Last year, thanks to a federal grant, the Vermont Early Childhood Fund (VECF) greatly expanded its funding, with a total of $6 million in awards slated for local communities from 2023 through 2025. The expansion also created a new type of VECF grant, the Innovation Grant, with the goal of creating innovative, replicable solutions to address some of Vermont’s most persistent barriers to serving children and families. One of the first Innovation Grant recipients was Northwestern Medical Center (NMC) in Franklin County, which received funding to increase access to autism screening and supports for Vermont families with children with developmental differences.
“The funding has allowed an explosion of growth that would not have been possible otherwise.”
—Dr. Colleen Moran
Thanks to the VECF grant, NMC has been able to greatly increase staffing, appointments, and services at their Pediatric Developmental Clinic. I talked recently about the impact of the Innovation Grant with Katherine Shattuck, C-PNP, C-PMHS, who leads the clinic; NMC pediatrician Dr. Colleen Moran, who oversees the project; and Kristy Cushing, PT, who provides administrative support to the clinic in addition to her work as Director of Rehabilitation Services.
“The funding has allowed an explosion of growth that would not have been possible otherwise,” Dr. Moran said. She explained that the VECF grant eliminated the risks of a quick expansion and gave the clinic the opportunity to work through logistical issues. “The grant has allowed us to expand with a safety net.”
“It’s going fantastic,” Shattuck said. “Only a year ago, the clinic was just in the planning stages. We started on a shoestring and a dream in September 2023 in collaboration with Northwestern Counseling & Support Services (NCSS), who provided a support staffer. We started out offering autism assessments two days a month. The VECF grant has allowed us to expand that to four days a month for initial assessments plus a fifth day each month for feedback appointments.”
The grant has also allowed the clinic to add speech therapy and occupational therapy (OT) four to five days a week, with a particular focus on services that are in short supply across Vermont. “Our pediatric speech therapist, Leanne Saddlemire (MS, CCC-SLP), works with feeding issues,” Shattuck said. “Our pediatric occupational therapist, Hannah Bloom (MOTR/L), focuses on sensory processing and emotional regulation.”
With the addition of psychologist John Dou in June 2024, the clinic will further expand its services, allowing them to offer more comprehensive evaluations for older children. Assessments are done in a single day, with a feedback appointment the following week, where families receive not only a diagnosis (when appropriate), but referrals and connections to wraparound supports.
“Whatever a family’s concern is, we can help.”
—Katherine Shattuck, C-PNP, C-PMHS
Families across Vermont need access to autism screening, but the need for ongoing supports for families with autistic children is just as acute. NMC’s clinic has made this a major focus of their expansion. They’ve added a clinic coordinator, Amy DuPrat, and a behavioral case manager, Abigail Dunham (BSW), both of whom are making a big difference for families.
“Amy, our clinic coordinator, makes sure that if we recommend something, families know who they can contact, whether that’s for supports through the schools, home health, early intervention (EI), or a developmental disability and behavioral specialist,” Shattuck said. Abigail Dunham, the clinic’s behavioral case manager, supports families dealing with behavioral challenges. One family that visited the clinic had a child who was leaving the house in the middle of the night. The clinic was able to connect the family with a behavioral specialist who helped them create a comprehensive safety plan. “Whatever a family’s concern is, we can help,” Shattuck said. Clinic staff also work with area schools, consulting with classroom teachers and even attending IEP meetings.
The clinic has also partnered with NMC’s audiology department to purchase specialized equipment allowing them to provide hearing screenings to children at the clinic and throughout the community. The grant has allowed for additional training in auditory processing disorder and the purchase of tools for hearing aid molds, which has meant that children can get hearing aids more quickly, without having to travel outside their community.
“I don’t have to give up hope.”
—A parent at the clinic
NMC’s clinic had initially planned to offer autism assessments to children 6 and under, since early assessment, diagnosis, and access to services has long been shown to lead to better outcomes. But they soon found that there was also a great unmet need among older children.
“A lot of the kids in our clinic had older siblings with a concern for autism,” Shattuck said. “Parents told me that their older children had sat on waiting lists till they aged out. One mother of a toddler asked me at her child’s feedback appointment, ‘Is there any way you could see my 8-year-old?’ She told me she was so happy to get an autism diagnosis and services for her toddler. She said, ‘I don’t have to give up hope.’ And she told me she had given up hope of getting help for her 8-year-old. So we expanded our assessments to students in kindergarten, then to first graders and some second graders. With the addition of a psychologist to our staff, we’ll be able to offer some services to children of any age with a concern for autism.”
In addition to assessments for older children, the clinic has received many requests for autism assessments from outside their local community, reflecting the unmet demand for these services across the state. Referrals are accepted only from primary care providers, yet in their eagerness to be seen, many families have reached out directly. (All referrals must come through primary care.) The clinic is dedicated to keeping their waiting list to six months.
One key takeaway from the clinic’s first year has been the importance of non-medical administrative and support staff who can keep the clinic running smoothly and work with families after a diagnosis. “This funding has given us the support to figure out how to make this as efficient and patient-centered as possible while also figuring out the number of hours we need for each team member,” Shattuck said. “We have to account for scheduling, phone calls, follow-ups, non-billable hours.”
Feedback from families, pediatricians, and the broader community has been appreciative and enthusiastic, with some families shedding tears of relief at finally having access to the services their children need. Primary care providers have made comments such as, “I am so glad you have opened and you are willing to speak with us directly,” “I am glad NMC has been able to make this happen for our community,” and “I am glad you are seeing our kids!”
NMC’s long-term goal is to continue to expand the clinic to meet the needs of more families while reducing their dependence on outside funding. Staff are collecting and analyzing data to figure out how to make the clinic self-sustaining.
“When you step back, it’s remarkable to realize what we’ve been able to achieve,” Dr. Moran said. “It’s easy to forget that only a year ago, Katie [Shattuck] was just coming to me with this idea. We’ve been surrounded by people who shared and supported the dream. If you build it, they will come!”
Looking for resources for autism screening and services in Vermont?
The Vermont Department of Mental Health has an Autism Workgroup that both providers and parents are welcome to attend. The Autism Workgroup has a resource list for parents and providers.
Children with Special Health Needs (CSHN), part of the Vermont Department of Health – Family & Child Health Division, developed this infographic and FAQ to help families and providers to identify supports that do not require a formal autism diagnosis.
The 2023/24 VCHIP/CHAMP Quality Improvement project includes a cohort of clinicians who are learning to conduct autism assessments in primary care settings in the following counties: Addison, Caledonia, Rutland, Chittenden, Bennington, Franklin, and Windsor. Over time, this project aims to increase access to autism screening across the state.
Interested in applying for a VECF grant?
The Vermont Early Childhood Fund (VECF) is a Building Bright Futures (BBF) initiative to support creative solutions that improve the well-being of Vermont children through age 8, their families, and their communities. BBF will begin accepting applications for the fall 2024 round of VECF grants in August 2024.
