Proposal could provide service flexibility for Texas kids with autism


The Texas Health and Human Services Commission is considering a proposal that would allow contractors of Applied Behavior Analysis (ABA) services in the state to establish a treatment plan for a child with autism based on their individual needs.

ABA is one of several therapies that children with autism spectrum disorder can learn from. It uses evidence-based teaching techniques to hone in on specific behaviors. Currently, children affected with autism spectrum disorder only have access to 30 hours of ABA services each month up to six months.

If they don’t use the 30 hours each month, those hours are no longer available. The program provided focused ABA to 1,008 children in fiscal year 2017. Under the proposed amendments, providers and clients would have the flexibility to stretch out the 180 hours over a span of a year.

“If there’s a bad weather day and the center closes or a provider’s sick or a kid is sick and it’s especially towards the end of the month, you don’t have enough time to make up those hours,” Jolene Sanders, advocacy manager with Easterseals of Central Texas, said.

Sanders’ son, Lourson, received ABA services through this program in 2016.

“After that six months, we saw incremental progress and then that six months kind of dropped off and we had that interim period when we had to wait,” Sanders said.

Lourson’s services primarily focused on social and communication skills, Sanders said. He’s since switched over to a different insurance plan to receive ABA, but Sanders says families that Easterseals often works with are constantly worried about their children’s services under the current setup.

Even with the possible changes, some groups are still concerned this might not be enough. Jacquie Benestante, director of external affairs of the Autism Society of Texas, says it may not help children with more intensive needs.

“We’re not seeing an improvement for more intensive needs and more intense hours,” she said. “There’s no increase in funding and there’s no increase in hours. Those kids that have intensive needs are still going to burn through those hours pretty quickly.”

Other parents encourage families to look beyond ABA services for their children as well.

“Autism is so variable,” Greta James Maxfield, Family Support Specialist with Texas Parent to Parent, said. “It’s so different and parents have a unique situation in which there are many hours of observation in varying environments and circumstances. Parents often know what happened before or after or last week and can put their child’s behavior into a wider context. I think that it’s really important that professionals really tap into that eyewitness account of how their child is, what they’re doing and what is the nature of their disability. So often, I think that professionals have their toolkit and everything, but they make very cursory, very brief observations.”

Texas HHSC says its Children’s Autism Program collects child outcomes data that focuses on child progress over the course of treatment and demographic data on clients served, including age at diagnosis, age at program enrollment, insurance coverage, race/ethnicity, gender and family income.

“We’re consistently looking for ways to best use appropriated funds by listening to families, stakeholders and contractor feedback,” a spokesperson emailed in a statement. “The Children’s Autism Program has used this approach to develop the proposed rule amendments that will modify time limitations on services that will not only assist with providing more prescriptive treatment to children across the autism spectrum, but will assist our contractors in serving additional children within a fiscal year.”

Sanders and other advocacy groups hope in 2019, lawmakers will consider additional legislative action to help grow the program. 

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