Children and families in many 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 many months 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.
How Being SMART Can Help
The School Medical Autism Review Team (SMART) process can help. 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.
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 or early intervention team, who sees the child on a daily basis. 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 combination with Autism Center of Excellence (COE) training through the Washington State Health Care Authority (HCA), SMART is a mechanism that allows children to qualify for Applied Behavior Analysis (ABA) and other therapies covered by Medicaid.
SMART was initially developed and piloted by the Lewis County Autism Coalition in collaboration with state partners.
A growing number of counties in Washington State –including Clallam, Grays Harbor, Island, Lewis, Mason, Pacific, and Whatcom — are currently using a SMART process to provide a comprehensive assessment for ASD for children in their local community. Some SMART Teams provide a final autism diagnosis for children, others have developed an organized process to have children seen by a local clinical expert. Chelan/ Douglas, Kitsap, Okanogan, San Juan, Skagit and Snohomish counties are in the process of developing or revising their SMART approach. Additional counties exploring the SMART concept include Clark, Cowlitz/Wahkiakum, and Grant counties.
Each county has their own unique pathway based on the providers and services available in their community.
Map of SMART Teams and Project ECHO Autism Primary Care Providers (3/21)
Starting in May, 2021 there are now monthly Zoom videoconference calls connecting SMART teams in Washington. The Zoom video conference calls are 12-1 pm, and alternate between the 3rd Thursday and the First Friday of each month. 2021 Thursday calls: May 20, July 15, September 16, November 18. 2021 Friday calls: June 4, August 6, October 1, December 3.
For More Information
Contact: Kate Orville, MPH, firstname.lastname@example.org or Sophie Lu, MN, PPCNP-BC, ARNP, email@example.com, University of WA, Medical Home Partnerships Project (MHPP). The Washington State Department of Health, Children with Special Health Care Needs Program provides funding for the MHPP technical support to communities.
- Suggested Billing and Diagnosis Codes for Autism Centers of Excellence (COEs) and SMART Teams (updated 2/21)
- Map of Washington State School and Medical Autism Review Teams (SMART) and Networks (updated 3/21)
- SMART Fact Sheet
- “Get SMART-School and Medical Collaboration to Evaluate Children for Autism” (Introduction to SMART)-Oct 26, 2018-Eighth Annual Southwest Washington Autism Conference, Centralia, WA
- School Medical Autism Review Team (SMART): A Virtual Interdisciplinary Process for Autism Assessment in Washington State (poster)- Amy Carlsen, RN, 2017 Autism CARES Conference
SMART Tools Developed by Counties
Thurston County SMART Team (serving Thurston County children 0-5)
- Contact through South Sound Parent to Parent SMART webpage – flyers available in English and Spanish
Lewis County Autism Coalition SMART Forms
Whatcom Taking Action General Interdisciplinary Developmental Evaluation System (GIDES)
- Whatcom GIDES Communication Observation Tool
- Whatcom County Common ABA Application Form (one form for all ABA programs in county)
- Single Entry Access to Services (SEAS) Referral Form (updated 3/2021)
- Communication to Primary Care Provider about a Child
- Communication to School – from Provider
- Communication to School – from Family
Skagit County Autism Partnership (SCAP)
Skagit Original forms (not current)
Mason County Autism Coalition
- SMART Intake Packet – Spanish (updated 2/2021)
Pacific County SMART Team
- Parent / Guardian Letter and Checklist
- Demographics Form
- Getting to Know Your Child (SMART Tool)
- Authorization and Consent of Release and Disclosure
- Willapa Behavioral Health Release of Information