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Development and Evaluation of an Educational Initiative to Improve Hospital Personnel Preparedness to Care for Children with Autism Spectrum Disorder

Lucarelli, Jennifer, MD*; Welchons, Leah, PhD; Sideridis, Georgios, PhD‡,§; Sullivan, Nancy R., PhD‡,‖,§; Chan, Eugenia, MD, MPH‡,‖,§; Weissman, Laura, MD‡,‖,§

Journal of Developmental & Behavioral Pediatrics: June 2018 - Volume 39 - Issue 5 - p 358–364
doi: 10.1097/DBP.0000000000000580
Original Articles

Objective: To evaluate the effectiveness of a multimodal educational curriculum on increasing hospital personnel's awareness of successful strategies and comfort in caring for children with autism spectrum disorder (ASD).

Methods: We developed a 3-part training for front-line staff (i.e., front desk, clinical assistants, and phlebotomists) in 8 outpatient hospital departments frequented by patients with ASD. Following a needs assessment, participants completed an online educational module and then attended an in-person seminar tailored to each department. To evaluate training effectiveness, we administered pre-, immediate post-, and 1 month post-training surveys assessing personnel attitudes, comfort, perceived knowledge, and behaviors around caring for patients with ASD.

Results: We trained 168 staff members from 8 departments. On the needs assessment, participants (N = 129) reported a mean 2.5 behavioral incidents involving patients with ASD over the previous 3 months; 92% believed that the training would be helpful for their work. Across pre-, immediate- and 1-month post-training surveys, scores improved on all questions related to personnel attitudes about the importance of ASD-friendly care, comfort interacting with patients with ASD, perceived knowledge about ASD, and self-reported frequency of behaviors intended to help children with ASD adjust to the hospital setting (p < 0.05). There was no difference in baseline scores or change in scores between clinical and nonclinical personnel. On a program evaluation (N = 57), 81% rated the training as “very good” or “excellent,” and 87% reported that they would be able to apply training material immediately to their role.

Conclusion: This training initiative led to improvement in attitudes, comfort level, perceived knowledge, and self-reported behaviors of hospital personnel working with patients with ASD, which was maintained over 1 month.

This article has supplementary material on the web site:

*Center for Children with Special Needs, Floating Hospital at Tufts Medical Center, Boston, MA;

The Kelberman Center, Utica, NY;

Division of Developmental Medicine, Boston Children's Hospital, Boston, MA;

§Autism Spectrum Center, Boston Children's Hospital, Boston, MA;

Harvard Medical School, Boston, MA.

Address for reprints: Jennifer Lucarelli, MD, Center for Children with Special Needs, Floating Hospital at Tufts Medical Center, 800 Washington St, Boston, MA 02111; e-mail:

Supported by a grant from the Boston Children's Hospital Program for Patient Safety and Quality.

Disclosure: The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Received September , 2017

Accepted March , 2018

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