Wednesday, December 11, 2013

Ontario Children Waiting Too Long For Access To Autism Programs - Ontario Auditor General Report 2013


News Release

For Immediate Release                                                             December 10, 2013

CHILDREN WAITING TOO LONG FOR ACCESS TO AUTISM PROGRAMS, AUDITOR GENERAL SAYS
(TORONTO) Screening for autism is often occurring late, and children who are diagnosed then face long waits for access to some of the programs that could help them, Auditor General Bonnie Lysyk says in her 2013 Annual Report. In addition, certain services are not being directed to those that may benefit the most.

“The Ministry of Children and Youth Services has quadrupled autism funding over the last decade, but there are still more children with autism waiting for government-funded services than there are chil­dren receiving them,” Lysyk said today following the release of the Report.
Intensive Behaviour Intervention (IBI) is the Ministry’s primary autism program, and the Ministry has also introduced several other programs, including applied behavioural analysis (ABA)-based services, and respite programs.
The audit found that children with autism are diagnosed in Ontario at a median age of a little over 3 years, later than the screening period of 18 to 24 months old endorsed by the Canadian Pediatric Society for children with risk factors. Then, due to long wait lists, Ontario children do not typically start IBI until almost age 7. Research has shown that children who start IBI before age 4 have better outcomes than those who start later. In addition, although scientific research shows that children with milder forms of autism have better outcomes with IBI, the program is currently available only to chil­dren assessed with more severe autism.
Following are some of the Auditor General’s other significant findings:

    ABA-based services, the only type of funded therapy available to children with mild to moderate forms of autism, allow a child to work on only one goal at a time and may not be sufficient for those who have many behavioural problems or goals to achieve. After achieving one goal, the child returns to the bottom of the wait list.

    The lead service agencies decide how to allocate Ministry funding for IBI between two service-delivery options: direct service, where the child receives service directly from a service provider at no cost; or direct funding, where the family gets funds from the lead agency to purchase private services. Wait times for IBI services can differ significantly between the two options and among regions. In one region in 2012, the average wait for IBI services under direct funding was five months longer than under direct service. In another region, the situation was reversed.  

    Children discharged from IBI services in 2012/2013 under the direct-funding option received on average almost one year more of services than those under the direct-service option (35 months versus 25 months). As well, children receiving IBI under the direct-service option often received fewer hours of therapy than they were approved for.

    Children transitioning to high school and beyond receive minimal support.

    Since 2006, the Ministry has reimbursed up to 60 individuals a total of $21 million for the cost of IBI therapy and other expenses outside of the regular service system. Per child, this represents more than double the value of services that a child in the regular service system typically receives.

For more information, please contact:
Bonnie Lysyk
Auditor General
(416) 327-1326


For more information and to view the full 2013 Annual Report, please visit 

www.auditor.on.ca

6 comments:

farmwifetwo said...

Which proves yet again that gov't mandated ABA is a failure. It proves yet again that only 25% of parents actually push and work hard to get the services that their children require.

Sorry.... I saw the article in CBC and I rolled my eyes at those parents. I have had 3 parents since June ask me for advice and each and every one has refused to do what is necessary.

No sympathy here at all.

H L Doherty said...

FW2 I knew what you were going to say before I read your comment. You had a negative experience with ABA which can happen with any therapy/treatment/intervention as we found out when my son suffered an adverse reaction to his Lamotrigine anti seizure med and we came close to losing him. The fact remains though that Lamotrigine is widely reported as successful for approximately 99% of those who receive it. ABA does not work for all but your bad experience does not negate the hundreds of studies reviewed by the US Surgeon General, the American Academy of Pediatrics, MADSEC (Maine) and other state agencies and the autistic children who have made gains from ABA. We didn't have access to ABA for Conor to any significant level pre school years. What we were able to learn and apply helped us communicate with him when ordinary communication did not work in important areas of life like pre-school toilet training and management of meltdowns. You are free to tell your "ABA didn't work for us" story as often as you want but you really should give some consideration to the studies done over the decades and the autistic children who are reported to have made substantial gains from ABA. Other than our usual ABA and autism discussion, and notwithstanding your stated lack of sympathy for others, I wish you and your family a happy holiday season.

Anonymous said...

I would like to wish you, Conor and your wife and other children
(if you have.)
A happy holiday season.
Your wife deserves alot of credit. The pictures your posts show a loving and caring person.

Anonymous said...


Harold,

The additional conditions associated with autism can limit the effects of ABA on various functions in life like toilet training.
A child must be physically ready for toilet training. The retaining and pushing of bowels
needs to be physically mastered as well as the social mastery of the process. Often an expert in the field of occupational therapy would
be a better expert to see rather then an ABA therapist. For this reason ABA alone is sometimes not the solution.

H L Doherty said...

10:24 pm

Thank you.You make a number of good points. On toilet training though I actually toilet trained my son who is severely autistic with "profound developmental delays" a couple of years before he started school. I did it by literal application of the true principle underlying ABA ... by rewarding success. Conor had a stomach flu one weekend. I stayed with him watching his every expression and noise. If I saw the slightest sign of discomfort I rushed him to the bathroom and seated him on the toilet. He was seated on the toilet for every bowel movement that weekend. Success every time! We have literally never had problems with toilet issues since that weekend. I do realize though that much depends on individuals, not all are the same.

Anonymous said...

I completely disagree with anon 10:24. Intensive toilet training programs (such as the one written in the book A Work In Progress-love this one!) work and work very well with kids on the spectrum. It makes clear to the child the connection between going/producing and rewards which then helps them to understand what they are feeling when they need to go and then where to go.

An FYI anon, I can't tell you how many kids I have helped who were total toilet training failures at advanced ages due to some OT or some lame aide telling parents it's sensory and they need to be ready. Foolish. Toilet train at around age four and use an intensive program and the child will be trained in days.

Also, Farm Wife must have had the ABA team from hell or she is a very difficult parent because many aspects of ABA are very effective with kids on the spectrum. She sounds difficult IMO and most sane BCBA's would walk awasy from her which is what I expect happened and now she is very bitter towards the entire industry.