Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


48th Annual Convention; Boston, MA; 2022

Event Details

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Symposium #224
CE Offered: BACB
Challenges to Accessing Appropriate Care for Individuals Diagnosed With Neurodevelopmental Disabilities and Their Families: Highlighting Barriers and Discussing Potential Solutions
Sunday, May 29, 2022
10:00 AM–11:50 AM
Meeting Level 2; Room 251
Area: DDA/AUT; Domain: Service Delivery
Chair: Adam M. Briggs (Eastern Michigan University)
Discussant: Ivy M Chong (May Institute)
CE Instructor: Ivy M Chong, Ph.D.

Determining successful pathways to improve accessibility to and quality of care for individuals diagnosed with neurodevelopmental disorders (e.g., autism spectrum disorder) remains a major challenge for health care providers and society at large (Waxegard & Thulesius, 2016). That is, although timely diagnosis and entry into early intervention services is recommended for these individuals (Elder et al., 2017), caregivers often experience barriers when attempting to access this initial level of care. Further, barriers to accessing appropriate care become more complex throughout the individual’s life course (Malik-Soni et al., 2021) and caregivers find themselves continually faced with navigating a variety of challenges when attempting to secure services and resources to meet the needs of their family. The presentations within this symposium will highlight several of these challenges and discuss potential solutions that families might encounter when attempting to access initial care (i.e., waitlists and caregiver training) up until when they need to access emergency or intensive services (i.e., boarding patients with severe challenging behavior in the emergency department and inpatient units). A discussant will review how understanding these barriers is crucial for developing effective solutions and will offer strategies for improving access to services.

Instruction Level: Basic
Keyword(s): Autism, Needs assessment, Service delivery, Telehealth
Target Audience:


Learning Objectives: At the conclusion of the presentation, participants will be able to: 1. Identify barriers caregivers experience when attempting to access care for individuals diagnosed with neurodevelopmental disabilities 2. Discuss potential solutions for mitigating challenges associated with accessing appropriate care 3. Review future areas of research for improving access to services
Prevalence of Autistic Children Who Experience Delays to Behavioral Therapy in Michigan: A Summary of Survey Data Describing Caregiver Needs During This Time
ANDREA PETERSON (Eastern Michigan University), Adam M. Briggs (Eastern Michigan University), Jaimie Barr (Eastern Michigan University), Brittany Loder (Eastern Michigan University)
Abstract: Children diagnosed with autism spectrum disorder (ASD) in Michigan often face delays to applied behavior analysis (ABA) services in the form of waitlists. Using a survey distributed to caregivers throughout the state of Michigan, the current study aimed to assess the prevalence of delay to ABA services and barriers faced by caregivers of individuals with ASD when pursuing ABA services in Michigan. The results indicate that about 73% of caregivers’ children (n = 78) spent time on waitlists for ABA services, varying in duration from 1 month to over 1 year. Further, the majority of caregivers indicated they were concerned about their children’s behavior while awaiting services and would have been interested in receiving training during this time to help support them in managing behavioral concerns and teaching new skills to their children. Recommendations for addressing child and caregivers’ needs during this time are reviewed and directions for future research and practice are discussed.
Feasibility of Adapting RUBI Behavioral Parent Training to Telehealth
RYAN J. MARTIN (May Institute), Jaime Crowley-Zalaket (Children's Specialized Hospital), Cynthia M. Anderson (May Institute)
Abstract: Behavioral parent training, such as the Research Unit on Behavioral Interventions (RUBI) Autism Network’s parent training program, is efficacious in empowering caregivers and improving the behavior of autistic children but it is typically provided face-to-face in clinical settings. Unfortunately, barriers exist to accessing such services, including an insufficient number of trained providers and long distances to travel. A telehealth version of RUBI could alleviate such barriers. The purpose of this study was to evaluate the feasibility of adapting RUBI parent training to be delivered via telehealth (RUBI-T). We present the results from 14 parent-child dyads that participated in a feasibility study of RUBI-T. Results indicate that RUBI-T can be implemented with fidelity and is acceptable to parents. Further, RUBI-T holds promise of efficacy in reducing children’s challenging behaviors, improving adaptive skills, and reducing parent stress. Implications for both future research and clinical practice are also discussed.

Hospital Boarding of Patients with Autism Spectrum Disorder and Severe Problem Behavior: Issues and Barriers

ALI SCHROEDER (Western Michigan University), Lloyd D. Peterson (Western Michigan University), Stephanie M. Peterson (Western Michigan University), Jessica Detrick (Western Michigan University ), Kelsey E. Stapleton (Western Michigan University)

Individuals with autism spectrum disorder (ASD) who engage in severe problem behavior are often brought to the emergency department (ED) by their families when there is no other option to ensure safety. Individuals may remain in the ED for extended periods. We executed a grant with a local ED to decrease the length of stay of these individuals by arriving to the ED within 24 hours of admission to conduct functional behavior assessment, develop treatment recommendations, and train parents, caregivers, and/or staff to implement them. This presentation will describe the results and focus heavily on the barriers experienced in providing said service. We will discuss the ramifications for future projects of this nature and ways to approach removing those barriers.


A Treatment Model for Children Diagnosed With Neurodevelopmental Disabilities Boarded on Psychiatric Inpatient Units

MATHEW C. LUEHRING (University of Colorado), Patrick Romani (University of Colorado, Anschutz Medical Campus)

Boarding has been defined as “the practice in which admitted patients are held in hallways or other emergency department (ED) areas until inpatient beds become available” (U.S. Department of Health and Human Services, 2008) and represents a widespread challenge to accessing appropriate care for individuals with psychiatric needs. Several published articles (Nicks & Manthey, 2012; Nolan et al., 2015) have described the prevalence of boarding and provided guidelines related to decreasing boarding in EDs. However, less research has examined preventing and addressing a related challenge of patients boarded for extended periods of time on inpatient psychiatric units without a clear disposition plan. This presentation will describe a treatment model for individuals boarded on psychiatric inpatient units. The treatment model consists of (a) modifications to common psychiatric and behavioral treatments to enrich the patient’s time on the inpatient unit and (b) strategies to interact with external team members (e.g., Medicaid) to facilitate a timely transfer from the unit to an appropriate level of care. Initial results showed improved duration between aggressive outbursts and improved staff safety while caring for these patients for extended periods. Recommendations will be made for future research dedicated to understanding and preventing boarding on psychiatric inpatient units.




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