis, research, and training. The network seeks to:

1. demonstrate the value of interdisciplinary diagnostic clinics that accurately identify FASD in persons of all ages,
2. provide comprehensive treatment planning (medical, mental health, educational/vocational, and social service) to reduce secondary disabilities, and
3. locate and intervene with the birth mothers of these individuals to prevent recurrent births of affected children.

An additional goal is to disseminate this approach to other communities and train and support those local efforts to develop similar programs. The FAS DPN holds clinics at the IHDD and across the state of Washington. Each clinic in the network uses the same interdisciplinary approach and systematic diagnostic method, the 4-Digit Diagnostic Code and FAS facial recognition software developed by FAS DPN faculty. The FAS DPN began diagnosing patients in 1993 and has diagnosed over 3200 patients to date. The FAS DPN has expanded both nationally and internationally through the training of interdisciplinary teams. IHDD faculty members have trained over 225 interdisciplinary teams worldwide.

Other network activities include training UW students, interns, fellows and community professionals; offering an online course to instruct professionals on the use of the FASD 4-Digit Diagnostic Code; distributing FAS Facial Photographic Analysis software and downloadable diagnostic guides; and creating one of the largest clinical/research databases that it uses to conduct studies to improve the diagnosis and intervention strategies used for individuals with FASD. The FAS DPN is also providing annual reports describing demand for services to stakeholders including the Department of Health, the Department of Social and Health Services, the Department of Corrections, and the Office of the Superintendent of Public Instruction.

The FAS DPN co-chairs the Washington State Fetal Alcohol Spectrum Disorders Interagency Work Group (FASD IAWG) established in 1995 through legislation. The mission of the FASD IAWG is to ensure coordination of State programs/institutions (UW, DOH, DSHS, OSPI, and DOC) for individuals with FASD and women at risk of having children with fetal alcohol exposure. The FASD IAWG reports periodically to the Governor’s Council on Substance Abuse and key legislative committees to promote public policy for FASD prevention. These reports are posted on the Washington State FASD website (fasdwa.org) created and maintained by the FAS DPN.

The Washington State Fetal Alcohol Syndrome Diagnostic & Prevention Network (FAS DPN) is a network of one Washington State community-based clinic and the core clinical/research/training FAS DPN clinic at IHDD. The core clinic at the IHDD was first established in 1993 through support from the Centers for Disease Control. The single clinic was expanded into the statewide FAS DPN clinical network in 1995 through legislation.

Contact: Beth Ogata (bogata@uw.edu)
Core Function: Technical Assistance and Outreach Training

The First Steps Program Curriculum is a set of self-study modules created by IHDD nutrition faculty for Registered Dietitians (RDs) working in the First Steps program for the Department of Health. The curriculum consists of a set of nine self-study modules which have recently undergone extensive updating. Module topics cover clinical skill-building and the role of the RD in the First Steps program; performing the nutrition assessment; nutrition for normal pregnancy, postpartum and breastfeeding; nutrition for the young infant; and nutrition therapy for specific conditions of pregnant women and infants.

Each online module takes from 30 to 60 minutes to complete and includes a quiz on the content. RDs who achieve a score of at least 80% receive continuing education credit with a certificate which can be downloaded and printed. Each module provides a list of resources on the specific module topic, including links to relevant websites.

Contact: Emily Myers (emily.myers@seattlechildrens.org)
Core Function: Clinical Services

The Infant Development Follow-Up (IDFC) clinic was established in 1977 to provide developmental follow-up of children from 3 months to 5 years of age have developmental risk factors due to prematurity (born at 32 weeks gestation or earlier), low birth weight (under 1500 grams or 3 pounds 5 ounces) or prenatal exposure to drugs. The goal of the clinic is to provide early identification and referral for early intervention for the neurodevelopmental and neurobehavioral problems associated with prematurity, drug exposure and other biomedical and environmental risk factors. Each year about 350 clients visit the IDFC to receive diagnostic and treatment services. The majority are referred to CHDD by the University of Washington Medical Center. The clinic also conducts long-term follow-up clinical research concerning neonatal outcomes, complications, and treatment results.

The IDFC provides an ideal setting for interdisciplinary training. Approximately 25 trainees representing the disciplines of developmental pediatrics, psychology, audiology, nutrition, occupational therapy, and physical therapy participate in training each year. Continuing education presentations regarding the outcomes of low birth weight infants are delivered to local, state, and national audiences variously comprised of health care professionals, early interventionists, special educators, parents, and interdisciplinary trainees.

Contact: Sophie Lu (sophielu@uw.edu)
Core Function: Clinical Services

The Late and Moderate Preterm Babies (LAMBs) Follow-up Clinic at the CHDD works with children who were born between 32 weeks to 36 weeks and 6 days gestation, or 4 to 8 weeks early. We provide developmental assessment and ongoing monitoring. Knowing that these children are at higher risk for developmental differences, our goal is to catch any problems early to help the child grow, learn, and thrive to their highest potential. A LAMBs clinic evaluation includes:

• A comprehensive medical history, neuromotor exam, and a Level 2 norm-referenced screening and assessment tool (The Capute Scales Cognitive Adaptive Test (CAT) Clinical Linguistic & Auditory Milestone Scale (CLAMS)).
• A detailed report on findings with recommendations for services, medical evaluations, laboratory studies, or imaging if pertinent which is sent to the primary care provider.
• Patients will also receive an audiology evaluation at 1 year-old, autism screening at 1 and 2 years-old, and oral health screening at 1 year-old.
• LAMBs clinic patients typically see a developmental pediatric nurse practitioner. The child will also see a pediatric registered dietician or pediatric audiologist depending on the child’s age. Pediatric physical therapists, pediatric occupational therapists, developmental pediatricians, social work, and psychologists are also available for on-site consultations.

Contact: Jennifer Gerdts (jvarley@uw.edu)
Core Function: Professional Training

LEND (Leadership Education in Neurodevelopmental and Related Disabilities) is a graduate level, interdisciplinary training program which prepares health professionals for leadership roles in providing health care for individuals with neurodevelopmental disabilities and their families. The LEND program at CHDD is one of 52 LEND programs in the United States federally funded through the Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act, and administered by the Maternal and Child Health Bureau under the Workforce Development Division.

The purpose of LEND is to provide training for health professionals who will assume leadership roles across the nation. These leaders assure the continued development of a comprehensive system that serves the needs of children and youth with neurodevelopmental disabilities, including autism spectrum disorders and other special health care needs. Program faculty participate in clinical research and policy development and partner with community programs to better serve the needs of these individuals and their families.

The LEND interdisciplinary training program enrolls health care professionals who have completed entry level training in their discipline. This includes postdoctoral fellows who have completed professional training and graduate students who are enrolled in academic programs at the University of Washington and other institutions in Washington State. Trainees complete clinical and didactic components to meet the requirements of our LEND program. Established community professionals also enroll in LEND to deepen their training in neurodevelopmental disabilities.

Long-term fellows engage in at least 300 hours of interdisciplinary training framed by an individual interdisciplinary leadership plan. The plan includes a leadership project, clinical experiences, public policy experience and a didactic program of core seminars intended to establish knowledge and skills based on individual needs and core training competencies. Long-term fellows present their projects at an annual forum and receive a certificate of recognition.

UW LEND is in its fifth decade. Former trainees hold leadership positions in academia, public health, community programs, and health care facilities across the nation. LEND has a major responsibility for continuing education and technical assistance in the state of Washington and the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) region.

UW LEND partners with major advocacy groups, programs affiliated with UW, Seattle Children’s Hospital, State of Washington Title V programs, and community partners to implement a state-of-the-art curriculum.

Contact: Beth Ogata (bogata@uw.edu)
Core Function: Information Dissemination

Nutrition Focus is an online newsletter that focuses on nutrition challenges of children with special health care needs and their families. The newsletter is written for health care providers and others who work with children with special health care needs. The goals of the newsletter are to increase awareness of nutrition and to share useful assessment and intervention strategies within the health care community. Continuing Education credit is available.

Each online article highlights a specific disorder or nutrition concern and offers practical suggestions and guidance for families and health care professionals. Sample topics include: Nutrition Issues for Children with Down syndrome; Intrauterine growth retardation and small for gestational age – Nutrition Management; Homemade blenderized tube feedings; Eating/feeding problems of children; Emergency Preparedness – Helping Families and their CSHCN,  Transition for adolescents with special health care needs to adult health care and nutrition services; Breastfeeding the infant with special health care needs, Pediatric Malnutrition, Weaning from Tube Feedings, and Family Centered Care.

Contact: Beth Ogata (bogata@uw.edu)
Core Function: Technical Assistance and Outreach Training

This project is part of the Pacific West Maternal and Child Health Distance Learning Network that was developed by a collaboration between IHDD and the University of Southern California’s UCEDD. The network was overseen by nutritionists from state Title V programs in HRSA Regions VII, IX and X. It was developed in response to the training needs identified by maternal and child health practitioners providing services in the Pacific West.

The Nutrition and Oral Health component includes development and implementation of a distance-learning curriculum on nutrition and oral health for children. The curriculum was developed with the help of advisory group members from HRSA regions VIII, IX, and X and other experts in the field of nutrition and oral health. This web-based curriculum is intended for use by dental professionals, primary care providers, nutritionists, educators, therapists, and others who serve young children. The curriculum includes practical examples and family-centered practice and cultural competence are incorporated into the material. Continuing education credit is available for dental and nutrition professionals upon completion of this web-based training at http://depts.washington.edu/pwdlearn/.

Contact: Beth Ogata (bogata@uw.edu)
Core Function: Technical Assistance and Outreach Training

This project was part of the Pacific West Maternal and Child Health Distance Learning Network that was developed by a collaboration between IHDD and the University of Southern California’s UCEDD. The network was overseen by nutritionists from state Title V programs in Health Resources and Services Administration (HRSA) Regions IX and X. It was developed in response to the training needs identified by maternal and child health practitioners providing services in the Pacific West and by MCH continuing education program priorities established in maternal and child nutrition.

A computer-based curriculum, Nutrition for Children with Special Health Care Needs, was developed with an interdisciplinary Advisory Group made up of practitioners from state Title V programs in HRSA regions IX and X. The curriculum is available on-line and is composed of six self-study modules. Continuing education credit is available for nutrition professionals, and the material is also used by nurses, physicians, nurse practitioners, and therapists. In addition to continuing education, the material is also used as a reference by several publications and by individual practitioners. This is available on-line at http://depts.washington.edu/pwdlearn/.

Contact: Susan Adelman (adelms@uw.edu)
Core Function: Technical Assistance and Outreach Training

The Parent Autism Support Service (PASS) is a program structured to support parents in the early months after a diagnosis of autism. The PASS Program is run by the Parent Professional Partnership, also known as the Family Leadership Discipline of the University of Washington LEND program. Faculty and Family Trainees who have children with special needs, or are very knowledgeable of the services and support available to families of children with autism, provide follow-up to families one-week post diagnosis and then monthly for six months. During the six months, families are connected to providers within their local communities to continue to support them in the care of their child.

COVID-19 restrictions and recommendations have increased virtual services for some agencies. The PASS program is in the process of creating a video library to assist families new to developmental disabilities with vocabulary, resources and parenting strategies.

The PASS program has been in place for six years and has provided care coordination to over 150 families who have children newly diagnosed with autism at the University of Washington. Email passvc@uw.edu for more information.

Contact: Lisa Mancl (lmancl@uw.edu)
Core Function: Clinical Services

The Pediatric Audiology Clinic has three primary goals:

1. To identify hearing loss as early in life as possible;
2. To provide access to hearing technology; and
3. To coordinate follow-up services for intervention, monitoring and ongoing evaluation.

Activities of this clinic include newborn hearing screening at the University of Washington Medical Center (UWMC), diagnosis of hearing loss in the IHDD clinic, dispensing hearing technology (hearing aids, hearing assistance devices) to families of infants requiring them, and ongoing follow-up with clients served.

The Pediatric Audiology Clinic serves about 200 clients each year at IHDD. The average age of these clients is 2.4 years. About 25% of clients who are evaluated are identified as having a hearing impairment. Universal newborn hearing screening was implemented at UWMC in 2004 and has been a success, continuing to be well-received by both the nursing and medical staffs. This program is a collaborative effort between the Pediatric Audiology Clinic and the Department of Otolaryngology/Head and Neck Surgery at the UWMC. Data from this program are sent to the Washington State Early Hearing Detection, Diagnosis, and Intervention database for both neonatal screening outcomes and follow-up diagnostic testing.

Contact: Kate Orville (orville@uw.edu)
Core Function: Technical Assistance and Outreach Training

Children and families in many rural communities in Washington State are unable to access a timely assessment for autism or other developmental disabilities and get connected to helpful services. They may wait for 1-2 years for an autism evaluation at a distant tertiary care center because there is no option closer to home. Transportation and language barriers are also issues for many families. School Medical Review Teams (SMART) were created in rural Washington State communities to address this challenge. There are seven operational SMART teams and This project is one of the priorities that has come out of the work in CAM communities.

SMART is a model that builds on and expands community capacity in rural and underserved communities that do not have access to a local multidisciplinary diagnostic center. Using a shared document, the SMART tool, families are able to collect records of evaluations from their school, early intervention agency, local providers, and pediatrician to inform an interdisciplinary evaluation and diagnosis of autism. In the SMART approach, experienced pediatric primary care providers, schools, early intervention agencies, and families come together and share their knowledge and evaluation results in order to facilitate a virtual, comprehensive assessment of a child. This process provides a close link between a child’s primary care provider (PCP) and school team, who sees the child on a daily basis. Some larger communities are choosing a Network instead of team approach, where there are multiple clinicians who diagnose children, but have organized countywide processes to receive school and early intervention assessments and connect children to needed services. In combination with Autism Center of Excellence (COE) training of pediatric primary care providers through the Washington State Health Care Authority (HCA), SMART is a mechanism that allows children to qualify for Applied Behavior Analysis (ABA) therapy covered by Medicaid.

Contact: Lisa Mancl (lmancl@uw.edu)
Core Function: Professional Training

This project provides specialized training for Doctor of Audiology (Au.D.) students at UW. A major focus of PATE is involvement of Au.D. students as long-term trainees in the LEND (Leadership Education in Neurodevelopmental and related Disabilities) program at the IHDD during the second and third years of their four-year program. Trainees receive didactic and clinical experience to prepare them to provide services in clinical, early intervention, and educational settings and to provide counseling and support services to families. They also learn to work collaboratively within interdisciplinary teams and to use their skills and knowledge to become leaders in their discipline. The project has a specialized curriculum that is disseminated widely to help increase community capacity for pediatric audiology services.

During the first year of their Au.D. program, trainees complete foundational coursework in adult and pediatric audiology. In year two, coursework focuses on specialized areas of audiology, including the hearing impaired child. Clinical practica in year two takes place at IHDD specialty clinics. In year three, trainees will continue required Au.D. coursework, develop and present a LEND leadership project. In year four, all clinical rotations will be focused in pediatric audiology settings in the community. During their counseling practicum, students will work with standardized patients who are portraying the parent of a child with hearing loss. Work with a standardized patient will supplement their clinical experience and provide them immediate and specific feedback on their counseling skills. Finally, students will work with early intervention consultants to learn strategies for working with families with newly diagnosed children and helping them to facilitate communication with their infants.

Contact: Susan Wendel (swendel@uw.edu)
Core Function: Technical Assistance and Outreach Training

The purpose of these online modules is to support workforce development of health care professionals who work with people that have developmental disabilities by enhancing knowledge of the contributions of various disciplines. The seven modules (audiology, psychology, physical therapy, speech and language, occupational therapy, nutrition and social work) were prepared by LEND faculty and other experts. Each module focuses on the contribution and roles of a specific health care discipline, illustrating the unique and shared roles within an interdisciplinary team setting. They allow self-paced learning and disseminate the interdisciplinary training curriculum to a broad audience. The modules are required curriculum for all UW LEND trainees, and may also be accessed by trainees in other LEND programs across the US, as well as undergraduate and graduate students in various academic and training programs at the University of Washington.

Contact: Lisa Mancl (lmancl@uw.edu)
Core Function: Professional Training

The WA State Early Hearing-Loss Detection Diagnosis and Intervention (EHDDI) Learning Community is supported by a collaboration between the Washington State Department of Health EHDDI program and the University of Washington. Professionals at the UW Institute on Human Development and Disability and Speech and Hearing Sciences Department provide professional continuing education training through webinars, in-person seminars, and online resources.

The WSELC provides training and technical support to professionals across disciplines and across the state. The WSELC is also a place to connect, share ideas and results, and learn from each other through both in-person and virtual interactions. The WSELC aligns professionals around common goals and best practices to support children who are deaf and hard of hearing and their families. Professionals involved in this learning community include newborn hearing screeners, pediatric audiologists, family resource coordinators, and early intervention providers practicing in the state of Washington.