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College of Medicine

Innovative Programs

Community-based Autism Liaison and Treatment Program (CoBALT)

What is the  CoBALT (Community-Based Autism Liaison and Treatment) Project?

CoBALT’s mission  is “ the right child to the right services at the right time and right place”. 

The James L. Dennis Developmental Center (DDC) is the primary center to conduct developmental diagnostic evaluations on children in the state of Arkansas.  Therefore, many families may face long waiting times to be seen at the DDC.  This waiting period can cause a child to lose valuable time in getting access to treatment. Additionally, slow referrals and lack of information on how to access therapies and waiver programs can contribute to a family’s frustration.

To help with this problem, CoBALT was created.

CoBALT is a joint venture between the University of Arkansas for Medical Sciences Department of Pediatrics and the Arkansas Department of Human Services Division of Developmental Disabilities Children with Special Health Care Needs (Title V CSHCN).  ​

In this program, DDC clinicians conduct annual trainings for “mini-teams”  who learn to do Tier 2 assessments to assess for developmental delays and Autism Spectrum Disorder concerns. As their skills mature, clinically experienced CoBALT teams have the capability to diagnose autism,  but a primary goal of the CoBALT teams is to diagnose developmental disorders that are NOT autism and to help families find appropriate services in their local community. When a CoBALT teams suspects an  Autism Spectrum Diagnosis, the child is referred on a “fast track” to the Dennis Developmental Center for a full autism team evaluation.  CoBALT teams therefore assist families obtain quicker access to local resources, or  specialized developmental evaluations which results in a timely and  appropriate diagnosis, and quicker referral for therapy services. 

Who is on a CoBALT  mini-team? 

CoBALT teams are comprised of:

1)  medical professionals (Physician or Advanced Nurse Practitioner)  who are seasoned  in assessing young children with developmental delays, has an interest in expanding diagnostic skills and being a knowledgeable provider of Early Intervention/Early Childhood referrals and family support.​

2) another professional that has  knowledge of child development, who can complete diagnostic testing (Speech Pathologist, Psychologist, or Behavioral Specialist).

These teams participate in an intensive 2-3 day training with the facility and staff of the DDC who specialize in developmental disorders, especially Autism Spectrum Disorders.

During the training, CoBALT teams are educated about autism and developmental delays. They are given tools to screen and identify young children with a possible Autism Spectrum Disorder. Representatives from Early Intervention, Early Childhood, and Title V services in the CoBALT team’s area of Arkansas are also invited and are introduced to the teams to facilitate direct network building, thereby helping forge and strengthen relationships between CoBALT teams and DHS resources.  Teams also have to opportunity to connect with family support resources such as AAROC (Arkansas Autism Resource and Outreach Center).

cobalt
With greater knowledge about the diagnostic process,  comorbidities that accompany ASDs, and information about therapies /programs for families to purse,  the CoBALT teams  will be stronger community resources for families, schools, and care providers.

In their respective local areas, CoBALT teams can assess children ages 12-42 months, who present with developmental delays and ASD concerns.

Who is in charge of the CoBALT Project?

The Cobalt leadership team is based at the UAMS Dennis Developmental Center (DDC) . The  team is comprised of :

Principal  Investigator:  Jayne Bellando, Ph.D.

Co-director: Jaimie Flor, M.D.
Specialty nurse/Triage nurse: Rae Lynn Johnson

Coordinator/Logistic Support: Stefanie Jernigan

CoBALT representative:  Sheryl Davide-Ureta, M.D.  (ACH CoBALT team)

The DDC team-in-charge is responsible for setting up annual trainings. In addition, the leadership team  provides ongoing support to the community CoBALT teams by:

  • Scheduling  DDC evaluations as requested by CoBALT teams
  •       Directing patients to an appropriate CoBALT team in the community
  •       Providing  information about  didactics  relevant to the team’s practice (example: journal articles pertinent to DD/ASD practice; participation in lecture series,  mini- lectures during teleconference meetings quarterly)
  • Answering questions CoBALT teams may have

Who are the current CoBALT teams?

We envision a hub model , with trained regional providers linked to CoBALT leadership at UAMS DDC  for training, support, continuing education, and clinical consultation.

These regional teams are:

Little Rock

Sheryl Davide-Ureta, M.D.;
Laura Clark, APRN;
Aubrey Berber APRN
ACH General Pediatrics
1 Children’s Way
Little Rock, Ar. 72202
501 364-1050

Forrest City

Curt Patton, M.D.
East Ar. Children’s Clinic
901 Holiday Drive
Forrest City, Ar. 72335
870 633-0880

Mena

Ron Beckel, M.D.
Kelley Dotson, APRN
Mountain View Clinic
1102 Crestwood Circle
Mena, Ar. 71953
479 394-7301

Rogers

Barry Allen, M.D.
Community Clinic of Northwest Ar
1233 W. Popular St.
Rogers, Ar. 72756
479-636-9235

Fort Smith

Casey Stewart, M.D.;
Jennifer Johnson, M.D.
RVPSC Northside Clinic
4900 Kelley Hwy.
Fort Smith, Ar.
479-785-5700

Mandi Williams, APRN
Center for Psychiatric Wellness
7217 Cameron Park Dr.
Fort Smith, Ar. 72903
479-831-6007

Paragould

Vern Ann Shotts, M.D.
Child and Adolescent Clinic
1204 W. Kings highway
Paragould, Ar. 72450
870-239-5437

Marion

Ayesha Shah, M.D.
Pediatric Associates
200 Pine St.
Marion, AR. 72367

Batesville (held quarterly)

Gwen White, M.D.
The Children’s Clinic
1770 Harrison St. Suite N
Batesville, Ar. 72501
870-262-2200

Expectations

We expect to train teams annually. Trained teams are expected to conduct Tier 2 evaluations and make subsequent  referrals to DDS (Early Intervention or  Early Childhood Program, depending on age at referral) or to the DDC for further diagnostic clarification. Team performance will be monitored  to track numbers of children/families served.

The CoBALT project manager will report quarterly to DDS. Outcomes to be scrutinized include:  changes in Early Intervention/Early Childhood access,  numbers of referrals to the DDC from the CoBALT teams, time frames from identification of need to receipt of services and appropriate evaluations.

CoBALT has been collecting quality improvement data since the Fall of 2016.

Highlights:

What are the future plans of the CoBALT Project?

Future as well as ongoing plans include:

a) support and maintenance of existing teams
b) refining the training component to include Tier III evaluations for ASD
c) training additional teams as needs and interest from other community medical providers manifest

 

In addition, CoBALT is committed to promoting awareness and  providing educational opportunities regarding ASD. With this in mind, CoBALT is engaged in an ongoing,  two-year didactic program on Autism,  with the Connecting Across Professions (CAP) tele-education series through UAMS Learning on Demand. The lecture series is entitled: Autism Spectrum Disorder: Moving the Needle to help children and families in Arkansas. To register for Learn on Demand and series notifications, visit www.learnondemand.org

To learn more about CoBALT and see our information about providers and families: Visit www.cobaltar.org

If you are interested in becoming a member of the CoBALT family, please contact:

Dr. Jayne Bellando (Email: BellandoJayne@uams.edu)

Dr. Jaimie Flor (Email: JMFlor@uams.edu)

Autism and Developmental Disabilities Monitoring (ADDM) Program

Contents

What is AR ADDM?

What is Autism Spectrum Disorder?

Newest Data on Autism Prevalence

What can we do with this information?

Identified Prevalence of Autism Spectrum Disorder in Arkansas – Year by Year

What is AR ADDM doing currently?

What services and support resources are available in Arkansas?

For more information

Who are our UAMS AR ADDM staff?

What is AR ADDM?

Arkansas Autism and Developmental Disabilities Monitoring (AR ADDM) is a program funded by the Centers for Disease Control and Prevention to estimate the number of children with autism spectrum disorder (ASD) and other developmental disabilities living in Arkansas. AR ADDM uses surveillance methods modeled after CDC’s Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP). The program includes investigators with UAMS and operates in collaboration with the Arkansas Department of Health and the Arkansas Department of Education to track the number and characteristics of children with ASD.

What is Autism Spectrum Disorder?

CDC: Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication and behavioral challenges. See www.cdc.gov/ncbddd/autism/facts.html

Newest Data on Autism Prevalence

An estimated one in 66 Arkansas children (or 1.5 percent) has been identified as having ASD. This estimate is based on information collected from health and special education records of 8-year-old children living in Arkansas in 2016. As many as 1 in 57 (1.8 percent) children were identified with ASD in the 36-county area where both health and education records were reviewed.

CDC Press Release:  Autism prevalence slightly higher in CDC’s ADDM Network

MMWR Article:  Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016

Community Report on Autism

We invite you to explore the interactive maps and graphs CDC offers with the Autism Data Visualization tool. The data presented through this online tool come from four different federal data sources and highlight changes over time in reported ASD prevalence estimates and in the characteristics of children identified with ASD.

What can we do with this information?

AR ADDM’s latest findings can be used to:

  • Promote early identification of ASD (e.g., Learn the Signs. Act Early.),
  • Plan for ASD services and training,
  • Guide future ASD research, and
  • Inform policies promoting improved outcomes in health care and education for individuals with ASD.

Stakeholders in Arkansas might consider different ways to reduce disparities in identification and lower the age of first evaluation and diagnosis by community providers.

Identified Prevalence of Autism Spectrum Disorder in Arkansas – Year by Year

Click the tracking year for fact sheets with key findings and resources.

Surveillance/ Tracking Year Birth Year Arkansas Coverage Prevalence per 1,000 Children This is about 1 in X Children…
2002 1994 All 75 Counties

Health & Education sources

6.9 1 in 145
2008 2000 One County

Health & Education sources

10.5 1 in 95
2010 2002 All 75 counties

Health & Education sources

15.5 1 in 65
2012 2004 16 counties in central Arkansas

Health sources only

12.0 1 in 83
2014 2006 All 75 counties

Health & Education sources in 48 counties

13.1

15.5*

1 in 77

1 in 64*

2016 2008 All 75 counties

Health & Education sources in 36 counties

15.1

17.7*

1 in 66

1 in 57*

*Prevalence (2014 and 2016) was higher in the area where both health and education sources were reviewed.

 

What is AR ADDM doing currently?

AR ADDM continues tracking ASD for 2018 and 2020 in 21 counties in central Arkansas, adding 4- and 16-year-olds to the existing tracking of 8-year-olds: Arkansas Autism Program Receives $2.17 Million in Federal Funding January 17, 2019

What services and support resources are available in Arkansas?

First Connections. Services for children under the age of 3 years with developmental delays or disabilities.

1-800-643-8258 https://dhs.arkansas.gov/dds/firstconnectionsweb/#fc-home

Department of Education’s Special Education Unit. Special education services for children with disabilities, ages 3 to 21.

1-800-482-8437 https://dese.ade.arkansas.gov/offices/special-education

Arkansas Autism Resource and Outreach Center. Support, education, and advocacy for families of individuals with ASD.

1-800-342-2923 www.aaroc.org

Dennis Development Center (DDC) and Schmieding Development Center (SDC). Diagnostic multidisciplinary team evaluations for children presenting with developmental and behavioral concerns. Provides comprehensive developmental assessments of children from birth to 21 years of age.

DDC 501-364-1830 SDC 479-750-0125

CDC’s Learn the Signs. Act Early. Alan Mease, Arkansas’ Act Early Ambassador

amease@eqhs.org

https://www.cdc.gov/ncbddd/actearly/index.html

Project Connect Resource Guide. Arkansas resources for families and professionals on child development and what to do if there is a concern.

https://cied.uark.edu/programs/special-education/pro-development-childrens/project-connect.php

Spotting Autism in Early Child Care Settings. Training for child care providers on identifying children at risk for being diagnosed with autism, available through Healthy Child Care Arkansas.

www.healthychildcareAR.org

Community-Based Autism Liaison and Treatment (CoBALT) Project. Comprehensive diagnostic assessments, early intervention services, and family support.

https://pediatrics.uams.edu/specialties/developmental-pediatrics/cobalt-program

Arkansas Transition Services. Assists students with disabilities, educators, parents, agency personnel and community members in preparing students to transition from school to adult life and reach positive post-school outcomes.

www.arkansastransition.com

For more information:

CDC Autism and Developmental Disabilities Monitoring (ADDM) Network

CDC Autism Spectrum Disorder (ASD) Homepage

Who are our UAMS AR ADDM staff?

Principal Investigator: Maya Lopez, M.D.

Project Coordinator: Allison E. Hudson, CRS

Assistant Project Coordinator/Abstractor: Yvette D. Schwenk, M.S., LPE-I

Abstractors: Stefanie L. Jernigan, Sandra K. Walker, J. Michelle Cantrell-Kelley

AR ADDM is committed to the highest standards of confidentiality and data security. Information that could potentially identify individuals is not included in any results reports or presentations.

Leadership Education in Neurodevelopmental Disabilities (LEND)

The Arkansas LEND program is a unique interdisciplinary training program for future leaders in the field of neurodevelopmental disabilities. LEND is organized through UAMS and is a unique collaboration among the UAMS Department of Pediatrics, the Association of University Centers of Disabilities (AUCD), University Center for Excellence on Developmental Disabilities (UCEDD) and the state’s Title V organization. The Arkansas LEND program is part of a national network of similar collaborative programs and funded through the national Maternal and Child Health Bureau of the Health Resources and Services Administration. The national LEND network recognizes that 15-18% of children have developmental and behavioral problems, including autism spectrum disorders (ASD) and other neurodevelopmental disabilities. The reported prevalence of ASD continues to be on the rise nationally and, specific to Arkansas, current estimates are that out of every 66 children in the state have ASD. The Arkansas LEND program recognizes too few health professionals have the necessary skills to diagnose and intervene with neurodevelopmental disabilities. LEND is comprised of a wide range of faculty and experts for the primary purpose of improving the health of infants, children and adolescents with disabilities through training and education. LEND programs accomplish this by preparing trainees from diverse professional disciplines to assume leadership roles in their respective fields and by ensuring high levels of interdisciplinary clinical competence. More information about our Arkansas LEND program can be found at: xxxxxx (and add here the page the LEND student is going to be updating).

Eldon Schulz Service Awards

Dr. Schulz received his medical degree at the University of South Dakota School of Medicine in 1980. He completed his pediatrics residency at the University of California, San Diego and continued his training with a developmental/ambulatory pediatric fellowship at the University of Massachusetts Medical Center. For the next six years Dr. Schulz practiced as a civil servant for the U.S. military in the Exceptional Family Member Program in Heidelberg, Germany.

Dr. Schulz joined our faculty as an Assistant Professor in the Department of Pediatrics in 1991 and received an additional appointment in the Department of Physical Medicine and Rehabilitation three years later. He was promoted to Associate Professor in 1996 and to Professor in 2005.

Dr. Schulz served as Medical Director of Rehabilitation Services at Arkansas Children’s Hospital since 2001. He was Section Chief for Developmental-Behavioral and Rehabilitative Pediatrics for the majority of his UAMS career, and previously served as Medical Director of the Dennis Developmental Center, in 1992-1999 and 2011-2012. In 2008 Dr. Schulz was invested as the inaugural recipient of the Rockefeller Endowed Chair for Children with Special Needs at Arkansas Children’s Hospital. He led grant-funded initiatives that improve the lives of children, including the Arkansas Regional Leadership Education in Neurodevelopmental Disabilities (LEND) training program and the Community-Based Autism Liaison and Treatment (CoBALT) project. Dr. Schulz served our state in innumerable other ways, including many years as Medical Director for the Arkansas Division of Developmental Services, Medical Director of the Arkansas Title V Program for Children with Special Health Care Needs, and Medical Director for the Easter Seals Rehabilitation Center.

We lost Eldon in June 2018, but his legacy will forever be respected and cherished in our Section. His passions for interdisciplinary care and community advocacy continue to inform and inspire the work we do. The LEND program within our Section established the Eldon Schulz Service Awards to recognize current and future leaders in our state dedicated to providing outstanding service, and advocating for people with developmental disabilities and their families.

Dr Eldon Schulz

Eldon Schulz, M.D.

Eldon Schulz Award Winners:

Faculty Award Winners
2020
Elizabeth Cleveland, ABD, CCC-SLP

2019
David Deere, MSW, MTh

Trainee Award Winners
2020
Chayla Slaton, MS

2019
Andrew Cope, MHA

grad party for DBP fellow 2

Jaimie Flor, M.D., Jill Fussell, M.D., Paulette Wy, M.D. Eldon Schulz, M.D., Alberto Allegre, M.D., Paola Carrasco MD, Maya Lopez, M.D.