The Issue

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

Medical Home: School Medical Autism Review Team (SMART)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 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 Pathway

To view an example of the pathway a child goes through to get and autism diagnosis, Skagit County Multidisciplinary Autism Review Team put together this spreadsheet. Credit goes to Kay Walter. for creating this document. Each county has their own unique pathway based on the providers and services available in their community.


Who’s SMART?

SMART was initially developed and piloted by the Lewis County Autism Coalition.

Seven counties in Washington State –Grays Harbor, Island, Lewis, Mason, Pacific, Skagit and Whatcom — are currently using the 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 expedited process to have children seen at a diagnostic tertiary care center.  Other counties exploring/developing  SMART teams include Clallam, Clark, Cowlitz/Wahkiakum and San Juan.

SMART Team Contacts

There are quarterly Zoom videoconference calls connecting SMART teams in Washington, and periodic interactive webinars for clinicians diagnosing autism as part of a HCA Center of Excellence.  The video conference calls are 1-2 pm, the 3rd Thursday of every quarter (March, June, Sept, Dec.)

For More Information
Contact: Kate Orville, MPH, 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.


SMART Tools Developed by Counties

Lewis County Autism Coalition SMART Forms



Whatcom Taking Action General Interdisciplinary Developmental Evaluation System (GIDES)


Skagit Multidisciplinary Autism Review Team



Greater Grays Harbor (Grays Harbor/Pacific)



Mason County Autism Coalition