Toronto, April 20, 2016 – The Ministry of Children and Youth Services has declared that as of May 1, Ontario will no longer provide Intensive Behavioural Intervention (IBI) to children of five years and older. A group of nine Board Certified Behavior Analysts™ (BCBAs), who are practitioners and advocates for children with Autism Spectrum Disorder (ASD) and who look at the full scope of the science behind treatment, have significant concerns with this new provincial policy. This group of BCBAs believes it is their professional, personal, and social responsibility to bring to the government’s attention that the proposed changes will have a destructive effect on this community of children, their families, and all present and future Ontarians.
“The recent unjustifiable, ill-advised implementation of an age cutoff for funded IBI is regressive and foreshadows a dark future for those denied access to treatment” said Dr. James Porter, BCBA and Clinical Psychologist. Intensive Behaviour Intervention (IBI) teaches skills that are fundamental to a child’s ability to integrate and participate in family, community, school, and with social life. Beginning May 1, access to IBI will be limited to children ages two to four. Currently, children wait two to four years to get IBI treatment. Between the diagnosis and treatment wait times, the new policy changes capping access to IBI at five years old means 1,000s of children will miss out on this life changing treatment. This group of BCBAs questions the ethics of the decision, as the Ministry’s own expert panel did not even recommend cutting kids over five off of the waitlist. Without access to treatment, it puts the welfare of children at risk, and studies have proven that treating children with ASD, rather than denying them treatment, is more costeffective for taxpayers in the long run.
“As BCBAs it is our responsibility to recommend treatment based on clinical need and not constrained by age,” said Nancy Marchese, BCBA and Psychological Associate. “It is completely unethical that the government is denying children over five years old, IBI, a treatment that allows them to learn critical skills that are integral to their development and quality of life.”
Earlier this month, the Ministry of Children and Youth Services announced a new provincial policy for autism services along with its plans to invest $333 million in autism over the next five years. The new policy is said to increase access, reduce wait times, and expand Intensive Behaviour Intervention (IBI) for children ‘in the appropriate developmental window’ – identified as two to four year olds. BCBAs who do the work and oversee IBI treatment program were not on the expert panel to inform decisions about this new policy. Further, this group believes this new policy was built through a narrow scope of research, neglects important empirical evidence from the behaviour analytic field, and that more stakeholders need to be involved in the decision-making process, such as parents and BCBAs. This group of BCBAs has identified three main challenges to the new policy:
● it will leave children with ASD at significant risks including severe challenging behaviors, reduced adaptive and self care skills, the absence of meaningful communication skills and long term dependence on their families and society
● the scientific viability of the proposed Autism Program Model is questionable
● the methodology for the roll-out of the model is impractical
This group of BCBAs suggests a more evidence-based behaviour analytic approach to treating autism, which can lead to important differences and allow the optimal success of children living with ASD. This would require access to early and accurate diagnosis, a customized approach that matches the treatment program to the needs of the child, and the services of IBI (ie: 20-40 hours per week) without arbitrary age cut offs. This group also believes ethical and economic implications of a less intensive treatment model for children over the age of five who have never received IBI treatment must be considered, as it has no current support from scientific data and efficacy studies.
This group of BCBAs has recently presented these concerns to the Ontario Ministry of Children and Youth Services with hopes of change before the alterations are made on May 1st.