The Montana Department of Public Health & Human Services (DPHHS) announced this week that it will increase services for Medicaid-eligible youth with autism and other disabilities.
DPHHS director Adam Meier said in a news release that now Medicaid-eligible youth with autism, Serious Emotional Disturbance (SED), or those eligible for the agency’s Developmental Disabilities Program now have access to what is called Applied Behavioral Analysis (ABA) Services.
Meier said ABA is a type of therapy that can improve social, communication, and learning skills through positive reinforcement: “Experts consider ABA to be the gold-standard treatment for children with Autism Spectrum Disorder, but it can be used in the treatment of other developmental conditions as well."
This type of therapy is provided by licensed Board Certified Behavior Analysts (BCBAs), Board Certified Assistant Behavior Analysts (BCABAs) and Registered Behavior Technicians (RBTs). There are about 60 BCBAs in Montana. It is estimated that hundreds of Montana youth, up to age 21, could potentially benefit from this change.
“This is exciting news for Montana,” said Candice Maurer, a BCBA with Arrows Behavior Academy in Livingston. “ABA therapy has been proven to help any child decrease maladaptive behavior and increase the teaching of new skills.”
Maurer explained that she’s treated individuals and used ABA to improve communication, develop self-control, self-management, play skills, increase academic proficiency, and build independence.
For example, in recent years, Maurer said she worked with a child to overcome some very difficult physically aggressive behavior and at the same time develop new skills. This was done through a completely non-aversive technique known as ‘Delay, Denial, Tolerance Training’.
“Utilizing this strategy allowed for the child to quickly develop much needed communication skills and without the use of punishment strategies,” Maurer said. “This is a wonderful therapy to use for just about any child who is struggling with problem behavior and especially for children who have been through trauma.”
Mauer elaborated that she is especially excited for the expansion of ABA services to include children with SED diagnosis. “I believe that ABA is an under-utilized intervention for children who fall into his demographic, so I’ve very pleased to see Montana now allowing BCBA’s to treat these children,” Mauer said.
DDP Bureau Chief Lindsey Carter said prior to making this change, DPHHS received input from stakeholders highlighting the importance of increasing access to these services. DPHHS worked to identify potential barriers for providers and members, such as restrictions on where the services could be provided and requirements for family members to be present during treatment.
“We conducted an extensive review of the available literature and then surveyed and worked with a stakeholder group of BCBAs to make key changes to the program,” Carter said. “One of the recommendations was regarding the importance of providing more flexibility in clinical decision making to BCBAs so they are able to tailor treatment to the individual and family they are serving.”
Carter said with this increased access to services and improved flexibility, the goal is that more licensed BCBAs will choose to provide services in the state.
Historically these services have only been available to youth with autism. However, this expansion includes additional populations. “This expansion provides an opportunity for individuals who are on our waiting list for DD waiver services access to ABA treatment, which is known to be pivotal in achieving the best outcomes,” Carter said. “It also gives individuals with SED diagnoses another treatment option that has traditionally been unavailable to them. We’re excited this opportunity is now available to many more Montana families.”