Don Wachelka (M.A. BCBA) Founder of Beam ABA Services, looks at how meeting the ABA needs of rural communities may increase accessibility and affordability for UK families
Among the many challenges families face when receiving a diagnosis of autism is the financial pressure associated with their child’s disability. Medical expenses alone are estimated to be four to six times greater than a child without autism spectrum disorder (ASD). In addition, intensive behavioural interventions are estimated to cost between £40-60K annually¹. At this cost, provision can seem out of reach for many families.
This financial consideration is coupled with the sometimes enormous challenge of gaining access to competent providers and high quality services. Particularly when providers often have long waiting lists; parents I have spoken with have been quoted up to two years for some ABA providers within the UK.
There are about 700,000 people in the UK living with autism - that's more than 1 in 100. And as the rate of diagnoses increases, so does the need for highly qualified personnel.
While there is already a significant shortage in metropolitan and urban areas, the problem is only exacerbated in rural and isolated areas. Which is all very disheartening when everything we know about a good prognosis relates to early intervention and intensive treatment.
The case for an online delivery
The concept of telepractice for ABA could provide an answer. Telepractice refers to applying technology to the delivery of services at a distance by linking a clinician to patient or clinician to clinician for assessment, intervention, and/or consultation.²
This is relatively new in our field and while the research looks promising as an effective treatment³ nothing has yet to be documented on cost savings.
Advances in technology have tremendously expanded our capacity to deliver quality services to remote audiences. Tools such as Skype make it possible to bring a professional into your home without the time and expense of travel. Collaborative video platforms make assessment, diagnosis and communication with a healthcare provider possible.
Further, the field of ABA has advanced significantly with its curriculum, behaviour-progress tracking and report writing software. All these advances in technology could provide a solution to the accessibility issues for those living in rural communities.
Technology could increase affordability.
By definition ASD is a scale and those with a diagnosis will present with varying needs and abilities. Telepractice won’t be right for everyone and there is work to be done to identify where it is most appropriate and effective. But as a way of putting ABA provision within reach of more families it is worth further investigation and I for one am excited by the opportunity it presents.
Here we list several research articles on the efficacy of telepractice as a delivery method for an ABA intervention.
Donald Wachelka, M.A. BCBA, Founder, Beam ABA Services
¹ Amendah, D., Grosse, S.D., Peacock, G., & Mandell, D.S. (2011). The economic costs of autism: A review. In D. Amaral, D. Geschwind, & G. Dawson (Eds.), Autism spectrum disorders (pp. 1347-1360). Oxford: Oxford University Press.
³Boisvert M, Lang R, Andrianopoulos M, Boscardin ML) Tele-practice in the assessment and treatment of individuals with autism spectrum disorders: a systematic review. Developmental Neurorehabilitation 2010; 13(6): 423-432.