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Integrating the RITA-T in Practice

Setting up the RITA-T in Clinic - Pediatric Practices:

  • Specific clinicians (pediatrician, and/or NP) are trained on the RITA-T in a practice:
  • When other pediatricians in the practice have a child they are concerned about, they refer to the clinician trained. They also start conversation with family and make sure family already connected with EI services.
  • Clinician trained on RITA-T then schedules as a preventative visit/Screening visit: completes the RITA-T and write up.
  • Referral for evaluation using the fast track intake form.
  • Trained Residents in their continuity clinics and if seeing someone with concerns, then complete MCHAT and RITA-T in a separate visit.
  • Residents start conversation with family, make sure child is receiving EI services.
  • If results are in risk range, and if resident concerned, then complete referral to diagnostician using the Fast-Track intake form.

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Setting up the RITA-T in Early Intervention 

  • A group of providers trained specifically on the RITA-T. Usually providers in an Autism subgroup within EI program.
  • When providers are working with a child and they have concerns for ASD, if they are not trained for the RITA-T, they refer to providers trained with it for administration.
  • Providers start conversation with the family while referring to diagnostic clinic through RITA-T Fast-track clinic.
  • Example of a particular EI program - THOM in Worcester

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Level 1 Screening:

If the toddler is younger than 18 months, you can use the CSBSDP-IT 

If toddler older than 18 months, you can use the MCHAT-R/F

https://brookespublishing.com/product/csbs-dp-itc/

https://mchatscreen.com/ 

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History and Observation Tool to Facilitate Evaluation of Children with Suspected ASD:

We have put together this form to facilitate the evaluation of children with suspected ASD. We use this in addition to a level-1 screen and the RITA-T to develop a clinical impression.

Early Autism Screening Inventory (EASI)

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Example of a referral form to the RITA-T Fast Track Clinic at UMass Medical Center

We created the following form - please feel free to edit and adapt it to your own clinics

RITA-T Fast Track Intake Form

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Write up in a report:

1. We usually summarize the EASI in the history. 

2. We developed the following paragraph for the RITA-T:

The Rapid Interactive screening Test for Autism (RITA-T) in Toddlers was administered. RITA-T is a  screening test administered to young children (ages 18 months to 36 months) identified at risk for ASD, or who scored positive on a Level 1 screening test, or if their providers are worried about. The RITA-T includes nine semi-structured play-based presses that examine constructs that have been described to be delayed in children with Autism Spectrum Disorders (ASD). Scoring is based on a total of 30 points. The RITA-T has been validated and standardized. 

Score <12: Low-risk range for ASD

Score 12-16: Moderate Risk for ASD and needs further testing.

Score >16: High Risk for ASD.

@firstname@ scored a *** placing *** in the ***category.

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Billing:

Qualifies for a CPT code 96110 (screening)

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Finding Early Intervention Programs in Massachusetts

Early Intervention in Massachusetts