Association for Behavior Analysis International

Behavior analysts know that getting children with ASD enrolled into ABA treatment at the earliest possible age is important to achieving the best outcome. To resolve barriers that both parents and providers encounter and reduce delays to ABA service, Behavior Analysts need to collaborate with other providers in this service system. Parents typically start by talking to their pediatrician, then their insurance provider, a diagnostician, then get referred to ABA and other therapeutic/educational services. This complex process is difficult to navigate for all stakeholders, resulting in delays to service. Because other stakeholders within the system of care have earlier contacts with families, it is important for Behavior Analysts to collaborate with these stakeholders to develop ways to reduce delays in starting ABA. This presentation provides a review of barriers identified, including targeting marginalized populations, and proposed solutions created by a community-based research team made up of parents, providers at each access point, payors, community group leaders, and governmental leaders, who are currently targeting this issue. Barriers identified and discussed will include parent engagement, the referral process, coordination of care, provider and family education, equitability of services, and simplification of workflow for providers distributing resources and educational materials to families.

Intermediate - Audience members should have a basic understanding of ABA principles and procedures related to the care of individuals with ASD and their family. Audience members should also have the ability to complete a basic cost benefit analysis assessing variables associate with successful outcomes and the ability to evaluate individual client and family barriers that might impact treatment outcome.

In order to enable more equitable access to care for underserved families, providers must work to identify barriers to access behavioral services. A team of stakeholders participated in the development of products and strategies targeting access, using a collaborative community-based approach to evaluate experiences of providers and families within the Wayne County Michigan Medicaid state funded system. Both parents and providers expressed concerns about the complex processes to gain access to ABA treatment. Additional concerns were identified by the group related to ensuring equity in access for underserved families. Barriers identified included limited resources for families and providers designed to understand the system of care, knowledge on the steps to gain access to behavioral services, and what choices amongst service providers are available for families. Permanent product solutions were developed to address equitability and inclusion barriers for families and providers. A variety of surveys, media, and documents were developed through this process for use by service providers, both within and outside of the ABA community, to achieve equitable access to behavioral services. This presentation will also review recommendations about ways to facilitate collaborative work within a local healthcare system to increase awareness of barriers and urge more intervention research to explore the means for removing them.

Individuality of treatment has always been a primary focus in the field of ASD and ABA. Factors such as trauma, age, and family barriers have guided Behavior Analyst’s individualization of portions of treatment including teaching procedures, reinforcers, goals, and behavior intervention plans. However, in order to ensure true individuality of care for all clients, all stakeholders involved should be culturally competent. Cultural competence involves learning and understanding the views and practices of different cultures. Our cultural beliefs and traditions influence our thoughts and actions, and therefore, should be considered as early as screening and diagnosis. Parents have interactions with a variety of stakeholders including pediatricians, diagnosticians, schools, ABA and other therapeutic services. Starting at screening and ending at treatment implementation, each client’s cultural beliefs should be a consideration in the way stakeholders communicate with families regarding diagnosis, what assessment is chosen, what goals are chosen, what materials are used in programming, and much more. This presentation will include discussions and recommendations for how to modify treatment when encountering language barriers, stigma involving diagnosis, lack of support and understanding from support communities, and differing beliefs on the roles for men and women coming from different back grounds.