Habayeb Serene, Inge Anne, Myrick Yetta, Hastings Amanda, Long Melissa, Hoffman Sarah Barclay, Parker Shaakira, Theodorou Penelope, Soutullo Olivia, Beers Lee, Godoy Leandra
Children's National Hospital, Washington, District of Columbia.
The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Pediatrics. 2023 Nov 1;152(5). doi: 10.1542/peds.2022-060584.
Children with autism face significant barriers to accessing evaluations and intervention services often because of confusing referral processes, lack of centralized coordination across organizations serving children with autism, insurance coverage gaps, multiyear waitlists for diagnostic services, and limited provider knowledge about autism. Racism and systemic inequities exist and persist in autism care across the United States. This article reviews targeted initiatives implemented by a multidisciplinary team to advocate for, and address barriers faced, by autistic children and their families in Washington, DC. We describe initiatives across multiple levels of the health care system including: 1. infrastructure-building initiatives (eg, coalition-building, policy, and advocacy); 2. enabling services (eg, population- and community-level supports that increase provider capacity to serve children's and families' needs); and 3. direct services (eg, innovative, gap-filling programs that directly serve children and families). We review outcomes and describe lessons learned.
自闭症儿童在获得评估和干预服务方面往往面临重大障碍，这通常是由于转诊流程混乱、为自闭症儿童提供服务的各组织之间缺乏集中协调、保险覆盖缺口、诊断服务多年的等候名单以及提供者对自闭症的了解有限。种族主义和系统性不平等在美国各地的自闭症护理中存在且持续存在。本文回顾了一个多学科团队实施的有针对性的举措，以倡导华盛顿特区的自闭症儿童及其家庭并解决他们所面临的障碍。我们描述了医疗保健系统多个层面的举措，包括：1. 基础设施建设举措（例如，建立联盟、政策和宣传）；2. 支持性服务（例如，在人群和社区层面提供支持，以提高提供者满足儿童和家庭需求的能力）；3. 直接服务（例如，直接为儿童和家庭提供服务的创新型、填补缺口的项目）。我们回顾了成果并描述了经验教训。
