South Carolina Presumptive Eligibility Policy Dramatically Increases Access to Early Intensive Behavioral Intervention for Young Children at Risk of Autism Spectrum Disorder

December 18, 2014

The South Carolina Act Early Team, co-chaired by the UCEDD Director/LEND Leadership Team member (David Rotholz, Center for Disability Resources) and the South Carolina LEND Assistant Training Director and Leadership Team member (Anne Kinsman, Greenville Health System Children's Hospital Pediatric Psychology) has, through its diverse membership of state agency and community organizational leaders, led the way with a policy of presumptive eligibility.

This policy, developed through the collaborative effort of the team, provides for children under age 3 years to be eligible for Early Intensive Behavioral Intervention (EIBI) services through the Part C program (BabyNet) if they are found at risk of Autism Spectrum Disorder (ASD) based on a two-tiered screening system implemented by approved screeners. By using the Modified Checklist for Autism in Toddlers (MCHAT) along with the Screening Tool for Autism in Toddlers (STAT) to determine presumptive eligibility, the number of children receiving EIBI under Part C in South Carolina has increased from 86 in 2012 to 331 in 2014 (the policy was introduced in October, 2012).

Along with this significant benefit to children under age three, is the seamless transition from Part C to state DD Agency funded EIBI at age three for children who receive a formal diagnosis of an Autism Spectrum Disorder. While there was initially some question about the potential for false positives from the two-tiered screening process (i.e., children being found at risk later being found not to have ASD), the screening process has been shown to be a highly reliable method for its intended purpose. Of the 376 children made eligible for (and receiving) EIBI all but 8 were later diagnosed with an ASD through a formal diagnostic process involving the Autism Diagnostic Observation Scale Second Edition (ADOS 2).