School Medical Autism Review Teams (SMART)

Contact: Kate Orville (
Core Function: Technical Assistance and Outreach Training

Children and families in many rural communities in Washington State are unable to access a timely assessment for autism or other developmental disabilities and get connected to helpful services. They may wait for 1-2 years for an autism evaluation at a distant tertiary care center because there is no option closer to home. Transportation and language barriers are also issues for many families. School Medical Review Teams (SMART) were created in rural Washington State communities to address this challenge. There are seven operational SMART teams and This project is one of the priorities that has come out of the work in CAM communities.

SMART is a model that builds on and expands community capacity in rural and underserved communities that do not have access to a local multidisciplinary diagnostic center. Using a shared document, the SMART tool, families are able to collect records of evaluations from their school, early intervention agency, local providers, and pediatrician to inform an interdisciplinary evaluation and diagnosis of autism. In the SMART approach, experienced pediatric primary care providers, schools, early intervention agencies, and families come together and share their knowledge and evaluation results in order to facilitate a virtual, comprehensive assessment of a child. This process provides a close link between a child's primary care provider (PCP) and school team, who sees the child on a daily basis. Some larger communities are choosing a Network instead of team approach, where there are multiple clinicians who diagnose children, but have organized countywide processes to receive school and early intervention assessments and connect children to needed services. In combination with Autism Center of Excellence (COE) training of pediatric primary care providers through the Washington State Health Care Authority (HCA), SMART is a mechanism that allows children to qualify for Applied Behavior Analysis (ABA) therapy covered by Medicaid.