Browsing by Author "Hines, Elesia N."

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    Identifying Autism Spectrum Disorder in a High-risk Follow-up Program through Quality Improvement Methodology
    (Wolters Kluwer, 2024-04-03) Raches, Christine M.; Hines, Elesia N.; Hines, Abbey C.; Scott, Emily K.; Pediatrics, School of Medicine
    Introduction: Children born prematurely are at increased risk for autism spectrum disorder (ASD). ASD can be diagnosed between 18 and 24 months of age, but access barriers and medical complexity can delay diagnosis. ASD screening was implemented in a high-risk infant follow-up program using QI methodology. The project aimed to screen 60% of children and refer 90% of those with positive screens. Methods: The team developed a standardized workflow to administer the M-CHAT-R/F to HRIF patients between the ages of 16-22 months. Telehealth ASD assessment, using the TELE-ASD-PEDS, was conducted for those who screened positive. Monthly team meetings were held to implement change cycles and review the impact of the previous month's change. Results: Within 7 months of program implementation, ASD screening exceeded the 60% aim. The program referred 72% of patients who screened as medium/high risk on the M-CHAT-R/F. The remaining patients were not referred per provider discretion. Twenty-seven percent of patients who received an autism evaluation received an ASD diagnosis. The average age at diagnosis was 22.5 months. Conclusions: An ASD screening protocol was implemented for patients enrolled in a high-risk infant follow-up program. Patients identified as at risk for ASD received an expedited telehealth ASD evaluation. The screening protocol was maintained for 13 months and is now part of the standard workflow. Screening has been expanded to other HRIF clinics, and evaluation appointments have been added to meet access needs. QI methodology is an effective tool for implementing ASD screening and referral in multidisciplinary HRIF programs.
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    Parent–Child Separation Due to Incarceration: Assessment, Diagnosis, and Treatment Considerations
    (2020-03) Hines, Elesia N.; Thompson, Shannon L.; Moore, Michelle B.; Dickson, Amy B.; Callahan, Kristin L.; Pediatrics, School of Medicine
    Decades of research and clinical observations have demonstrated the harmful effects of parent-child separation on children's short- and long-term well-being (Society for Research in Child Development, 2018). Young children may be separated from their parents due to a variety of circumstances. This article provides recommendations for the assessment, diagnosis, and treatment of young children who experience trauma as a result of being separated from their parent due to incarceration. An example of a multidisciplinary health care clinic is highlighted to demonstrate how clinicians and community partners work together to provide evaluation and care coordination services for children in foster care.