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  • Writer's pictureAlley Dezenhouse Kelner

A word of caution in the Wild West, post OAP era.

On April 1st 2019 the landscape of Autism treatment will change in Ontario. We will be back in the Wild West of service delivery where clinical oversight is a pipe dream, as many families will find themselves with champagne taste on a (buck-a) beer budget.

Yes, there will be agencies that maintain standards in the name of ethical business and clinical practice (and I'll be happy to name names if you ask--in the name of consumer protection), but there will also be a whole new sub culture of "agencies" (and I use that word loosely) offering programming that is "behaviour-like" or "ABA-like" or "therapeutic-ish". I'm sorry, but I didn't study for this many years to see ABA or mental health support for the autism community get a bad name because of flawed application and zero clinical validity. I've always said, I am not in the game of slandering other agencies, but I WILL tell you who I'd send my own kid to.

With the combination of less funds and the ability to use funds on transport, technology and respite we open ourselves up to "agencies" (there I go again using that word loosely) offering "therapy" (again, a real loose definition not rooted in evidence), who may even be calling it "respite" to side step the (already marginal) necessary clinical oversight required specifically for behavioural service. We'll end up with "agencies" cutting cost on staffing, failing to individualize and generally moving to a model that looks more like "after-school-recreation" than therapy. Remember, ABA can be delivered across modalities, and at a well-run centre/school, it will be--but that doesn't mean that babysitting is ABA, and it certainly doesn't mean that anything is ABA as long as it's occurring in an "ABA centre".

Now at this point, we don't actually know if respite (or technology purchases, or transportation) will have to be supervised by a board/college certified individual (or someone pursuing it) but we do know this--in any field, there are less than stellar professionals; there are those who are well intentioned but fail to measure up due to lack of skill or experience, and perhaps less frequently (but more riskily) those who try to make a dollar off the the fears of parents and make false promises that cannot be actualized. The purpose of this blog is not to "fear monger" as the current political party in power loves to suggest, over and over, like a broken record. Instead, it's to open your eyes as the consumer to the important things to think about, the important questions to ask of your current or future provider moving into the post-IBI era in Ontario:

You should ask...

1. Are you qualified to offer this service? What exactly qualifies you (be specific please), and how many years of experience do you have in THIS population, delivering THIS exact service?

2. What will you do if you find my child's needs change and he or she no longer seems a good fit?

4. What are my options if I am not happy at any point.

5. How do you describe your scope of competencies? (Remember: a jack of all trades is a master of none!)

And in my humble opinion, one of the MOST important questions--

6. What education AND experience do you possess in supporting mental health needs in an autism population; if you don't have any (at least be honest about it and...), what is your referral process for those who fall outside your scope of expertise?

This is by no means an exhaustive list, but I am working on that and will keep you posted <3

In the meantime, from my family to yours, keep on fighting the good fight.

Keep on speaking your truth, and keep on reaching out for help when you need it.

None of us can go at this alone!

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