In 2006, the U.S. Congress passed the Combating Autism Act (P.L. 109–416). The Act appropriated a total of $168 million, including $42 million for the Health Resources and Services Administration (HRSA), to focus on autism and related developmental disability education, early detection, and intervention. Under the authority of this Act, HRSA’s Maternal and Child Health Bureau (MCHB) launched the Combating Autism Act Initiative (CAAI) in September 2008, with the long-term goal of developing a system of services that includes: 1) early developmental screening; 2) conducting early, interdisciplinary diagnostic evaluations to confirm or rule out ASD and other DD; and 3) providing early, evidence-based interventions for children with a confirmed ASD diagnosis.

In accordance with the objectives specified in the legislation, the CAAI awarded grants to:

•  Increase awareness of ASD and other DD
•  Reduce barriers to screening and diagnosis
•  Support research on evidence-based interventions for ASD and other DD
•  Promote the development of evidence-based guidelines and tools for interventions
•  Train professionals to use valid and reliable screening and diagnostic tools and provide evidence-based interventions for ASD and other DD

Additionally, MCHB introduced a broad-based objective for the CAAI aimed at creating systems- level improvements at the State level that would improve access to comprehensive, coordinated health care and related services for children with ASD and other DD.

To accomplish these objectives, MCHB awarded grants to three distinct but complementary program areas that are responsible for 1) training health and allied health professionals, 2) conducting research, and 3) improving State systems of care. Over the course of the 3-year grant period, CAAI funds were awarded to 39 Leadership Education in Neurodevelopmental Disabilities (LEND) Training Program grantees, 6 Developmental-Behavioral Pediatrics (DBP) Training Program grantees, 9 MCH Autism Intervention Research Program grantees, and 9 State Implementation Program grantees.

This report presents the results of a 3-year study to assess the performance of these grant programs in meeting the objectives of the CAAI. The study did not attempt to measure long-term outcomes, such as changes in the average age of first screening, because these impacts would generally not be discernible within 3 years. Instead, the study measured results of the grantees’ efforts in the areas of training, awareness building, research, and building comprehensive systems of care for ASD, all of which are expected to contribute to the realization of the CAAI’s long-term goal.