| Exploring Barriers to Treatment With Stakeholder Driven Research: Giving BCBAs a Seat at the Table|
|Saturday, May 29, 2021|
|11:00 AM–11:50 AM |
|Area: CSS/AUT; Domain: Service Delivery|
|Chair: Krista M. Clancy (Wayne State University)|
|CE Instructor: Krista M. Clancy, Ph.D.|
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.
|Instruction Level: Intermediate|
|Keyword(s): care coordination, equity, service access, Treatment barriers|
|Target Audience: |
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.
|Learning Objectives: At the conclusion of the presentation, participants will be able to: 1). identify ways to connect and collaboration with stakeholders in the community to improve the dissemination of accurate information about ABA and how to improve access for clients and their families. (2). identify barriers for families to gain access to treatment and provide permanent product solutions to improving access to behavioral services. (3). recognize differences between the beliefs and values of different cultures related to diagnosis and treatment of ASD and use that information to develop educational materials and treatment for clients and their families.|
| Identifying Gaps and Barriers and Inviting the Right Stakeholders to the Table|
|KRISTA M. CLANCY (Wayne State University), Tasha Kelly-Stiles (Michigan Public Health Institute), Julia Heany (Michigan Public Health Institute), Mat Edick (Michigan Public Health Institute)|
|Abstract: Systems of care for individuals with ASD and their families is very complicated. It can be difficulty to navigate and there are many professionals that are involved between the time that the parents have their initial concerns regarding their child’s development and getting their child enrolled in ABA services. As behavioral analysts, we know that children need to get access to ABA services by the time that they are 2-3 years of age in order to have the best outcomes in treatment. However, one of our biggest barriers to improving access is that we do not have contact with families until they have been screened and evaluated for ASD. There are many other professionals with differing opinions and knowledge gaps in what is needed to obtain ABA services that families encounter before behavior analysts have the opportunity to discuss services with families. The Michigan Innovations in Care Coordination project brought together all the stakeholders involved in this complicated system of care including parents; pediatric, diagnostic and ABA providers; payors; researchers; and community leaders to evaluate the gaps and barriers in access to develop an improved system of care that considers barriers that each stakeholder encounters along the way. Survey data collected and discussions amongst the stakeholders allowed this team to pilot changes targeting systemic improvement in Wayne County Michigan focused on parent engagement, parent and provider education, and coordination of care using technology supports to better communicate between providers and patients and to improve the referral process. This presentation will review the process of bringing this group together, keeping the stakeholders engaged in the project, and what barriers were identified by the team.|
Identifying Accessibility Barriers to Behavioral Services
|ADRIENNE BRADLEY (Behavioral Frontiers), Michelle Madison (Starfish Family Services), Fatima Othman (Behavior Frontiers), Jill Idicula (University Pediatricians Autism Center), Krista M. Clancy (Wayne State University), Mat Edick (Michigan Public Health Institute)|
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.
Incorporating Cultural Competency Within Autism Spectrum Disorder Diagnosis, Assessment and Treatment: What Do We Need to Consider?
|JILL IDICULA (University Pedestrians Autism Center), Fatima Othman (Behavior Frontiers), Adrienne Bradley (Behavioral Frontiers), Krista M. Clancy (Wayne State University), Mat Edick (Michigan Public Health Institute)|
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.