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Autism, a bio-neurological developmental disability that generally appears before age three, impacts brain development in the areas of social interaction, communication skills and cognitive function. Individuals with autism typically have difficulties in verbal and non-verbal communication, social interaction and play. Though there is no cure, research is ongoing and with appropriate support and treatment people with autism can see improvement of their symptoms.

A diagnosis of autism is not a one-size-fits-all label. Children and adults with autism can fall anywhere on a spectrum of disorder and function. Whether a child is a recently diagnosed toddler or a teenager dealing with the challenges of learning how to handle coworkers and the dating scene, autism can affect the whole family.

Since it was stood up three years ago, the mandatory Exceptional Family Member Program helps service members whose families include individuals with special needs, including autism, access the resources and support available to them both on Joint Base Andrews and in the broader community. EFMP Family Support Specialist Adreinne Barnett said that while autism research is a hot topic in the news, it is still not certain what causes the disorder: Genetic mutations, early childhood immunizations or environmental factors.

“It’s going to be a while, before they can say what the cause is,” said Malcolm Grow Medical Clinics and Surgery Center Special Needs Coordinator Nicole Macri. “It probably is a combination of those factors. What we do know, is that it is becoming more prevalent among dependents.”

About one in every 88 children born in America today is diagnosed with some form of autism. The latest edition of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, released in 2013, includes updated criteria for diagnosing autism and discusses previously ignored factors such as environmental trauma.

Service members may first learn about EFMP at a pediatric visit, or in a conversation with a child care provider. Whether newly diagnosed or just new to JBA, families must register their EFMP-eligible members, and once they do they can take advantage of the information and other services EFMP provides.

Macri helps identify families with an exceptional family member, and then helps to coordinate their medical, behavioral and mental health care. She also facilitates medical processing for dependents of service members who are preparing for a permanent change of station, whether within the continental United States or abroad. That process can take as long as 90 days, and involves paperwork which can look overwhelming.

“There’s a lot of negative thinking about the medical piece before PCSing, but this makes sure that the services and support an exceptional family member needs to thrive are available at that gaining installation,” said Macri, whose professional background is in mental health as it relates to child welfare. “If we can identify an exceptional family member before they arrive here, we do care coordination between TRICARE, here, Fort Belvoir and Walter Reed (National Military Medical Center).”

Since August of 2013, “there have been a lot of back and forth e-mails,” between her office and the EFMP’s family support program. “There had been a disconnect between the medical and support sides of the house, and we’re bridging that gap for kids,” Macri said.

Both Macri and Barnett try to reach families as they PCS in to Andrews, to explain what the EFMP process is for future PCSing, as well as to explore what each office can do for the family while they are stationed here. Many parents ask for information on peer support groups, especially if their children are young.

“Parents are coming in kind of dumbfounded, after what looked like a normal pregnancy,” Macri said. “Infants and Toddlers is a big referral point.”

Each state has an Infants and Toddlers program, Barnett said. Maryland’s is run through the Department of Education. Resources are available based on where a family lives, so families at JBA take advantage of services in a number of Maryland and Virginia counties as well as the District of Columbia, depending on their home residence.

“Very rarely do you see a county that will go to another county to provide services, “ said Barnett. “Each state handles things differently, as well.”

Since EFMP was stood up three years ago, Barnett has been networking and giving briefings to raise awareness of the program among eligible families. She also helps parents download and understand the forms they need to enroll in EFMP and related offerings like the Extended Health Care Options program. ECHO offers more intensive services such as equine therapy.

Since parents are dealing with a different system every time they PCS, “it is important to have the right words to find what you need,” Macri said.”Some have had bad experiences at the last three bases where they were assigned, so I tell them to let me change their mind. Others have never been enrolled in EFMP before they get here.”

Sometimes, those needs are things the parents themselves have no idea are available, such as as many as 12 hours each month in Air Force respite care.

“Parents and active duty service members have a family and a job, and just being human you have to take care of yourself. It can be overwhelming, if you don’t know what’s available,” Macri said. “I ask, ‘Are you taking care of yourself?’ two hours later and some tears, they can move on.”

Military Resources for Autism Supports

American Military Families Autism Support

Specialized Training of Military Families (STOMP)


USAF EFMP Respite Care Program

Exceptional Family Member Program-Family Support

Military & Family Support Center

1191 Menoher Drive


Military One Source

Maryland Autism Resources

Kennedy Krieger Center for Autism and Related Disorders

The One World Center for Autism, Inc. (Prince George’s County)

Social, psychological and educational needs of children and adolescents

John Carroll School

1400 Nalley Terrace

Hyatsville, Md.

The Whole Self Friendship Center (Anne Arundel County)

Therapeutic integration programs for children and adolescents

331 Gambrills Road

Gambrills, Md.


Autism Connect-State of Maryland

Virginia Autism Resources

Parents of Autistic Children of Norther Virginia

Autism Society of Northern Virginia

Northern Virginia Therapeutic Riding Program

National Organizations

National Autism Association

Pathfinders for Autism

Autism Speaks