Transcript Services for Individuals with Autism Spectrum Disorder

Services for Individuals with
Autism Spectrum Disorder –
Minnesota’s New Benefit
Age and Disabilities Odyssey
Conference
June 17, 2013
What is Autism Spectrum
Disorder?

Autism Spectrum Disorders (ASD) are defined
as a set of complex disorders of brain
development that appear in infancy and affect
how children process information and respond to
people and the world around them.

Autism appears to have its roots in very early
brain development, however, the most obvious
signs of autism and symptoms of autism tend to
emerge between 2 and 3 years of age.
What is Autism Spectrum
Disorder

ASD is considered a “spectrum” disorder due to
the range in symptoms from mild to severe and
the variation from individual to individual.

ASD occurs across all racial, ethnic and
socioeconomic groups.

ASD appears in boys five times more often than
girls affecting nearly 1 in 54 boys compared with
1 in 252 girls.
What is ASD?

ASD can be associated with significant cognitive
impairment, however some persons with ASD
are extremely bright and highly verbal and may
excel in highly defined areas of expertise such
as visual skills, music, math, and art.

ASD is also associated with other conditions
such as difficulties in motor coordination and
attention, and physical health issues such as
epilepsy, sleep, and gastrointestinal
disturbances.
What is ASD?

It is this variation in range and manifestation of
signs and symptoms from individual to individual
that compounds
the difficulty of screening and
•adding to the difficulty of diagnosis.
diagnosis and then in identifying appropriate
treatment.
Characteristic Features of ASD

Social interaction challenges: Interacting in a social
manner and relating to others (core deficit of ASD)

Communication challenges: Communicating verbally,
non-verbally and socially

Behavioral challenges: Responding to people, interests,
and the world around them in a flexible and adaptive
manner
Medical Diagnosis and Educational
Identification of ASD

There are no medical tests for diagnosing autism. Both educational
and medical assessments of ASD require professionals with specific
training and expertise in ASD.

Both evaluations are based on a thorough parent/caregiver interview
of medical and developmental history and a thorough observation
of the quality of the individual's communications, social interactions,
and of his or her activities and interests.

There are specific standardized tests that may be included by either
the educational or medical professional but the determination is
based on observational and reported data.
Medical vs. Educational


Educational Identification - ASD is a special education
category that is defined as a specific set of challenges,
with on-set in childhood, that adversely affect a pupil's
functioning and result in the need for special education
instruction and related services.
Medical Diagnosis – Similar processes and procedures
are performed to diagnose ASD, leading to access to
medically necessary therapies including speech,
occupational therapy, physical therapy, or other
therapies such as intensive interventions through CTSS.
CDC ASD Prevalence Data in U.S.
Prevalence of ASD in MN

Minnesota Department of Education
reported 15,378 individuals between birth
and 21 years of age.

Approximately 1 in 81 individuals have an
ASD in MN
( MDE, 2011)
DHS ASD Data



17,454 individuals with ASD in CY2010
58% were children under age 18
Three-fifths receive at least one long-term
service and support
– Young children (under age 6) most likely to
receive PCA
– Adults more likely to receive HCBS waiver
Legislative History of ASD




Senate Task Force – 2008
Legislative Task Force – 2009 and 2011
Private insurance mandate efforts
What is different about this year?
Brief History of ASD Treatment


Behavioral Approaches – Applied
Behavior Analysis (ABA), Lovaas, Pivotal
Response Training (PRT)
Developmental Approaches – D.I.R Model,
R.D.I. Model, Denver Model, P.L.A.Y.
Project
The New ASD Benefit

Key Elements:
– Multidisciplinary, diagnostic evaluation and
treatment plan development
– Individualized, culturally competent child and
family-centered intervention
– Rigorous independent progress monitoring
– Coverage with evidence development: A
“learn while doing” approach
– On-going stakeholder input into development
of the benefit
Coordination of Benefit with
other Services


Children’s Therapeutic Services and
Supports
Home and community based services
– Waivers
– PCA

Schools/Early Intervention
Next Steps

New Benefit Development:
– Develop an internal and external core group of
advisors
– Coordinate with internal work group to ensure
continuity of services across administrations
– Consult with external clinical advisors from MN and
nationally
– Develop a stakeholder input process that addresses
–
–
–
–
Providers
Parents
Health Plans
Other State Agencies
Purpose of Advisor Work Groups
• Define standards for best practice in screening,
diagnosis, treatment, progress monitoring, and
culturally responsive, individualized child treatment
and parent education
• Develop best practice in research and
accountability in order to “learning while doing” and
further the evidence base
• Implement an effective stakeholder input process
to ensure a broad base of community and agency
support