Care options for people with autism spectrum disorder (ASD) and other intellectual and developmental disabilities (IDDs) have expanded in recent years. The expansion is driven by a variety of factors: policy focused on equal care and coverage, a deeper understanding of ASD and IDDs, changing expectations of clients and their families and the emerging focus on outcomes-driven care.
In a webinar moderated by Chris Larson, a reporter with Behavioral Health Business, Doreen Samelson, EdD, MSCP, Chief Clinical Officer at Catalight, and Mitze Burnett, PsyD, MA, LMFT, BCBA, CEO of Burnett Therapeutic Services, shared insights on modalities of care for ASD and IDDs, why flexible, family-friendly options are critical and how the treatment landscape has evolved in recent years.
Five key takeaways were:
- One size doesn’t fit all. For years, Applied Behavior Analysis (ABA) has been the gold standard for ASD care. Tiered ABA usually involves in-home care with many hours per week, up to 40. However, research has shown that fewer hours and other approaches to care can be just as effective and, in some cases, more effective. Other modalities of care can also offer additional benefits. For example, parent-led ABA has been shown to increase parental self-efficacy and reduce stress. Given the diversity of people diagnosed with ASD, having options is important. For example, someone with autism, an average IQ and an anxiety disorder needs very different treatment than someone with profound autism and a major intellectual disability.
- The best treatment is personalized. Clients will benefit from a personalized treatment plan that starts with carefully matching care providers and practitioners to the individual. Providers should then partner with the individual and their family on specific goals. Individuals with high intellectual ability and anxiety might benefit from a program that includes cognitive behavioral therapy to address anxiety, as ABA may be less effective for them. Someone with profound autism, on the other hand, may benefit from learning the most important words that communicate their preferences, keep them safe and support their overall wellbeing, rather than trying to learn prepositions.
- Data should be top a priority for payer and provider organizations. Data and research are foundational to driving clinical innovation in ASD and IDD. Data in medical and surgical care has become readily available with the widespread adoption of electronic medical records systems, but behavioral health lags behind in data collection. However, some organizations have put a premium on data collection and research, like Catalight. Catalight has more than a decade’s worth of real-world behavioral health data at its fingertips. This data is the engine behind many of the clinical innovations and treatment insights the organization has brought to market and used to help drive quality outcomes and overall wellbeing.
- Clinical innovation drives continuous care improvements. Driven by robust data-gathering practices, clinicians develop new treatments, refine protocols and develop quality measures that are important in value-based care. And, innovations can do more than improve care. Parent-led or lower-hour practitioner-led therapies effectively increase the capacity of the existing behavioral health care workforce, increasing access that’s sorely needed in many parts of the country. With less time-intensive treatments, families have more time to juggle work, school and sibling commitments. There are also cost savings by delivering fewer hours overall. Catalight has achieved 30% cost reductions in value-based contracts.
- Success is best defined by measuring whole-family wellbeing. ASD and IDDs impact the entire family. Many of the tools and scales available to measure the effectiveness of care have traditionally focused on external manifestations of ASD, such as hand flapping or rocking—but these are often self-soothing behaviors. Measuring improvements in overall wellbeing should be the top priority if the ultimate goal is happiness and quality of life. Catalight has developed wellbeing scales for precisely that reason. There are three: one for families, one for adults and one for children, which measure how well treatment is helping people achieve a better state of wellbeing. Measuring the wellbeing of the client is critical to understanding treatment effectiveness, but measuring its impact on the rest of the family is equally important.
With the prevalence of IDDs rising – autism in particular – flexible treatment options that meet clients and their families where they are today are more critical than ever. Catalight is a non-profit that serves more than 12,000 people every day. With a research team focused on advancing care and practitioners on the ground delivering innovative treatments, Catalight’s goal is to partner with clients, families, payers and providers across the ecosystem to improve and advance wellbeing while reducing costs and improving quality.