Early intervention can play a vital role in the development and wellbeing of a child with Autism, but what is the cost and who will pay for it? Dr Nancy Sadka has some answers for parents and carers.
A mother strokes her toddler’s forehead and notices her child’s need for medical attention. She sees the doctor and is handed a prescription for the ailment with guidelines specifying the medication’s dosage, frequency, duration, and the form it comes in (capsule or liquid). She buys it from the pharmacy and follows the instructions on the label when administering it to her child; after all, the very essence of the child’s health and well-being is dependent on that prescription.
If we analyse the above scenario and break it down into steps of actions, we find the components of a story which is similar to when a young child receives his diagnosis of Autism with variants in complexity and implementation.
The need for medical attention: The parent or someone close to the child notices that he is not pointing, looking, sharing, or responding to his name. These are the developmental milestones that lay the foundation for social communication.
The doctor’s appointment: The child is seen by the paediatrician and assessed by a multi-disciplinary team who confirm the diagnosis using the DSM-5 for Autism Spectrum Disorder, a lifelong disability.
The prescription for the ailment: The parent is handed a prescription for Autism, which is Early Intervention. However, unlike your typical prescription, this medication comes with no instructions. It does not specify the type of intervention: speech therapy, occupational therapy, Applied Behaviour Analysis (ABA) or Early Start Denver Model (ESDM), the dosage or the frequency of administration (3 hours or 20 hours per week) or how long to keep the child on the program (9 months or 3 years).
If the very essence of health and wellbeing of the young child with Autism is dependent on that prescription of Early Intervention, then how will the parent be able to make an informed decision in regards to the “instructions”, where will the parent source the intervention, and how will it be funded?
Parents and other professionals should be well informed that there is scientific evidence that the type and dosage of early intervention can play a vital role in the child’s development and wellbeing. The majority of studies indicate that a minimum of 15 – 20 hours a week of early behaviourally-based therapy over a period of 1 to 3 years, depending on the severity of the condition, produces the best outcomes in functionality for young children with Autism. Research has not yet established which child responds best to what type of therapy; for example ABA or ESDM? But it is clear that the developmental trajectory of children who undergo an intensive early intervention program is altered as a result of the intervention, albeit at different rates.
So what is the cost and who will pay for early intervention? The National Disability Insurance Scheme (NDIS) is a program initiated by the Australian Government to meet the needs of all Australians with a disability. It will “fund reasonable and necessary supports that help participants to reach their goals, objectives and aspirations, and to undertake activities to enable their social and economic participation”. This statement aligns itself with the purpose of early intervention for Autism. When young children with Autism receive their much needed 15 to 20 hours per week of intervention, they can learn to communicate, and to cultivate the necessary skills to engage in society and contribute to its economic growth.
When children with Autism have inadequate funding and limited access to intensive early intervention, it will delay or impede (rather than enhance) their development. This is no different to withholding much needed medication when they are ill. In the absence of known causes and cures, the best available evidence tell us that for better outcomes, children with Autism need intensive (about 15 to 20 hours) early behavioural intervention.
To check to see if your child with autism is eligible for the NDIS and for resources for planning, please follow this link.
Dr Nancy Sadka works at the Olga Tennison Autism Research Centre (OTARC) at La Trobe University as a Research Officer for early identification and diagnosis of Autism.