SARRC.PDF

Gila River Indian Community Grant Application Cover Sheet
Municipality Information
Date of Application: May 7, 2013
Name of City, Town or County: Maricopa County
Mayor or Board of Supervisor's Chairman: Chairman Kunasek
Mailing Address: 301 W. Jefferson, 10 th Floor
City: Phoenix State: AZ Zip Code: 85003
Department/Non-Profit Information
Department or Organization Name: Southwest Autism Research & Resource Center (SARRC)
Mailing Address: 300 N. 18th Street, Phoenix, AZ 85006
Contact Person*: Marcy Adkins Title: Grants Manager
Phone Number: 602-218-8213 E-mail Address: madkins@autismcenter.org
*The individual listed here will be our direct point of contact for grant-related questions or requests for information.
Duplicates of all grant correspondence will be sent to the contact person.
Grant Information
Program or Project Name: Remote Telemedicine Program Expansion to Include Toddlers
Purpose of Grant: To continue SARRC's existing Remote Telemedicine Program and expand
services to include toddlers as early as 6-18 months of age.
Beginning and ending dates of Program or Project: 11/1/2013 — 10/31/2015
Amount Requested: $150,000 Total Project Cost: $199,100
EJMulti-year Request — If checked, # years requested: 2
Priority Funding Area:
ZEconomic Development ZEducation 0Healthcare DPublic Safety riTransportation
Geographic Area Served: Maricopa County and rural communities within Arizona
Signature:
Mayor OR County Chairperson BOS: Date:
Typed Name and Title:

I
Southwest Autism Research &
Resource Center
(SARRC©)
Proposal to
The Gila River Indian Community
Expansion of SARRC's Remote Telemedicine
Program to Include Infants and Toddlers
The Southwest Autism Research & Resource Center
Campus for Exceptional Children: 300 N. 18th Street
Colonel Harland Sanders Center for Autism Studies: 2225 N. 16th Street
Phoenix, AZ 85006
(602) 340-8717
www.autismcenter.org
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Southwest Autism Research SZ Resource Center
A: NARRATIVE
1. Purpose of Grant
a. Describe the proposed program or project
The Southwest Autism Research & Resource Center (SARRC) is proposing a two-year project to
expand its Remote Telemedicine Program, currently funded by the Gila River Indian Community
(GRIC), to include infants and toddlers as early as 6 months - 24 months of age diagnosed with, or
at risk for an autism spectrum disorder (ASD). As of the date of this proposal, and since the
inception of the program in 2009, the youngest children were enrolled at 24 months of age.
The program will continue to be provided to families it typically serves; however, expanding the
program to include infants and toddlers will increase the likelihood of an earlier diagnosis, and
provide the opportunity to offer treatments and therapies at a critical point in the child's
development. Current research shows if the early signs of autism are caught in infancy, intensive
treatment may have a much greater impact than a later diagnosis.'
The program will be identical to the existing Remote Program, with some curriculum modifications
to address the needs of infants and toddlers; and consists of a week-long intensive on-site training,
and a 12 week follow-up period via telemedicine. The program offers the same therapies for infants
and toddlers currently being used since there is an overwhelming consensus of researchers
showing the most effective treatment available is early intervention using research-based
behavioral techniques. Utilizing these proven techniques, and with the advent of new and
innovative ways to communicate, SARRC explored, and then initiated, ways to provide those same
behavioral techniques to families living in remote areas.
Historical Background
To help serve families in remote areas or military bases, GRIC funded SARRC's Remote Program in
2011 after the pilot program, funded by the national Organization for Autism Research and the
Arizona-based Kemper & Ethel Marley Foundation, proved successful. GRIC funding enabled SARRC
to continue to demonstrate how remote telemedicine is indeed a viable method of providing
intensive behavioral therapies to families who have limited access to programs or qualified
clinicians in their area.
Looking Forward
Expanding the Remote Program to include infants and toddlers may also support a current SARRC
research project funded through the National Institutes of Health (NIH) in collaboration with
Georgia Institute of Technology in Atlanta, Georgia; and Behavior Imaging Solutions, a medical
technology company based in Boise, Idaho. SARRC's Vice President and Research Director, Dr.
Christopher J. Smith is co-developing the Naturalistic Observation Diagnosis Assessment (NODA) to
produce a new online technology with the potential to cut delays in getting an autism diagnosis,
which currently take months and even years. 2
1 Woods J., Wetherby, A., (2003) Early Identification of and Intervention for Infants and Toddlers Who Are at Risk
for Autism Spectrum Disorder, Language, Speech & Hearing in Schools; 34, 180-193
2 Scott, Eugene." App Aims for Faster Autism Diagnosis." Arizona Republic, 13 April 2013: Print.
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Southwest Autism Research & Resource Center
Typically, there is no clear line of communication between parents, the professionals providing
their child's services, and the state or other agencies granting services. Through the development of
a Smartphone app, NODA will reduce the amount of time necessary for diagnosis of ASDs, improve
enrollment in research studies, and reduce waitlist time for clinical services.
Infants and toddlers recruited by the NODA project can be referred to the Remote Program for
continued services; and newly recruited families in the Remote Program would be excellent
candidates to participate in the NODA research study. Although the Remote Program will not
receive NODA funding, NODA will channel potential candidates into the Remote Program, thereby
affording them additional support, services, and feedback from national experts in the field. [A
detailed description of NODA is included in Attachment 3]
SARRC respectfully requests funding from the Gila River Indian Community to expand the existing
Remote program to include infants and toddlers.
"I just wanted to say 'thank you.' I believe that the week I
spent at SARRC was probably the most valuable week of
Jonah's life. Every person we worked with was awesome.
The tools I received were priceless. I am doing everything in
my power to follow through with the therapy recommended.
I can't thank each one of you enough! I look forward to
sharing Jonah's progress with you!"
Thompson Family (Military)
Glendale, AZ
b. Describe how the proposed program or project satisfied one or more of the "priority
areas" identified by the Gila River Indian Community.
SARRC's proposal to the Gila River Indian Community (GRIC) addresses GRIC's education priority
by providing education and intensive training on early intervention techniques and therapies to
parents of children newly diagnosed with, or at risk for an autism spectrum disorder living in rural
communities and military bases. SARRC is expanding remote services to include infants and
toddlers since studies are showing the first signs of an ASD may be noticed as early as six months of
age.
Research clearly establishes that for children diagnosed with autism, early intervention has
significant impact on how well children's social, communication and language skills improve and
grow over time; the earlier a child starts therapies, the better the outcome. Through the Remote
Program, parents are given the tools they need to be their child's interventionist and advocate long
after the program ends. Along with structured guidance from skilled clinicians, parents are
educated on the basic principles of Applied Behavior analysis (ABA) and the motivational
procedures of Pivotal Response treatment (PRT) to help guide their child to produce positive
behaviors. When parents know what the clinicians know, their children receive consistent hands-on
interventions whether at SARRC, at home or in the community. 3 , 4
Brookman-Frazee, L., Vismara, L., Drahota, A., Stahmer, A., & Openden, D. (2009).
Parent Training interventions for children with autism spectrum disorders. In J. Matson (Ed.) Applied Behavior Analysis for
Children with Autism Spectrum Disorders: A Handbook (pp. 237 -257). New York: Springer.
4 Koegel, R.L., Openden, D., Fredeen, R., & Koegel, L.K. (2006). An overview of
Pivotal Response Treatment. In R.L. Koegel & L.K. Koegel (Eds.), Pivotal Response Treatments for Autism: Communication,
Social, & Academic Development (pp. 3-30). Baltimore: Paul H. Brookes.
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Southwest Autism Research 8z Resource Center
c. Identify the needs/problems to be addressed, target population and number of people to
be served by the project.
When SARRC originally applied for funding from GRIC, the prevalence report from the US Centers
for Disease Control showed one of every 110 children were being diagnosed nationally, with 1 in
100 in Arizona. Alarmingly, within a few short years, the national rate has increased to 1 in 88 being
diagnosed, with Arizona having one of the highest rates of 1 in 64. An autism diagnosis continues to
be more prevalent than all types of pediatric cancer, AIDS, and diabetes combined; knows no
boundaries; and affects children from all racial, ethnic, and socioeconomic backgrounds.
Most of the families served by SARRC over the last 15 years reside in metropolitan Phoenix or have
the means to travel to Phoenix for services; but, for thousands of families living in one of Arizona's
sprawling rural areas, or on military bases, weekly or daily drives to SARRC for therapies are not
feasible. Because autism services are nonexistent in most remote communities, these families had
little hope of accessing the services their children desperately needed. With the continuing increase
in children being diagnosed with ASD, there is also a shortage of relevant services and qualified
clinicians for those who reside in remote regions and military bases.
By expanding services to include infants and toddlers, SARRC will also assist families in getting a
timely diagnosis thereby giving these children a better chance for success by starting therapies as
early as possible. However, the first problem in confronting autism is getting that diagnosis,
something many medical professionals may not feel comfortable with at such an early age. They do
not want to label an infant or toddler when there is no definitive medical test to determine whether
a child has an ASD; a diagnosis is made solely by observing behaviors.
The most obvious signs a child may have ASD tend to be identified between 2 and 3 years of age, yet
a recent study showed about 90 percent of parents reported they recognized an abnormality in
their child's development before 24 months of age; and most families initially express concern to
their pediatrician by the time their child is 18 months old. 5
Often, parents get a sense there is "something wrong", but can't quite define what that something
may be. For many reasons, including confusion over what behaviors and delays are early signs of
ASD; and a shortage of specialists and medical facilities treating ASD, parents find it difficult and
frustrating to get a correct diagnosis.
Early warning signs can often be caught if parents know what to look for; knowing what behaviors
and delays are potentially early signs of ASD. Since the earliest signs of autism not only involve the
presence of atypical behaviors (repetitive motor behaviors, peculiar speech/sounds), but also
involve the absence of neurotypical behaviors (eye contact, smiling, gestures, play,
communication); behaviors can be somewhat difficult to spot. Although each child develops
differently, there are typical social, verbal and emotional milestones for infants and toddlers. We
know most infants imitate some movements and facial expressions at around three months of age;
they begin to develop a social smile around four months, and make solid eye contact by five months
of age; therefore, infants and toddlers not smiling or vocalizing by six months of age may be at risk
and should potentially be referred to a specialist for a diagnosis. Frequently, the earliest symptoms
of autism are misinterpreted as signs of a "good baby," since the infant may seem quiet,
5 DeGiacomo A., Fombonne E, (1998) Parental Recognition of Developmental Abnormalities in Autism, Eur. Child and Adolescent
Psychiatry; 7, 131-136
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Southwest Autism Research & Resource Center
independent, and undemanding; or the child may be considered highly irritable and "going through
a stage".6
The Remote Program will not only assist families in recognizing behaviors and signs of ASD, but will
also train parents on how to use those same evidence-based practices and techniques wherever the
child may be; a skill they can use in any given situation long after the program ends.
It is anticipated that over the next two years of funding, the Remote Program will provide 50
intensive trainings, with a 12 week period of follow-up, to rural and military families throughout
Arizona and will include infants and toddlers it its outreach plan.
Because the program has not yet enrolled infants and toddlers, there are no expectations as to what
percentage of children served will be between 6 months and 24 months of age; however, data will
be collected and reported per proposal guidelines. (Based on previous SARRC data, during the first
year of GRIC funding, 76 percent of children served were between 24 months and 5 years; 22
percent were between 6 and 10 years of age, and 2 percent were "other/unknown".)
d. Describe the project goals and objectives, and your plan to meet them.
The objective of the program is to provide parents of children with ASD (from 6 months of age
onward) with the skills and techniques they need to emulate the clinician's skills, and to utilize
telemedicine as a means to provide follow-up support and oversight to families in their natural
environments. This two-part process enables parents to be among their child's most important
therapists long after the program ends.
To ensure the program is a good fit, families are screened and provided an orientation prior to the
program to appropriately identify the child's deficits; and provide individualized services specific to
the needs of the family and the child.
The goals of the Remote Program expansion are:
• To provide 50 weeks of intensive, hands-on, on-site training to families in rural
communities and military bases at SARRC's main campus, plus a 12 week period of
continued training, support, and feedback as needed via telemedicine platforms (e.g. web-
based programs, I Phones, Skype, etc.)]
• To open program enrollment to include families of children between 6 months and 24
months of age at risk, or diagnosed with, an autism diagnosis
SARRC will meet these goals by continuing to recruit families through its currents contacts, and
revising outreach materials to reach new contacts that work with infants and toddlers. Outreach
includes rural community pediatricians, health care centers, social service agencies, childcare
facilities, and military bases throughout Arizona. Referrals may also come from the NODA research
project noted earlier.
6 Howlin, P, Moore, A. (1997) Diagnosis of Autism: a survey of over 1200 patients in the U.K., Autism; 1, 135-162
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Southwest Autism Research & Resource Center
e. Define the project as a new or continuing program.
The project is a continuing program currently funded by GRIC, utilizing SARRC's existing
telemedicine framework and remote parent training curriculum. With this new proposal, the
program will expand to include infants and toddlers as young as 6 months of age with the
curriculum being tailored to address the needs of infants and toddlers.
"The week long program at SARRC has been the most
beneficial communication tool for us as a family, and we
have already seen great improvement in Isabella. Isabella
frequently will ask for what she wants instead of just taking
us by the hand and showing us. We will continue to
implement these techniques and look forward to interacting
with the staff at SARRC. Alex, Megan, and Tiffany were very
kind, professional, and compassionate. Thank you all very
much for all of your help."
Marshall Family
Sierra Vista, AZ
f. Identify other organizations, partners or funders participating in the project and their
roles.
There are currently no other funders for this program. Historically, SARRC's telemedicine program
emerged from a research project originally funded by the Organization for Autism Research (OAR)
in March, 2009. The purpose of the OAR research project was to evaluate the efficacy of using
telemedicine as a tool for providing continued support to parents as their children's skills and
behaviors change.
Since the OAR project was solely for research purposes, SARRC requested and received a grant in
2010 from the Kemper and Ethel Marley Foundation. The Marley Foundation grant helped fund the
salary and benefits of a skilled clinician and other areas of the project not covered by the OAR
project. Both the OAR and the Marley Foundation funding ran through February, 2011; GRIC funded
the project beginning November, 2011 through October, 2013.
g. Indicate any application to and/or awards made by a Tribe other than the Gila River
Indian Community for state shared revenues for this and/or any other projects/
programs.
SARRC has not previously requested funds at any time from any other Tribe other than Gila River;
however, SARRC is in the process of submitting an application to the Tohono O'odham Nation for
Education & Training Series: Social Skills across the Lifespan for Individuals with Autism Spectrum
Disorders. There are no other applications to any Tribe, and no other requests submitted or pending
for the Remote Program.
h. Provide a timetable for implementation.
Since this is a continuing program, the basic foundation has already been developed. To expand the
program to include infants and toddlers, SARRC will revise its curriculum to meet the needs of
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Southwest Autism Research & Resource Center
infants and toddlers, and revise its marketing materials for new and existing contacts in rural areas
and military bases.
REMOTE TELEMEDICINE PROJECT TIMELIN E
RESPONSIBLE
• KEY DATES ACTIVITY PERSON(S)
Nov - Dec, 2013 Redesign marketing materials to address recruitment of infants and toddlers Clinical Staff;
Development
Staff
Nov - Dec, 2013 Revisit contacts referring families to the program. Contacts may include rural Clinical
community health centers, early childcare centers and pediatrician offices; Supervisor
identify and connect with military personnel responsible for family referrals to
services such as those provided by SARRC; research and add new contacts that
work with infants and toddlers
Nov - Dec, 2013 Create lists and send e-blasts and direct mail marketing materials Clinical
Supervisor;
Development
Staff
Dec, 2013 and Recruit families - once a family is identified, a telephone interview will be Program
ongoing based on conducted to assess the appropriateness of the program for the family Coordinator
family enrollment
Jan, 2014 and Provide program orientation - following the interview, the program Program
ongoing as families coordinator will provide a telephone orientation explaining how the program Coordinator
enroll will work over the course of the next 13 weeks; all necessary paperwork is
completed via email, fax or regular mail
Ongoing Enroll families and provide baseline assessments on each child/toddler. Clinical
Formal assessments include, but are not limited to, the Autism Diagnostic Interventionist;
Observation Schedule (ADOS), Vineland Adaptive Behavior Scales (VIBS); may Research Team
also include the Modified Checklist for Autism in Toddler (M-CHAT), and the
NODA assessment for infants and toddlers. In addition, each family participates
in observational assessments consisting of the parents' correct implementation
of Pivotal Response Treatment (PRT), child responsivity to opportunities for
expressive social communication and self-initiations. Scores are then
calculated and a report is written on current skill levels and recommendations
for intervention
Ongoing with Arrange for families to be brought in to Phoenix for five days of intensive Program
considerations for training (set up lodging with Ronald McDonald House; provide guidelines for Coordinator
family schedules reimbursement of travel, food costs, and other necessities, etc.)
Feb, 2014 and Provide initial one-week intensive training -- SARRC clinicians provide hands- Clinical
ongoing on intervention strategies five hours a day for five days Interventionist
Upon completion of Following the weeklong session at SARRC, families receive a report Clinical
week one of the summarizing outcomes of the program, the interventions implemented with Interventionist;
program the child, and recommendations for continued support Clinical
Supervisor
Immediately Provide support over a 12 week period via telemedicine I 'families return Clinical
following the week home and submit videos either through a web-based format or mail (for Interventionist
one phase families without computer access) to the SARRC clinicians of a parent's
interactions with the child in their home or community
Upon completion of Provide follow-up report and recommendations based on video observations Clinical
the 12 weeks Interventionist;
telemedicine phase Clinical
Supervisor
As requested by Continue follow-up or return visit as needed per family requests Clinical
family Interventionist
Ongoing Recruitment of potential candidates for NODA research project from enrolled Clinical
families Interventionist,
Clinical
Supervisor,
Research Team
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Southwest Autism Research SZ Resource Center
I. Identify long-term funding sources or project sustainability.
SARRC is continuing to work toward sustainability of the program by using the model of SARRC's
Community School, a program that started with a $500,000 government grant, and is now self
sustaining. During the recent economic downturn, SARRC began looking at ways to keep the
Community School and many of SARRC's programs viable without the support of government
funds. SARRC reevaluated programs, made appropriate cuts and weighed each program's potential
to be self sustaining. Explorations were made into accessing insurance payments for children with
ASDs, and an insurance billing system was put into place for those attending the Community School.
SARRC introduced private pay options for families without insurance, and initiated sliding scale
fees and scholarships for those unable to afford to pay full fees.
By following these procedures, the Community School has reached sustainability, a goal for many of
SARRC programs where possible. In its attempt to duplicate the success of the Community School,
SARRC is slowly making headway toward sustainability of the Remote Program by exploring a
number of options. SARRC was able to contract with the Ronald McDonald House to refer families
for community housing, with access to a community kitchen and nightly-sponsored dinners by
other nonprofits. This opportunity helped SARRC drastically reduce the cost of a family's stay, in
comparison to the cost of a hotel room for a week, and the cost of three meals (and snacks) per day
for the entire family. SARRC has also put in place where appropriate: (1) a private pay system for
families able to afford services; (2) approval to utilize funding from the State of Arizona
Department of Developmental Disabilities; and (3) authorizations from contracted insurance
companies to cover therapies.
Although insurance and private pay may be options for some, it isn't for many; nor do many
families have the financial means to take a full week off from work for the onsite training. It is for
those families that SARRC continues to explore individual, corporate and foundation support
beyond GRIC, and will utilize unrestricted funds when needed.
2. Reports
• Describe your plan to document progress and results. Interim and final reports will
be required for every grant awarded.
To measure the gains in skill levels of children with ASD as a result of intensive parent training and
telemedicine support, data are taken over the course of the program, with baseline data collected at
first meeting and continuous data collection throughout the course of the program.
Among the measurements performed during the remote program is the Parent Fidelity
Measurement, which measures how well parents implement techniques learned through the
program; and the Child Responsivity Measurement, which determines how many times a child
makes appropriate communicative responses when initiated by a parent.
According to data submitted with SARRC's report to GRIC on the progress of year one funding,
parents' fidelity rate started with an average of 24 percent and ended with an average of 69
percent—an increase of 45 percentage points; and the children's responsivity rate started with an
average of 30 percent and ended with an average of 64 percent—an increase of 34 percentage
points. This data are consistent with the progress children and families make over the course of the
program.
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Southwest Autism Research & Resource Center
Per requirements of the grant, interim and final reports will be provided to GRIC as requested and
will show outcomes of these measurements. Reports may also provide anecdotal observations from
staff and participating parents.
"I'm indebted. I got my first I LOVE YOU! The progress my
son has made has brought tears of joy to my entire family.
My son's therapists were amazed and literally in a 'shock of
silence' at the changes he has made in one week. He's
initiating a handful of works; but with prompting, he saying
so many more. His tantrums and bad behaviors have
lessened. We can walk through a store without him
wandering off and can follow a few one word prompts
correctly. Literally, I feel like I got my child back and that we
have renewed HOPE! There aren't enough words to express
the appreciation I have for this program."
Forrest Family
Prescott, AZ
B: ATTACHMENTS
1. A resolution from the applicable governing body in support of the proposed project
(eligible City, Town or County)
Attachment 1
2. A proposed budget for the program or project
Please refer to Attachment 2 for program budget and budget detail
3. List of other funders, potential funders and amounts committed or requested in
support of the proposed project.
N/A - At this time, there are no other potential funders either committed or requested for
the Remote Program, other than the Gila River Indian Community (funded through October
31, 2013)
Optional Attachments:
Letters of support (optional) that substantiate need for the project and collaboration
with other organizations.
Please refer to Attachment 3 for the following:
• letters of support
• a copy of the NODA poster presentation to the International Meeting for Autism
Research (IMFAR) 2011
Additional requested attachments:
A copy of SARRC's IRS determination letter included as Attachment 4
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Attachment 1
Resolution of Support


Gila River Indian Community Grant Application Budget
Expansion of SARRC's Remote Telemedicine Program to Include
Infants/Toddlers
A. Budget Period:
11/1/2013 through 10/31/2015
B. Expenses:
Please itemize expenses that are applicable to your program or project
Proposed Budget Amount Amount Secured In Kind Expense Total Budget
(list each budget Requested from from other
item) GRIC funders
' Salaries & Benefits
• 2 Clinicians $128400 $47,900 $176,000
• Supervision by
Clinical Director
Travel, food, lodging
and other family $20,000 $20,000
expenses for 50
families (50 weeks
of training) @ $400
per family
Video cameras,
computer, and/or $500 $500
hand-held devices
for telemedicine
program
PRT training
manuals, paper, $200 $200
copies, blank CDs,
office supplies
Marketing materials
to promote program $1,000 $1,000 $2,000
in rural areas and on
military bases
Postage/mailing
$200 $200 $400
Total Expenses $150,000 $49,100 $199,100
Southwest Autism Research & Resource Center 2013

C. Budget Detail if applicable (Narrative description of unusual budget items, in-
kind expenses, donations, etc.)
Since the inception of the Remote Program, SARRC has been seeking ways to lessen the
expenses of the program. SARRC has been able to contract with the Ronald McDonald
House to provide lodging for families for the week-long stay, which also includes a
community kitchen for families to cook their own meal, and meals sponsored by other area
nonprofits. This opportunity helped SARRC drastically reduce the cost of a family's stay, in
comparison to the cost of a hotel room for a week, and the cost of three meals (and snacks)
per day for the entire family. SARRC has also put in place a private pay system for families
able to afford services, approval to utilize funding from the State of Arizona Department of
Developmental Disabilities, and authorizations from contracted insurance companies that
cover therapies.
SARRC's actual cost of the program is $2,250 per family when you factor in staff time,
telemedicine equipment such as video cameras for the families, web-based platforms, pre-
paid mailings for families without computer access, etc. Families are reimbursed up to
$400 in personal expenses (transportation, additional meals).
Southwest Autism Research & Resource Center 2013

Attachment 3
Letters of Support
NODA Poster Presentation

melmed center
April 23, 2013
Cheryl Pablo
Program Administrator
PO Box 2172
Sacaton, AZ 85247
Dear Ms. Pablo,
I would like to offer this letter of support to the Southwest Autism Research 8z Resource
Center (SARRC) for funding of The Remote Program, a parent training program that
provides intensive hands on training for parents of children diagnosed with autism
spectrum disorders. The remote program addresses the needs of families living in rural
communities or on military bases throughout Arizona who have limited access to autism
services for their children.
Please consider my support for SARRC's application to the Gila River Indian
Community. As a developmental pediatrician, I have referred a number of families to
participate in SARRC's Remote Program and fully support this project's expansion to
include infants and toddlers identified at risk for autism.
I believe SARRC has the tools, passion and depth of resources that continues to make
programs for families impacted by autism a huge success. Given SARRC's proven
performance in the provision of programs and services that are research-based,
community-based, family-friendly and consumer-driven, I encourage your support of
their application.
4848 East Cactus Rd., Suite 940 • Scottsdale, AZ 85254
Tel: (480) 443-0050 • Fax: (480) 443-4018 • www.melmedcenter.com

April 24, 2013
Cheryl Pablo
Program Administrator
PO Box 2172
Sacaton, AZ 85247
Dear Ms. Pablo,
I am writing this letter in support of the Southwest Autism Research & Resource
Center's (SARRC) grant application to the Gila River Indian Community to
support the remote parent training program. Expanding the parent training
program to more rural communities and military bases would help families like
mine living in areas where few autism services are available, and what is available
can be very costly and not always effective.
We are the parents of Spencer Lundell who was diagnosed with an autism
spectrum disorder. Our family participated in the parent training program last
Spring and have returned for a second week of participation in 2013. We have
found it to be extremely helpful in advancing Spencer's communication skills. The
training gave us tools that we as parents can use with Spencer at any time
throughout the day.
Please consider SARRC's request for funding so that more families like our own
can receive much needed early intervention services.
Sincerely,
Amber Lundell
Stephen Lundell
Thatcher, Arizona

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Attachment 4
IRS Determination Letter

IRS liderrml Departiimitathery Ilevemm Service
P.O. Box 2508 In reply refer to: 0248167571
Cincinnati OH 45201 July 31, 2012 LTR 4168C EO
31-1496646 000000 00
00017595
BODC: TE
SOUTHWEST AUTISM RESEARCH AND
RESOURCE CENTER
g=.14 %MARCY ADKINS
6 300 N 18TH ST
PHOENIX AZ 85006-4103
008194
Employer Identification Number: 31-1496646
Person to Contact: MS. LEE
Toll Free Telephone Number: 1-877-829-5500
Dear TAXPAYER:
This is in response to your July 20, 2012, request for information
regarding your tax-exempt status.
Our records indicate that you were recognized as exempt under
section 501(c)(3) of the Internal Revenue Code in a determination
letter issued in MARCH 1997.
Our records also indicate that you are not a private foundation within
the meaning of section 509(a) of the Code because you are described in
section(s) 509(a)(1) and 170(b)(1)(A)(vi).
Donors may deduct contributions to you as provided in section 170 of
the Code. Bequests, legacies, devises, transfers, or gifts to you or
for your use are deductible for Federal estate and gift tax purposes
if they meet the applicable provisions of sections 2055, 2106, and
2522 of the Code.
Please refer to our website www.irs.gov/eo for information regarding
filing requirements. Specifically, section 6033(j) of the Code
provides that failure to file an annual information return for three
consecutive years results in revocation of tax-exempt status as of
the filing due date of the third return for organizations required to
file. We will publish a list of organizations whose tax-exempt
status was revoked under section 6033(j) of the Code on our website
beginning in early 2011.

0248167571
July 31, 2012 LTR 4168C EC
31-1496646 000000 00
00017596
SOUTHWEST AUTISM RESEARCH AND
RESOURCE CENTER
%MARCY ADKINS
300 N 18TH ST
PHOENIX AZ 85006-4103
If you have any questions, please call us at the telephone number
shown in the heading of this letter.
Sincerely yours,
)4244/4Ate-Ae.-
S, A. Martin, Operations Manager
Accounts Management Operations

lnternal Revenue SeMce
Department of the Treasury
P. O. Box 2508
Date: July 18,2005 Glnclnnatl, oH 45201
Person to Contaet:
SOUTHWEST AUTTSM RESEARCH AND Schaquistia Bolton 31-08028
RESOURCE CENTER Gustomer Service Representative
gOO N 18TH ST Toll Free Telephone Number:
PHOENIX AZ 85006-4103 8:30 a.m. to 5:30 p.m. ET
877-829-5500
Fax Number:
513-263-3756
Federal ldentlflcatlon Number:
31-1496646
Dear Sir or Madam:
This is in response to your request of July 18, 2005, regarding your organization's tax'
exempt stiatus.
tn March lgg7 we issued a determination letter that recognized your organization as
exempt from federal income tax. Our records indicate that your organization is currently
exempt under section 501(cx3) of the Internal Revenue code.
Our records indicate that your organization is also classified as a public charity under
sections 509(aX1) and l7Q(bXlXAXvi) of the Internal Revenue Code.
Our records indicate that contributions to your organization are deductible under section
1TO of the Code, and that you are qualified to receive tax deductible bequests, devises,
transfers or gifts under section 2055, 2106 or 2522 of the Internal Revenue Code.
lf you have any questions, please calt us at the telephone number shown in the heading of
this letter.
Sincerely,
ft--"Y*4*)
Janna K. Skufca, Director, THGE
Customer Account Services