asked me how to contact major IT organisations. You can't simply email Mark Zuckerberg at Facebook or Larry Page at Google and invite them to take part. So I suggested using the medium of the web. To get an idea in front of the relevant people in government or industry, I put the details on the web and wait for someone to tell those people. Sometimes this does not work, but usually the information gets to those in charge in a few hours or days (formulating the information so this happens is an art).
In my view, research into the use of IT in autism could have benefits for computer applications generally. Autism is characterized by impaired social interaction and and difficulty in interpersonal communication. Just as the web accessibility guidelines have resulted in better web applications for those without a disability, research into autism could lead to better ways to communicate online for everyone. Computer Mediated Communication (CMC) is limited compared to face to face, with limited ability to convey subtle verbal and visual signals. Research on autism may provide insights.
So here are the details of the Autism CRC proposal, for anyone interested:
- Call for cooperative research centre to combat autism, Media Release, Faculty of Health, University of Queensland, 31 March 2011
- Autism crc briefing for international summit (slides)
- Invitation to Participate: Proposal to establish a Cooperative Research Centre for a Better Start and Future for Autism Spectrum Disorders (PDF).
- Jill Ashburner, Autism Queensland, Phone: 07 3273 0075 Email: Jill.Ashburner(a)autismqld.com.au
Proposal to establish a Cooperative Research Centre for a Better Start and Future for Autism Spectrum Disorders
INVITATION TO PARTICIPATE
The core bid team invites your organisation to join a bid for the establishment of a Cooperative Research Centre (CRC) focussing on understanding, diagnosing and supporting Autism Spectrum Disorders.
PO Box 354 Sunnybank Qld 4109 Phone: 07 3273 0075 Email: Jill.Ashburner(a)autismqld.com.au
- Why pursue an Autism CRC
- What an Autism CRC could deliver
- About the Cooperative Research Centre Program
- Proposed core programs of the Autism CRC
- Core Program 1: A Better Start
- Core Program 2: Creating a future
- Core Program 3: Finding a place in society
- Innovative use of technology embedded across core programs
- Family supports embedded across core programs
- Appendix 1: Current core participants
To date, seven organizations have committed to being essential participants of the proposed Cooperative Research Centre for a Better Start and Future for Autism Spectrum Disorders (CRC for ASD). They include the University of Queensland, Queensland University of Technology, Curtin University, the University of New South Wales, La Trobe University, University of Western Australia and Autism Queensland (see appendix 1 for details). They have each committed to contributing $50,000-100,000 per annum over 10 years to the proposed CRC.
The Autism CRC bid team which consists of representatives from each of these seven organisations is seeking to develop collaborative partnerships with industry and end-user groups/ASD service providers to be involved in a Cooperative Research Centre focussing on the understanding, diagnosis and support of people with autism spectrum disorders (ASD). The purpose of this document is to inform potential participants about the vision and goals of the proposed CRC, the Australian Federal Government's CRC program, and core research program areas of the CRC.
Vision of Proposed CRC for a Better Start and Future for Autism Spectrum Disorders
The Autism CRC will enable earlier, more accurate and efficient diagnoses, and will find more effective and cost efficient ways of enabling children and adults with ASD to achieve valued life outcomes through an end-user driven, cooperative, public-private cooperative research centre.
Why pursue a CRC in ASD?
Autism Spectrum Disorder (ASD) is a lifelong condition affecting at least 1 in 1001 children with an estimated annual cost to Australia of $4.5-7.2 billion. With an unexplained 25-fold increase in diagnosis in the past 30 years, there are now more children with ASD than the combined number of children with cerebral palsy, diabetes, deafness, blindness and leukemia. Currently, diagnosis of autism is imprecise, time-consuming and expensive. While there is a diverse range of intervention programs, further evidence of outcomes for these programs is still required. Schools struggle to provide for children with ASD who frequently under-achieve academically, drop out, or are excluded for behavioural reasons. In adulthood, the majority experience dependence and unemployment, while around one third experience psychiatric illness.
What will a CRC in ASD deliver?
Many of the ongoing demands for disability support, which all governments are struggling to meet, will be alleviated through more accurate, cost- and time- efficient diagnostic procedures, innovative technological applications, evidence-informed interventions, appropriate curriculum and tailored supported education, and independent-living and workplace participation programs. The CRC will also provide a unique longitudinal perspective of the progress of children with ASD as they mature into adulthood.
Only through the establishment of a collaborative, inter-disciplinary research team of experts will we be able to improve the prospects of more than a million
Australians directly or indirectly affected by ASD2. Our team consists of experts in medicine (paediatrics, psychiatry, genetics, epidemiology), pharmacology, neuroscience, psychology, education, speech pathology and occupational therapy working closely with individuals with ASD and their families, schools and support service providers. By ensuring that services across the lifespan are ASD- friendly and evidence-informed, we will enable children with ASD to become citizens who contribute significantly to society. An Autism CRC will also build the capacity of the current and future workforce to deliver evidence-informed programs to people with autism and their families, and enhance the capacity of autism research in Australia.
1 Range of prevalence rates: 1 in 64 or 1.57 (Baron-Cohen, S. , Scott, F. J., Allison, C. Williams, J,, Bolton, P, & Matthews, F. (2009) Prevalence of autism-spectrum conditions: UK school-based population study. The British Journal of Psychiatry (2009)194, 500-509. doi: 10.1192/bjp.bp.108.059345) to 1 in 110 children or .9%. (Autism and Developmental Disabilities Monitoring Network Surveillance Year 2006 Principal Investigators (2009). Prevalence of autism spectrum disorders - Autism and Developmental Disabilities Monitoring Network, MMWR Surveillance Summary, Vol. 58, 1-29. 14 sites, United States, 2006: Centers for Disease Control and Prevention)
2 Estimate based on a prevalence rate of 1 in 100 and people affected (parents, siblings, grandparent, individuals x 20 years.
About the Cooperative Research Centre Program
The Cooperative Research Centre (CRC) Program is a program funded by the Australian Government Department of Innovation, Industry Science and Research.
The purposes of the CRC program are to:
- support medium to long-term collaboration between the producers and end-users of research. An end-user in this context refers to either a public or private entity capable of deploying the research outputs to deliver significant economic, environmental and/or social benefits to Australia.
- provide funding to build critical mass in research ventures between end- users and researchers which tackle clearly-articulated, major challenges for the end-users. CRCs pursue solutions to these challenges that are innovative, of high impact and capable of being effectively deployed by the end-users.
- stimulate a broader education and training experience for postsecondary students, particularly research students, to enhance their employment prospects, provide them with the skills needed to utilise research outputs and produce innovative end-user centred solutions.
At any one time a CRC must have among its essential participants at least one Australian:
- end-user (either from the private, public or community sector); and
- higher education institution (or a research institute affiliated with a university).
As a minimum, CRCs must undertake all of the following activities:
- medium to long-term end-user driven collaborative research;
- an end-user-focused education and training program at least including, but not limited to, a PhD program that complements the research programs and that builds engagement, innovation and R&D capacity within end-users
- Small to medium enterprise (SME) strategies that build their innovation and R&D capacity;
- utilisation activities to deploy research outputs and encourage take up by end-users.
The CRC program provides funding to supplement contributions by the participants. All participants must contribute resources to the CRC. These include both cash and in-kind, tied and untied contributions, and these must match the Commonwealth grant. However, to be a competitive application, the total participant contributions may need to be in excess of the dollar for dollar matching required by the guidelines.
PROPOSED CORE PROGRAMS OF THE AUTISM CRC
Based on extensive discussions among more than 60 key stakeholders from around Australia and the discussions of the core bid team the following programs will be the focus of the CRC.
Core Program 1: A Better Start
Diagnosis and Biological Underpinnings of ASD
Core Program 2: Creating a Future
The School Years - Enhancing
Student Learning and the Learning
Core Program 3:
Finding a Place in Society
Supports for Young People and Adults with ASD
Family support embedded across core programs
Core Program 1: A Better Start
Diagnosis and Biological Underpinnings of ASD
Current challenges for end-users
- End-users have expressed concerns about instances of both over- and under-diagnosis of ASD.
- Awareness of the early markers of autism, especially during the infancy and toddler period is lacking in the community, which leads to difficulties for both families and professionals.There is no uniform screening and developmental surveillance program for early detection of ASD in Australia.
- There is considerable variability in the diagnostic processes used in different states across Australia.
- Currently specialist training in identification and diagnostic procedures is inadequate, often leading to inaccurate diagnosis and delays in the delivery of appropriate intervention.
- As current "gold standard" diagnostic tools are very time consuming and require intensive and expensive training, they are not always used.
- There are no set supports and no clear integration or pathway from identification and diagnosis to intervention services, which leads to excessive stress for families and failure to cope and adapt.
- Although the range of phenotypes on the autism spectrum is extremely broad, there is currently no valid means of categorizing subtypes on the spectrum. This heterogeneity is one of the greatest barriers to progress in understanding the underlying biology, aetiology, ongoing development and outcomes in ASDs.
- There is currently no reliable Australian epidemiological data on ASDs.
- An internationally recognised cohesive group of ASD researchers from biological, medical and social science backgrounds will work collaboratively to address the current challenges surrounding early identification and diagnoses of conditions on the autism spectrum.
- National and international research efforts will lead to identification and validation of pre- and post-natal biomarkers (e.g., bio-chemical markers in blood and urine tests, growth parameters, brain scans) that have the potential to be included in diagnostic protocols
- Autism phenotypes will be profiled (matching genotyping with biochemical, neuro-cognitive and observable behavioural profiles) from early in development, which will also foster longitudinal studies of biological and behavioural growth and development.
- A DNA-chip or equivalent high-throughput genetic screen from identified biological markers to predict genetic susceptibility for ASD will be developed. Biomarkers on the chip may also be used to identify subtypes of ASD.
- Recommendations will be made regarding a national developmental surveillance program and a pilot program will be delivered to identify ASDs prior to 2-years of age.
- An awareness raising and training program around the early signs of ASDs for parents and professionals will be developed.
- A nationally endorsed protocol for accurate, efficient and evidence- informed diagnostic procedures for ASD will be developed.
- This nationally endorsed protocol for accurate, efficient and evidence- informed early identification and diagnostic procedures for ASD will facilitate the collection of epidemiological data, sorely needed in Australia. This will allow estimation of current and future demand for services on the basis of strong evidence.
- A national set of competencies for diagnosis of autism by health practitioners will be developed.
- Postgraduate educational programs and qualifications in regard to the early identification and diagnoses of ASDs will be developed for national roll out.
- A program for supporting families during the period of diagnosis, building on the Helping Children with Autism funded Early Days Workshops, will be developed. This will incorporate appropriate information, counselling and support for families.
- Recommendations for seamless integration between diagnostic and intervention services, and a pilot program will be delivered.
Social and economic benefits to Australia
- Identification of biomarkers to specify autism spectrum risk prior to the development of behavioural and cognitive manifestations will lead to early and accurate diagnosis and intervention approaches.
- Identification of biomarkers and the associated behavioural developmental trajectories that differentiate subtypes of ASD will enable services to be targeted to specific needs associated with these different subtypes including preventative and treatment approaches.
- Development of uniform screening and developmental surveillance programs for early detection of ASD in Australia, and promotion of knowledge around the early behavioural phenotype/s will also lead to more efficient and accurate early identification.
- More accurate, time-efficient and earlier diagnosis will reduce the cost associated with over-diagnosis and under diagnosis and enable earlier access to intervention for children with ASD, reducing the long-term impact of the disorder
- Accurate early identification and more efficient diagnosis, together with the development of a program to support families during this period will lead to increased capacity in the families around the support of their child, and ultimately to better developmental outcomes for the children and their families.
- Improved training of diagnosing practitioners will enhance diagnostic accuracy and efficiency and be attractive to overseas student markets.
Core Program 2: Creating a Future
The School Years - Enhancing Student Learning and the Learning Experience
Challenges for end-users
- Academic underperformance relative to level of ability among students with ASD
- Challenges with behavioural regulation in classrooms (frequently resulting in a suspension, exclusion or use of home schooling as a last resort)
- High incidence of students with ASD experiencing bullying in schools
- High incidence of anxiety and depression and other mental health issues among students with ASD (particularly in late primary school and high school)
- Students with ASD with sensory processing issues frequently find school environments overwhelming (e.g., excessive noise levels, visual clutter)
- How to address the unique needs of students with ASD within The Australian Curriculum framework (a.k.a. National Curriculum)
- Lack of knowledge and understanding of ASD amongst teachers and other school staff
- Need for current understanding arising from brain research to be applied to educational programs for students with ASD
What the CRC will deliver?
- Nation-wide research into the key elements of effective ASD-friendly education programs including the incorporation of:
- ASD- friendly pedagogies (e.g., routine use of visual supports, use of structure and explicit teaching)
- Innovative use of technology (e.g., iPads, iPods, iPhones, interactive whiteboards, computer software technology)
- ASD-friendly classroom environments (e.g., reduced background noise, use of visual structure, architectural design)
- An effective social emotional curriculum
- Positive behaviour supports
- Effective communication supports and language interventions
- ASD-friendly teaching principles (e.g. universal design, enhancing access to the Australian Curriculum)
- Educational programs of students with ASD guided by current brain research, through collaboration between researchers from multiple disciplines including educational psychology, allied health, neuroscience and education.
- Research on the effectiveness of individualised educational supports to cater for the specific needs of distinct cohorts within the autism spectrum (what works for which child, when?)
- Research on key elements to support successful transitions (from early intervention to early years schooling, transitions from primary school to middle years school/high school etc.)
- The use of uniform data collection methods and outcome measures to evaluate educational programs across the nation will provide a shared language with regard to educational, participation, and behavioural outcomes specifically suited to the Australian context.
- Training of teachers and other school staff on ASD-friendly curriculum approaches and inclusive assessment delivered through roll-out of a nation-wide in-service program.
Social and economic benefits to Australia:
- Enhancing educational approaches and processes will result in greater school success and retention in schools, access to tertiary education and employment and capacity for independent living in adulthood and, ultimately, reduced need for income and living supports of adults with ASD.
- Nation-wide implementation of uniform outcome measures and data- collection procedures will enable consistent evaluation and long-term monitoring of Australian children with ASD.
- Students with ASD across Australia will have equitable access to quality education guided by ASD-friendly principles to enhance their access to the Australian Curriculum.
- The capacity of Australian schools to deliver a quality education to students with ASD will be enhanced by better training and professional development for teachers and other school staff
- The educational approaches utilized to enhance the learning of students with ASD have a broader application and can be successfully applied and utilized with all learners.
Core Program 3: Finding a place in society
Tailored Supports for Young People and Adults with ASD
Current issues for end-users
- The limited evidence available suggests high levels of adverse adult outcomes such as long-term unemployment, dependence on families and social isolation, and secondary negative impacts on the health and wellbeing of individuals and families.
- Parents describe the need for interventions to address self awareness, relationships, autonomy and community living challenges.
- Little is known about effective interventions for adults with ASD to address participation in tertiary and vocational education, and workforce participation (employment).
- There is a very high prevalence of secondary mental health issues such as severe anxiety and depression in young people and adults with ASD that impact on their participation. Challenging behaviours also frequently impact on their participation.
The focus of the CRC on Australia-wide research will ensure:
- Accurate Australian baseline information about adult outcomes for people with ASD and the impact on families will be collected.
- A protocol for vocational assessment and guidance for post school study or work will be developed.
- Age appropriate adult programs addressing social interaction skills, emotion regulation, and relationships will be developed, evaluated and rolled out nationally.
- The effectiveness of already established pilot programs to support adolescents and adults with ASD to participate in tertiary and vocational education sectors will be identified and described in detail. The programs will include support for young people with ASD, academic staff, disability support staff and instructors.
- Australian models for employment for people with ASD, (e.g., in software testing) and other supported and open employment intervention models (e.g. AIM employment in WA) will be developed, evaluated and extended to other sites/states.
- Awareness of the strengths and challenges of people with ASD will be heightened in tertiary and vocational education facilities and workplaces, through customised training programs
- Opportunities to enhance social and community engagement and independent living (e.g., leisure, social interaction, community access, self maintenance) will be developed and evaluated.
- Social and emotional outcomes and quality of life, as well as community engagement and participation will be evaluated.
Social and economic benefits to Australia
- Adults with ASD will increase their participation in vocational and tertiary education and employment and community engagement, and reduce their dependence on families and spouses.
- The economic costs associated with income and living support will be identified and reduced.
- Effective ways of supporting the social emotional well being and quality of life of adults with ASD will be developed and this will enhance their societal participation and reduce long-term use of services including mental health services.
Innovative use of technology embedded across core programs
Current challenges for end-users
As people with ASD are almost universally visual learners and are less adept at processing speech, gestures and facial expressions, they naturally gravitate towards technology, which offers predictable and consistent environments with minimal distractions and the flexibility of working at their own pace. However, research on the effectiveness of different types of the hardware (e.g., laptops, iPads, iPods) and software in achieving particular outcomes is lacking.
- Specific outcomes that require further evaluation include the use of technology:
- as an alternative means of communication for children who have limited speech
- to support the understanding of social interaction (e.g., human gestures, emotions and facial expressions and appropriate ways to interact socially) using software applications
- to assist with organisation (e.g., visual schedules, electronic calendars, task sheets and electronic reminders)
- to support educational outcomes by (a) accommodating the learning styles/strengths of children with ASD and (b) improving written output (e.g., use of technology as an alternative to handwriting)
- as a vocational opportunity for young people with ASD for whom this area is a strength
- Services for children with ASD and their families in regional and rural Australia are infrequent and often inadequate. Possible applications of remote technologies using Australia's new high-speed National Broadband Network to overcome the tyranny of distance include:
- direct interventions with people with ASD
- support of professionals in health and education
- support of diagnosis of ASD, and diagnosis and management of secondary mental health issues particularly where there is limited access to paediatricians or psychiatrists
- Core program 2 will deliver research into the effectiveness of technological applications as an adjunct to educational approaches
- Core program 3 will develop and evaluate employment programs focusing on technology for young people with ASD for whom this is a strength>
- All core programs will incorporate cost-benefit analysis of the use of remote technologies to deliver supports to remote areas using the National Broadband Network
Social and economic outcomes to Australia
- Better outcomes for people with ASD in terms of communication, social understanding, education and vocational opportunities.
- Economic benefits arising from the Australian development of innovative technological applications, which would have both domestic and overseas markets.
Family supports embedded across core programs
Current challenges for families
- Families often report delays in diagnosis and high levels of stress during the gap between diagnosis and accessing a suitable service.
- Families of school age children report that school staff often do not appreciate the impact of ASD on their child and consequently misunderstand their child's learning needs and behaviour. Where routine school behaviour management strategies prove to be ineffective, schools frequently respond by suspending or sending students home, or encouraging parents to home school the child. As a result some parents experience difficulties in accessing a quality education for their child, and may be forced to reduce or abandon paid employment in order to care for or home-school their child.
- Parents often describe the experience of their child leaving school as "falling off a cliff" because of the challenges that their adult child experiences in accessing vocational or tertiary education, or finding employment. Many young people with ASD become socially isolated in the family home and continue to be dependent on their families as adults.
- When compared to other families, families of children with ASD are known to experience higher rates of anxiety and depression, and to have lower family incomes as result of the need to make alternative employment choices to care for their child.
The concerns of families of children with ASD will be addressed by the following programs:
- Core Program 1 will focus on better developmental surveillance, earlier, more accurate diagnosis, and a more seamless transition between diagnostic and intervention services.
- Core program 2 will focus on evaluation and implementation of ASD- friendly classroom programs and intensive social/emotional/self- regulation programs for students with complex behavioural needs. Training of school staff and raising awareness of the needs of students with ASD within school communities will also be an outcome of this program.
- Core Program 3 will focus on evaluation and implementation of adult programs addressing social interaction skills, emotion regulation, and relationships, and supports to enable adults with ASD to participate in tertiary and vocational education, employment and/or community programs.
Social and economic benefits to Australia
- More responsive services from children, adolescents and adults with ASD will reduce the stress experienced by families.
- Improved access to a quality education and/or post-school options such as vocational or tertiary education, employment and/or community programs will enable parents of a children or adults with ASD to participate in the workforce and in community life to the same extent as other parents. Increased workforce and community participation of family members will result in improved family well-being, higher family incomes, and benefits to the Australian economy.
CURRENT ESSENTIAL PARTICIPANTSThe University of Queensland
UQ has established an ASD Research Network bringing together staff in health and rehabilitation sciences, paediatrics, psychiatry from the Faculty of Health Sciences, psychology from the Faculty of Social and Behavioural Sciences, and neuroscience from the Faculty of Science and researchers in genetics and biomarkers, and psychological/cognitive science from the Queensland Brain Institute. This network places UQ in a strong position to harness this capacity to collaborate with researchers nationally and internationally to provide solutions to the issues raised by end users (individuals with ASD, their families and service providers).
Autism Queensland is a community-based, not-for-profit, incorporated association and the peak provider of services to children and adults with ASD in Queensland. Autism Queensland currently has over 8,500 registered clients from all areas of Queensland and offers a wide range of services including advocacy, family support services, family support groups, state-wide outreach services, information and help-line, accredited independent autism specific schools, early intervention programs, Autism Advisor program, respite services, and adult accommodation and recreation groups. Autism Queensland's
Research and Development team aims to conduct and support research that will enhance the potential of individuals with ASD to achieve valued life outcomes and improve the quality of life of people with ASD and their families. Current Autism Queensland research programs focus on (a) sensory processing;
(b) educational outcomes and (c) the use of evidence-informed practices and training needs of professionals who provide services to people with ASD.
Queensland University of Technology (QUT)
QUT has been acknowledged for its world-class research across a wide range of disciplines in the first comprehensive evaluation of research quality in all Australian universities. QUT has a strong eclectic knowledge base and research network drawing on expertise from health, science and technology, law, the built environment as well as all areas of education from early intervention through to senior schooling. This collaborative research partnership has as its main aim improving education outcomes for children and adolescents on the spectrum. The team has strong links to research networks both nationally and internationally, allowing them to capture information, and appropriately adapt it to and implement it within the Australian context. This allows them through their research within the Australian context to not only support the diverse needs of individuals on the autistic spectrum, but also their families and personnel who work with them.
La Trobe University
La Trobe University is recognized as a hub of excellence in autism, with the first research facility in Australia dedicated to ASDs, and the Victorian Autism Specific Early Learning and Care Centre. The Olga Tennison Autism Research Centre provides a vehicle for research, training opportunities, and collaboration between community services and research centres / universities involved in autism research both in Australia and overseas. Our mission is to advance knowledge of the nature and causes of Autism Spectrum Disorders, as well as to develop and study evidence-based strategies for supporting children and families affected by ASDs. Our research is conducted in a child-
friendly, purpose-built research facility within the School of Psychological Science and the Early Learning Centre. It allows for studies in all our areas of expertise including studies of physical growth and development, sleep patterns and biological (including genetic) markers. We also have access to computational facilities (including that required for biostatistics and bioinformatics as well as wet-lab facilities).
Curtin is widely recognised for the practical and applied nature of its courses and its innovative research which focuses on solving real world problems. Curtin has always fostered successful partnerships with community, industry, business and government to enhance the quality of our scholarship, teaching and research. With a strong commitment to end-user focussed research and growing capacity in the ASD field, especially in applied technologies, Curtin has been working with the University of Western Australia (UWA) and the Telethon Institute of Childhood Research (TICHR) in the establishment of the Western Australian Cooperation for Autism Research & Education (WACARE) that allows the complementary skills of each organisation to come together to better support the service providers and the individuals and their families affected by ASD.
University of New South Wales
UNSW brings strong partnerships between academic researchers and local health and educational service providers, offering ideal conditions for research into improvement in diagnosis and treatment across the age span. Academic contributors include faculty in psychiatry, pediatrics, and cognitive neuroscience, both through UNSW and through our close collaborations with Macquarie Centre for Cognitive Science, University of Sydney, and the Australian Institute of Health Innovation. Partnerships of relevance include the Autism Specific Early Learning and Care Centre in Liverpool, Sydney Children's Hospital, and collaborative work with other public and private health providers to improve services for individuals with Autism of all ages.Adapted from: Invitation to Participate: Proposal to establish a Cooperative Research Centre for a Better Start and Future for Autism Spectrum Disorders, Autism CRC Bid Team, 2010
University of Western Australia
UWA is an international leader in autism research, with particular expertise in paediatrics, psychology, psychiatry and diagnostics. Through the Telethon Institute of Childhood Research (TICHR), UWA has developed nationally-unique databases for autism research and monitoring, including the WA Autism Registry (prevalence monitor) and the Western Australian Autism Biological Registry (biological repository). UWA recognises the importance of a collaborative approach to autism research and has established close partnerships with a number of international institutions (e.g., University of Oxford,
University of Bristol) as well as Western Australia's largest autism service providers
(e.g., including the WA Department of Health, Autism Association of WA, Autism West, and Intervention Services for Autism and Developmental Delay). ...