Project Description:
This project is the administration of the state's Medicaid funded services for children with Autism Spectrum Disorders (ASD. It includes administration of the Arkansas Autism Partnership (AAP), the state's 1915(c) Waiver Program for intense early intervention for children 18 months to 8 years and the EPSDT ABA Therapy program for children 18 months to 21 years.
Since the prevalence rate of ASDs in Arkansas is quite high, 1:68, the need for intensive early intervention is significant. These programs are designed to provide autism specific, evidence-based interventions to eligible children as early as possible.
There are several unusual features of these programs which make the programs unique and, we believe, more effective that traditional programs. The two primary ones are listed below:
1. Services are restricted to the child's home and integrated community settings (such as church, grocery store, park, library) the family frequents where the child with ASD has difficulty engaging. No services are allowed in schools or clinics. This allows maximum functional skills acquisition and minimizes the need for generalization of new skills.
2. Parent(s) or legal guardian(s) are required to be present and to participate a minimum of 14 hours per week in the intervention with their child to remain in the program. This enables them to learn techniques used in treatment and to implement them consistently when treatment personnel are not present.
The program is in its fifth year and the benefits continue to be life-changing, for children and families. Many children go to kindergarten in general education environments with limited need for support/services. Others have acquired significant skills in areas of communication, self-care and behavior reducing their need for intensive services. These services are restricted to three years maximum and families are required to log a minimum of 20 hours per week to remain eligible.
The EPSDT Program provides home-based ABA Therapy to older children who have never been able to access autism specific services. Many f these children are teenagers who have developed resistant patterns of behavior due to the lack of appropriate early intervention. Since there are significant behaviors seen in these children, many have been given co-morbid diagnoses of behavioral health disorders such as Obsessive Compulsive Disorder, Oppositional Defiant Disorder, Intermittent Explosive Disorder, Attention Deficit Hyperactivity Disorder, Bi-Polar Disorder, etc.. Wit recurring behavioral episodes and reliance on behavioral health treatment approaches, including psychotropic medications and acute psychiatric placements, it becomes difficult to separate diagnosis from the effects of trauma and modeling.
This program does not have a minimum number of hours required per week but does require parents/guardians to be present during the in-home treatment by the team.
The most significant barriers to implementation of these programs are the limited trained workforce, particularly the number of Board Certified Behavior Analysts (BCBA), in the state, especially in more rural, remote areas, and the protest from BCBAs regarding the in-home location requirement. The BCBAs prefer a clinic-based service model where they can see more children in the same period of time and net a higher profit. The State believes that the benefits of natural environments, integrated settings and inclusion of parents in treatment far outweighs the difficulty of operating a home-based model.
Core Function(s):
Performing Direct and/or Demonstration Services, Performing Research or Evaluation, Developing & Disseminating Information, Continuing Education/Community Training
Target Audience:
Professionals and Para-Professionals, Family Members/Caregivers, Children/Adolescents with Disabilities/SHCN
Unserved or Under-served Populations:
Racial or Ethnic Minorities, Disadvantaged Circumstances, Limited English, Geographic Areas, Rural/Remote, Specific Groups
