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 or even 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.

How Being SMART Can Help

The School and 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 timely access to a local multidisciplinary diagnostic center.

In the SMART approach, experienced pediatric primary care providers, schools, early intervention agencies, other service providers and families come together and share their knowledge and evaluation results in order to facilitate a 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.

Some larger counties have adapted SMART from a team approach to a coalition model. Local autism coalitions focus on identifying and improving processes of information sharing between COEs and early intervention/schools, family engagement and connection to community supports.

In combination with Autism Center of Excellence (COE) training through the University of Washington Institute on Human Development and Disability and COE certification by 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.

Who’s SMART?

SMART was initially developed and piloted by the Lewis County Autism Coalition in collaboration with state partners.

As of November, 2023 seven counties have established active SMART teams – Clallam, Grays Harbor, Lewis, Mason, Okanogan, Pacific, San Juan, and Thurston.   Jefferson County is developing a team. Six counties participate in coalitions- Chelan, Douglas, Island, Pierce, Skagit and Whatcom – and five more are developing coalitions- Benton, Franklin, Kitsap, Snohomish and Spokane.  Additional communities are in the process of exploring or developing one or both models.

Each county has their own unique pathway based on the providers and services available in their community.   SMART teams include one or more clinicians who are an Autism Center of Excellence (COE).  Many of these clinicians also participate in Project ECHO Autism Washington  to further develop their autism evaluation and care management skills.   Many team members have also joined other Washington ECHOs focusing on caring for individuals with autism, intellectual disability and/or other developmental disabilities and their families, including an ECHO focused on resources for families.

Map of SMART teams and coalitions

Zoom videoconference calls connecting SMART teams in Washington take place every month. The calls are 12-1 pm, and alternate between the 3rd Thursday and the First Friday of each month. Remaining 2023 calls: Friday Dec 1.  Agenda and Powerpoint for Dec 1.

  • 2024 Thursday calls:  Jan 18, March 21, May 16, July 18, Sept 19, Nov 21.
  • 2024 Friday calls are: (Feb 2nd cancelled due to COE training), April 5, June 7, August 2, Oct 4 and Dec 6.

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.


  • Resources for Families
    • Miss Shayla’s Resource List
    • A brief menu of key financial, transportation and recreation resources to support people with intellectual and developmental disabilities and their families.  By a parent, for parents and families.  This list will continue to be updated and we welcome your suggestions.  Feel free to adapt this handout to your own community.

SMART in the News!

Mason County SMART Team – “Mason Health Launches School Medical Autism Review Team with local partners to help families find answers soonerJune 2022

Thurston County SMART team – article in Thurston Talks. 2/10/2021

County Teams and Networks

Autism Partnership of Island County (APIC)

  • Website in English and Spanish with Autism Screening, Evaluation and Resources for Families and Providers

Pacific and Grays Harbor SMART Team

Website (explains process, includes community resources etc.)


Okanogan SMART Coalition

  • Materials coming soon!

San Juan County Autism Collaborative  (SJCAC) 

Mason County Autism Coalition



Lewis County Autism Coalition SMART  Program



Thurston County SMART Team

Whatcom Taking Action General Interdisciplinary Developmental Evaluation System (GIDES)


Skagit County Autism Partnership (SCAP)


Skagit Original forms (not current)