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Indiana University School of Medicine
Indiana University School of Medicine
Pediatrics

Early Autism Evaluation Hub System

State of Indiana with sites marked with stars in counties

The Early Autism Evaluation (EAE) Hub system, a program of Indiana University School of Medicine established in 2012 and generously supported by Riley Children’s Foundation, is a statewide network of community primary care physicians and clinicians (PCP) with specialized training in autism diagnosis for children 14-48 months of age. Our mission is to improve access to early autism evaluations and provide connections to life-changing interventions and community resources that support optimal child development and family wellbeing. The EAE Hub system is now the largest known primary care system of autism diagnosis in the US with more than 20 sites representing numerous health systems.

We partner with primary care teams to accomplish our mission through key drivers of care:

  • Train diverse community clinicians in autism diagnosis and care management
  • Provide longitudinal support to care teams through a monthly learning collaborative
  • Maintain a repository of training materials and resources to support care delivery
  • Use quality indicator data to drive system refinements and quality assurance
  • Advocate across statewide systems for policies that support care of autistic children

Clinical Pathway

The EAE Hub standard clinical evaluation pathway involves administration or review of standard developmental and autism screening tools, an autism-focused diagnostic interview and medical history conducted with the child’s caregiver, physical examination, and administration of an observational assessment tool. The EAE Hub clinician synthesizes all assessment data to determine diagnosis, and the family is counseled on the diagnosis and next step recommendations and resources. The clinical report with diagnosis and tailored care plan is disseminated to the child’s family and referring PCP. When autism diagnostic outcome cannot be determined in the EAE Hub evaluation (e.g., due to complex clinical presentation), children are referred to an autism diagnostic specialist.

Initial evaluation begins with a thorough review of prior developmental screenings to assess areas of concern and guide the clinical interview.

A detailed interview is conducted with the caregiver, focusing on the child’s developmental and medical history and incorporating a systematic assessment of DSM-5 criteria for autism.

Clinicians administer a validated observational assessment tool, such as the Screening Tool for Autism in Toddlers and Young Children (STAT), to assess current social communication and behaviors associated with autism.

A targeted physical exam is performed to identify any medical findings that may contribute to or clarify the child’s developmental profile.

Findings from all components of the evaluation are synthesized to formulate a clinical diagnosis. The diagnosis is shared with the family in a collaborative and supportive manner.

A comprehensive clinical report is developed and provided to the family. This includes the diagnostic conclusions and tailored recommendations for next steps in care, including referrals for intervention, therapy, and other support services.

EAE Hub flowchart

Capacity Building and Education

To facilitate the early diagnosis and improve care of young children at increased likelihood for autism, the EAE Hub system is committed to building capacity of primary care clinicians through education and ongoing support. Our initial training course prepares PCPs for independent competency in autism diagnostic evaluation of young children. The course includes three phases of training, completed flexibly in either live or virtual format, and is hosted on Canvas (an online educational learning platform). Training typically takes approximately 30 hours to complete.

Following training, EAE Hub clinicians and teams are closely supported in launching their evaluation site and participate in our monthly virtual learning collaborative. The learning collaborative is offered twice monthly via Zoom with repeated content to maximize opportunities for busy PCPs and their teams to participate. The goal of the learning collaborative is to support community clinicians in applying quality improvement methods within their primary care practices. This approach enhances developmental screening and referral processes for children at increased likelihood of autism as well as supporting methods for connecting families to appropriate evaluations, therapies, and services. We often offer American Board of Pediatrics Maintenance of Certification (MOC) courses as part of the learning collaborative curriculum.

Watch the EAE Training Introduction

Highlighted Outcomes

Over 6,500 EAE evaluations have been completed since 2012. In 2024:

  • 1,325 children were served in the EAE Hubs, our largest annual volume to date.
  • Nearly 600 PCPs from 70 Indiana counties referred children for evaluation.
  • Average age of diagnosis was 33 months.
  • Average wait time from referral to evaluation was 3-4 months.
  • 56% of children received an autism diagnosis; the majority of children evaluated received a diagnosis of developmental delay. 
    ​
graph showing early autism evaluations increasing from zero in 2012 to almost 1,400 in 2024

EAE Hub Locations

The list of current sites and contact information is found below. New sites are added every year.

Cameron Pediatrics
306 Maumee St Ste 303
Angola, IN 46703
(260) 667- 5690

Riley Pediatric Care Center - Avon
1111 N Ronald Reagan Pkwy, Suite C1600  
Avon, IN 46123 
(317) 217-3120

Riley Pediatric Care Center - Bedford
1614 25th St.
Bedford, IN 47404
(812) 277-0118

IU Health Riley Physicians
4935 W. Arlington Rd.
Bloomington, IN 47404
812-353-3785

Riley Pediatric Primary Care – Fishers
11530 Allisonville Rd, Ste 190
Fishers, IN 46038
463-251-3937
*IU Health referrals only

The Bowen Center
2100 Goshen Road
Fort Wayne, IN 46808
260-471-3500

Marram Health Center
3229 Broadway, #115
Gary, IN 46409
219-806-3000

Kids First Pediatrics
5300 IN-64 Suite 105
Georgetown, IN 47122
(812) 366-0012

Maple City Health Care Center
808 N 3rd St
Goshen, IN 46528
(574) 534-0088

Community Physician Network Family
Medicine And Pediatric Care
3000 S. State Rd. 135, Ste. 310
Greenwood, IN, 46143
317-497-2400
* Community Health Network referrals only

Marram Health Center
704 S State Road 2
Hebron, IN  46341
(219) 996-2641

Riley Pediatric Care Center
1002 Wishard Blvd, Suite 2000
Indianapolis, IN 46202
317-944-4846

Eskenazi Health Center Pecar
6940 Michigan Rd.
Indianapolis IN 46268
317-266-2901
*Eskenazi referrals only

Riley Pediatric Primary Care
1002 Wishard Blvd, Suite 2001
Indianapolis, IN 46202   
317-944-2801
*IU Health referrals only

Riley Pediatric Primary Care - Indianapolis
9650 E. Washington St., Suite 245
Indianapolis, IN 46229
(317) 890-5552

Jasper Primary Care Physicians
1950 St Charles Street, Suite 4
Jasper, IN 47546
(812) 482-9555

IU Health Arnett
2600 Greenbush
Lafayette, IN 47904
765-448-8000 (ask for Peds triage)
* IU Heath Arnett referrals only

Riley Physicians Pediatrics
820 Samuel Moore Pkway, Suite C
Mooresville, IN 46158

ALL IN Pediatrics
2305 Green Valley Rd.
New Albany, IN 47150
812-949-0405
*ALL IN Pediatrics referrals only

Growing Kids Pediatrics
3321 Ballard Ln.
New Albany, IN 47150
812-944-4575

Deaconess Riley Children’s
Specialty Center
4209 Gateway Blvd., MOB 2
Suite 1100
Newburgh, IN 47630
812-858-3131

MHP Pediatrics
2451 Intelliplex Drive, Suite 240
Shelbyville, IN 46176
(317) 398-7337

Primary Care Partners of South Bend
300 South St. Louis, Suite 204
South Bend, IN 46617
574-251-1200

Lutheran Health Physicians
Pediatric Healthcare
902 Provident Drive, Ste A
Warsaw, IN 46580
574-269-8338

Meet the Team

Faculty Directors


23179-McNally Keehn, Rebecca

Rebecca McNally Keehn, PhD

Assistant Professor of Pediatrics

Read Bio

6489-Ciccarelli, Mary

Mary R. Ciccarelli, MD

Morris Green Professor of Pediatrics

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Dr. Carrie Leathers

Carrie A. Leathers, MD

Assistant Professor of Clinical Medicine

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Faculty Collaborators


51992-Ryan Lengacher, Tybytha

Tybytha Ryan Lengacher, PhD

Assistant Professor of Clinical Pediatrics

Read Bio

61004-Martin, Ann Marie

Ann Marie Martin, PhD

Assistant Professor of Clinical Pediatrics

Read Bio

9670-Huskins, Jordan

Jordan C. Huskins, MD

Assistant Professor of Clinical Pediatrics

Read Bio

Staff


Hannah Ricker

Hannah Ricker

Angela Paxton

Angela Paxton

   

EAE Hub Evidence

Beyond its clinical mission, the EAE Hub system functions as a dynamic health services laboratory situated within Indiana’s diverse communities. Our internationally recognized research has shown that primary care autism diagnosis is feasible, accurate, reduces evaluation wait time, supports entry into intervention and access to community supports, and is valued by caregivers.

Learn more about the HEART Lab

  • Saunders, A.W., Langdon, S., Paxton, A., McNally Keehn, R., Keehn, B. (2025). Brief report: Service referral and enrollment following autism diagnosis in primary care. Res. Autism, 123, https://doi.org/10.1016/j.reia.2025.202575.
  • Keehn B, Monahan P, Enneking B, Ryan T, Swigonski N, McNally Keehn R. Eye-Tracking Biomarkers and Autism Diagnosis in Primary Care. JAMA Netw Open. 2024;7(5):e2411190. doi:10.1001/jamanetworkopen.2024.11190 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2818669
  • McNally Keehn, R., Minshawi, N. F., Tang, Q., Enneking, B., Ryan, T., Martin, A. M., Paxton, A., Monahan, P. O., Ciccarelli, M., & Keehn, B. (2024). Accuracy of the Screening Tool for Autism in Toddlers and Young Children in the primary care setting. Autism, 0(0). https://doi.org/10.1177/13623613241292850
  • Martin, A. M., Keehn, B., Ciccarelli, M., Paxton, A., & McNally Keehn, R. (2024). Associations among race, ethnicity, and clinical profiles of young children evaluated for autism in the primary care setting. Journal of Developmental and Behavioral Pediatrics. https://doi.org/10.1097/DBP.0000000000001298
  • McNally Keehn, R., Swigonski, N., Enneking, B., Ryan, T., Monahan., P., Martin., A.M., Hamrick, L., Kadlaskar, G., Paxton, A., Ciccarelli, M., Keehn., B. Diagnostic accuracy of primary care clinicians across a statewide system of autism evaluation. Pediatrics. Published online July 18, 2023. https://doi.org/10.1542/peds.2023-061188
  • Martin AM, Ciccarelli MR, Swigonski N, McNally Keehn, R. Evaluation of race and ethnicity across a statewide system of early autism evaluation. The Journal of Pediatrics, 2022. doi: 10.1016/j.jpeds.2022.10.023.
  • McNally Keehn R, Tang Q, Swigonski N, Ciccarelli M. Associations Among Referral Concerns, Screening Results, and Diagnostic Outcomes of Young Children Assessed in a Statewide Early Autism Evaluation Network. Journal of Pediatrics. 2021; 233: 74-81.e8 doi: 10.1016/j.jpeds.2021.02.063
  • McNally Keehn R, Ciccarelli M, Szczepaniak D, Tomlin A, Lock T, Swigonski N. A Statewide Tiered System for Screening and Diagnosis of Autism Spectrum Disorder. Pediatrics. 2020 Aug;146(2):e20193876. https://doi.org/10.1542/peds.2019-3876

Media Highlights

Eye-tracking tool to spot autism sets sights on commercialization

Eye-tracking techniques could help primary care providers diagnose autism sooner, more accurately

Video Abstract: Diagnostic Accuracy of Primary Care Clinicians Across a Statewide System of Autism Evaluation

Statewide initiative shows primary care clinicians can diagnose autism in young children with high accuracy

Purdue researcher focuses on early detection for, strengths within individuals with autism

Blog: Insurers adding to access barriers for autism evaluations

Video Abstract: A Statewide Tiered System for Screening and Diagnosis of Autism Spectrum Disorder

Blog: Early Autism Evaluation Hubs are Changing the Diagnosis of Autism in Indiana

Article: New System Shown to Improve Early Diagnosis of Autism

IU School of Medicine study paves way for earlier autism diagnosis in Indiana

Supporting Organizations

Our research is made possible by generous support from:

  • Riley Children’s Foundation 
  • Kiwanis Indiana
  • Robert & Helen Haddad Family Foundation
  • National Institutes of Health
  • Indiana Clinical and Translational Sciences Institute
  • Indiana Department of Health
  • Purdue Big Ideas Competition 2.0
  • Society for Developmental Behavioral Pediatrics