- ASD —
- autism spectrum disorder
- CAAI —
- Combating Autism Act Initiative
- DBP —
- Developmental Behavioral Pediatrics
- HRSA —
- Health Resources and Services Administration
- MCH —
- Maternal and Child Health
- MCHB —
- Maternal and Child Health Bureau
- SDAS —
- Secondary Data Analysis Studies
Over the past 2 decades, autism has emerged as a major public health concern in the United States.1 Since 1995, the US Department of Health and Human Services has sharpened its focus on autism spectrum disorders (ASDs) through development of new initiatives that are aimed at increasing our understanding of autism, its causes, and potential treatments.2 However, families and young children with ASD and other related developmental disabilities continue to face many challenges in health care and educational service system access, ensuring optimal development through early intervention, a successful transition into adulthood, and fostering family well-being and positive family functioning in diverse racial and ethnic populations.
To further address autism as a critical and growing public health concern, Congress enacted the Combating Autism Act of 20063 in December 2006, which authorized programs to combat autism through research, screening, intervention, and education. As stated in this legislation, the Secretary of Health and Human Services shall “establish and evaluate activities to:
provide information and education on autism spectrum disorder and other developmental disabilities to increase public awareness of developmental milestones;
promote research into the development and validation of reliable screening tools for autism spectrum disorder and other developmental disabilities and disseminate information regarding those screening tools;
promote early screening of individuals at higher risk for autism spectrum disorder and other developmental disabilities as early as practicable, given evidence-based screening techniques and interventions;
increase the number of individuals who are able to confirm or rule out a diagnosis of autism spectrum disorder and other developmental disabilities;
increase the number of individuals able to provide evidence-based interventions for individuals diagnosed with autism spectrum disorder or other developmental disabilities; and
promote the use of evidence-based interventions for individuals at higher risk for autism spectrum disorder and other developmental disabilities as early as practicable.”
Congressional appropriations included funding for the Health Resources and Services Administration (HRSA) to implement Section 399BB of the Combating Autism Act. HRSA’s Maternal and Child Health Bureau (MCHB) has a long and rich history of implementing programs that include but are not limited to services, research, training, and system infrastructure building for ensuring the delivery of health care and related services to and promoting the well-being of all mothers, infants, children, adolescents, and children with special health care needs in the nation, including those with low incomes, from diverse ethnic or racial backgrounds, or isolated populations with limited access to care through Title V of the Social Security Act.4 Under the Combating Autism Act authority, HRSA’s MCHB developed the Combating Autism Act Initiative (CAAI) to address ASDs and other developmental disabilities by: increasing awareness; reducing barriers to screening and diagnosis; supporting research on evidence-based interventions for children and adolescents with ASD and other developmental disabilities; promoting evidence-based guideline development for interventions; and training professionals to use valid and reliable screening tools to diagnose or rule out ASD and other developmental disabilities, and to provide evidence-based interventions.
Within the CAAI, the MCHB implemented programs in 4 domains in 2008: (1) Combating Autism Training Programs, including expansions to existing Leadership Education in Neurodevelopmental Disabilities training programs, as well as new Leadership Education in Neurodevelopmental Disabilities training programs; growth of current Developmental Behavioral Pediatrics (DBP) training programs; and development of a Maternal and Child Health (MCH) Training Autism Resource Center cooperative agreement; (2) 2 Autism Intervention Research Networks focused on intervention research, guideline development, and information dissemination (1 network that is focused on physical health interventions, and 1 on behavioral, mental, social, and/or cognitive health interventions); (3) Combating Autism State Demonstration and Policy Programs, which have included the following: (a) the founding of the State Autism Demonstration grants, which have implemented comprehensive State autism plans to improve early screening, diagnosis, and access to comprehensive coordinated early intervention services and related health care for children and adolescents with ASD and other developmental disabilities; and (b) the formation of a State Public Health Coordinating Center, which coordinates with the State Autism Demonstration grants and develops and implements strategies for defining, supporting, and monitoring the role of State public health agencies in assuring that children and adolescents with ASD receive early and appropriate identification, diagnosis, and intervention; and (4) the Combating Autism National Evaluation, which will provide critical information on progress related to ASD and other developmental disabilities as required by the Combating Autism Act of 2006. Preliminary results from the national evaluation of HRSA’s CAAI included in a report to Congress in December 2010 were positive, indicating that the CAAI investments had achieved the program purposes of (a) promoting early screening and treatment of those diagnosed with ASD, (b) increasing the number of individuals who are able to screen and provide evidence-based services to those with ASD, and (c) advancing research into the development and validation of reliable screening tools and interventions.
In 2009 and 2010, additional funding was authorized by the Act to further HRSA/MCHB’s Combating Autism efforts in the areas of autism intervention research and training. With this additional funding for autism intervention research, the field-initiated R40 Autism Intervention Research, and Secondary Data Analysis Studies (SDAS) Programs were initiated in 2009, followed by the implementation of the DBP Research Network in 2010.
These Autism Intervention Research Programs, all components of HRSA/MCHB’s CAAI, are administered by the MCH Research Program, located within MCHB’s Division of Research, Training and Education. Since its inception in 1963, the MCH Research Program has supported groundbreaking investigations that have significantly influenced clinical management, organization, and delivery of health care services, preventive care, and early intervention for the maternal and child health population, including children with special health care needs.
The portfolio of MCHB Autism Intervention Research Programs funded in 2008–2010 includes the following program activities:
Two Autism Intervention Research Networks that focus on (a) intervention research, (b) tool validation for interventions, (c) guideline development, and (d) information dissemination on research findings, guidelines, and tool validation activities to health professionals and the public, especially families impacted by ASDs and other developmental disabilities. One network focuses on physical health interventions (AIR-P), and 1 network focuses on behavioral, mental, social, and/or cognitive health interventions (AIR-B).
Twelve field-initiated R40 Autism Intervention Research grants on evidence-based practices for interventions to improve the health and well-being of children and adolescents with ASD and other developmental disabilities, with a focus on addressing the unique and important needs of underserved populations.
Five field-initiated R40 SDAS grants on evidence-based practices for interventions to improve the health and well-being of children and adolescents with ASD and other developmental disabilities, utilizing exclusively the analysis of existing secondary data.
A DBP Research Network that focuses on the translation of multidisciplinary pediatric research to practice and fosters a new generation of developmental behavioral pediatric researchers.
A complete list of all HRSA/MCHB Autism Intervention Research Program projects awarded in 2008–2010 is included in Table 1. Information about all HRSA/MCHB CAAI programs can be found at http://mchb.hrsa.gov/programs/autism/. Subject to future amendment or reauthorization of Section 399BB, Public Health Service Act, Pub L No. 109-416, the Combating Autism Act of 2006 (42 USC 280i-1), it is expected that the MCH Research Program will continue and expand its autism intervention research programs. Manuscripts from select HRSA/MCHB Autism Intervention Research projects are included in this journal supplement.
- Accepted August 8, 2012.
- Address correspondence to Hae Young Park, MPH, Health Resources and Services Administration, Maternal and Child Health Bureau, 5600 Fishers Lane, 18A-55, Rockville, MD 20857. E-mail:
The opinions expressed in this article are those of the authors and do not necessarily reflect the views or policies of the institutions with which the authors are affiliated.
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
- ↵US Department of Health and Human Services. HHS fact sheet: HHS on the forefront of autism research. Available at: http://archive.hhs.gov/news/press/2001pres/01fsautism.html. Accessed August 22, 2012
- ↵Section 399BB, Public Health Service Act, Pub L No. 109-416, as amended by the Combating Autism Act of 2006 (42 USC 280i-1)
- Copyright © 2012 by the American Academy of Pediatrics