Despite Latest CDC Figures on Autism Spectrum Disorder, There is Hope

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Ensuring all children receive comprehensive behavioral therapy can reduce the challenges associated with ASD-related disability faced by children, families and society

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ABA has been demonstrated to reduce the need for special services and supports in school and increase the chances of children with ASD to live independently and succeed in the world on their own terms.

While last week’s report from the Federal Centers for Disease Control (CDC) on the increased prevalence of Autism Spectrum Disorder (ASD) reinforces a known trend, it also highlights an equally alarming finding: that we are not identifying and treating children with ASD according to evidence and best practices.

In 2016, there were 3,999,386 live births in the United States. Based on the CDC findings, that means during 2018 there are likely to be anywhere from 50,000 – 65,000 new toddlers across the country who will demonstrate behaviors, and deficits in communication and social interaction, that meet diagnostic criteria for ASD.

Unfortunately, despite substantial evidence as to the power of early intervention to improve the lives of children with ASD and their families, only a limited number of these children will secure timely and adequate treatment. While the American Academy of Pediatrics (AAP) recommends screening all children for ASD at 18 and 24 months of age, the CDC report notes that the average age at diagnosis is around age 4 -- and even later for less severe cases -- resulting in years of preventable delays in diagnosis and lost treatment opportunity.

However, numerous studies are quite clear: starting as soon as possible after diagnosis with intensive behavioral intervention based on the principles of Applied Behavior Analysis (ABA) can meaningfully improve a child’s developmental trajectory, significantly reduce their needs for special services and supports at school-age, and dramatically increase their capacity for independent living later in life.

“By ensuring they receive intensive behavioral interventions based on evidence and best practices, we have the opportunity to improve the lives of these children, and the hundreds of thousands of children across the country who are known to have ASD,” noted Steven Merahn, MD, a pediatrician and Chief Medical Officer at Centria Healthcare.

Simply Providing Access to Therapy is Not Enough

Since 2001, 46 states, the District of Columbia, and the US Virgin Islands have enacted insurance reform laws requiring some form of coverage for therapy based on ABA for children with ASD and their families. The social policy foundation of these “autism benefit” programs is based on the proven value of behavior analytic interventions to have powerfully positive effects on a child’s behavior, relationships, developmental progress, and family stability.

However, simply providing access is not enough; achieving these goals additionally requires standards as to the adequacy of treatment being offered. Expert guidance recommends a minimum of 25 hours per week 12 months a year for comprehensive interventions.

A January 2018 snapshot of current treatment authorizations for a cohort of 714 children under 6 years of age showed that only 33% of them were receiving treatment consistent with guidelines. For children over 6, differences in eligibility criteria and treatment policies between the healthcare and education systems can fragment their care and impede their chances of optimal outcomes. Delaying or inadequately providing therapy has substantial adverse effects and societal costs, including billions of dollars in special education until age 19 and social services and other supports until age 65.

“ABA is a dose-dependent therapy,” added Dr. Merahn. “Under-treatment leaves children at unnecessary risk for persistent and otherwise preventable ASD-related disability into adulthood.”

While the research community continues to study ASD, from a practical perspective ABA-based therapies are the most pervasive and accessible evidence-based forms of treatment currently available for children who are, and will be, diagnosed with ASD. ABA has been demonstrated to reduce the need for special services and supports in school and increase the chances of children with ASD to live independently and succeed in the world on their own terms.

State-level variations in policies and criteria for access and adequacy of care can limit our capacity for consistent achievement of optimal outcomes across the population of individuals with ASD, increasing the risk of persistent, preventable disability (and associated social and economic costs) and reducing the potential of these children to be productive students and integrated members of society.

“All children with ASD deserve ambitious therapeutic recommendations that consider the whole-child and provide all available opportunities to have the best developmental experience possible,” added Merahn. “The real issue is whether we can align our care systems for children with ASD to effectively achieve these goals.”

For references and additional data on this issue, visit: https://bit.ly/2rqZrTO

About Centria Autism Services:
Centria Autism Services is an operating division of Centria Healthcare, and a leading national provider of Applied Behavior Analysis (ABA) therapy for children with autism and their families. With national headquarters in Michigan, and more that 2,000 clinical staff working in ten states, Centria’s Optimal Outcomes approach combines child-centered evidence-based ABA with best practices to help children with ASD have the best developmental experience possible and acquire the skills to live independently and succeed in the world on their own terms.

About Applied Behavior Analysis:
Autism Spectrum Disorder (ASD) is complex neuropsychological condition that can adversely affect child development and global functioning through deficits in communication and social interaction, adaptive skills and learning, and patterns of restricted, repetitive behavior, interests, or activities. While the underlying cause of ASD is still unknown, numerous studies over 30 years have shown that starting as soon as possible after diagnosis with comprehensive intensive behavioral intervention based on the principles of Applied Behavior Analysis can improve developmental trajectory, reduce the needs for special services and supports at school-age, and increase the capacity for independent living.

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Matt Blouin

Matt Blouin
Centria Healthcare
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