Primer: Applied Behaviour Analysis, the therapy at the heart of Ontario’s autism controversy

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Not all children require IBI or comprehensive ABA programming for many hours per week. Many children require far less support. Autism is a spectrum, so there is no one-size-fits-all support solution. Intervention decisions need to be based on careful assessment of what the person needs.

Q: Is there any way to offer ABA at less cost?

A: For some children and adolescents less intensive, group-based delivery of ABA is clinically appropriate. However for other children intensive, comprehensive ABA is required in order to help them achieve best outcomes. For these children, who often have more autism symptoms or severe cognitive impairment, the evidence supports intensive, comprehensive ABA programming. For these children, access to tw0 hours a week versus 36 hours a week is tantamount to giving them nothing. However, it is  important to remember that for many children, or at different points of a child’s life, this level of intensive, comprehensive will not be necessary. There is no one-size-fits-all solution.

A: How will the new provincial system of payment affect the supply and demand for ABA providers?

Q: The new system will cause significant instability across all autism service providers, both public programs and private programs. Significant layoffs will occur, or are already occurring. As employment opportunities become less stable, behaviour analytic professionals at all levels will leave the field or province, or they will work in other populations, such as adult developmental services or geriatrics. This will further restrict the number of available practitioners and will likely result in a situation in which parents may have money for services, but they can’t find people qualified to provide early intensive behavioral services. With such limited funds available, clinicians will have to make difficult ethical choices — whether to provide services at suboptimal levels or to provide no service.

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