Autism diagnoses surge; access to treatment can’t keep pace

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Dr. James Moore is the director of training at the University of Southern Mississippi’s ABA Emphasis Program.

With one in 68 Mississippi children — almost 11,000 individuals — diagnosed with autism spectrum disorder, the state’s educators, analysts and advocates are working to decrease barriers to early treatment.

Last month, the advocacy group Autism Speaks held a press conference at the Capitol to highlight the effectiveness of applied behavior analysis in treating those with autism and the struggle some patients have endured in trying to receive such treatment.

The prevalence of autism diagnoses in Mississippi was reported to Legislature in 2016 by the Autism Advisory Committee. The one in 68 Mississippi children diagnosed with autism who were cited in that report reflected a jump from the one in 500 estimate a decade earlier.

Such a jump can be expected as awareness of autism spectrum disorder has increased, says advocates for autism treatment. Because behaviors range so drastically, it can be difficult to say just what that level of prevalence can mean for the state.

A 2007 study measured the lifetime distribution of incremental societal costs of a child with autism nationally and found that care could cost as much as $3.2 million for an individual with autism across their lifespan. For this reason, early and intensive therapy is encouraged to improve outcomes.

Dr. Kasee Stratton, a Mississippi licensed psychologist, operates the Bulldog CHARGE Syndrome Research Laboratory as well as serving as co-director of Mississippi State University’s Autism and Developmental Disabilities Clinic. Though her qualifications exceed that of a Mississippi Autism Board certified applied behavior analyst, she practices applied behavior analysis with her patients.

Dr. Kasee Stratton is a Mississippi licensed psychologist who practices ABA.

“(Applied behavior analysis) in essence works to improve positive behaviors — social skills, communication, interactions with folks — and minimizing challenging behaviors — tantrums, self-injury— the things that get you placed as the weird kid at school that no body works with,” Stratton said.

Certain behaviors are identified to be helpful for the individual, Stratton explained. The analyst breaks down that skill into small actions that are then taught to the person receiving treatment. Applied behavior analysis methods allow children to achieve basic skills such as reading and conversing at an earlier age, and in some cases, more involved educational skills, she said.

In order to improve access to treatments like applied behavior analysis, the University of Southern Mississippi is offering Mississippi’s first autism therapy degree program. 

In order to gain board certification from the Mississippi Autism Board, prospective analysts have rigorous training ahead of them.

“This is not a simple process by any means. I think that folks think, ‘Oh it’s just a master’s program,’ ” Stratton said. “Typically, it requires at least a master’s degree, typically in something like education, psychology or applied behavior analysis. There are set credentials for those things.”

In addition, each analyst undergoes 1,500 hours of practicum experience.

“That’s almost a year of a full time job and they’re doing that on top of their coursework while they’re doing that,” Stratton said. “And all of that has to be supervised by a Mississippi Autism Board certified applied behavior analyst or licensed psychologist. It’s really an intensive program. In two years, you’re doing two years of graduate course work plus a whole year of on-the-job experience, where you’re getting supervision.”

In addition, in order to maintain a license with the Mississippi Autism Board, each analyst must gain 12 hours of continuing education every year. Currently, there are only 33 licensed behavior analysts approved by the state.

“I hope that in the coming years we will see here in Mississippi the entities that deal with autism collaborate more,” said Dr. James Moore, director of training for the Applied Behavioral Analysis Emphasis Program at the University of Southern Mississippi. Moore said this collaboration could occur across existing state agencies.

“From one to three, they (those diagnosed as autistic) fall under the Department of Mental Health. After three they go into the Department of Education. And then they go back into (the Department of) Mental Health,” Moore noted. “We need to come together and collaborate.”

Moore said that such collaboration could help get analysts into public schools.

“I know of a school district right now,” Moore said, “that is trying to scrape together enough money pay for a behavior analyst for their district.”

Despite the effectiveness of the treatment and the demonstrable need in the state, Moore said there are relatively few jobs for Autism Board certified applied behavior analysts.

James Moore 

“The 11,000 estimated children in this state are proof of the need for this treatment,” Moore said. “But if employers in-state can’t compete with what out-of-state offers, we can’t keep our graduates. … Students (on the autism spectrum) cannot receive treatment that they don’t have access to. The spin out effect is exponential when you get down to it. It’s the difference between someone becoming a taxpayer instead of someone depending on the system.”

Pay is an issue, Moore notes. Just two years into its inception, Moore’s program will matriculate eight students on May 12 and another student in August. While four students already have offers or are likely to find employment in the state, the other half of the cohort will be taking their newly acquired skills elsewhere.

“I have a student here today who has been offered the job of clinic director of the autism clinic at Michigan State University. She’ll make more than our PhD faculty make,” he said. “So I can’t fault her for moving to Michigan State. She also has a son with disabilities and there are just better services in Michigan.”

In 2016, Michigan had an estimated population of just under 10 million, according to the U.S. Census; Mississippi, just under 3 million. Federal Reserve Economic Data  from 2015 said that Michigan’s Gross Domestic Product was $468 billion compared to Mississippi’s $105 billion. Service sector jobs clearly are more numerous in a state with a much larger population that is generating four times as much GDP.

“When (Michigan’s) Legislature passed reforms, they said, ‘We have to train the professionals,’” Moore said. “They gave four of their universities half a million dollars for start-up funds. They were able to build state-of-the-art clinics and go out and hire competitive faculty and pay to keep them.”

“If we were to see that in some universities like Southern Mississippi or maybe some … like Delta State — who is primed to meet a huge need in the Delta — if all of those universities were to get that kind of state level funding, we would be able to hire and keep expert level trainers who could then help us increase our numbers in terms of training professionals.”

In addition to more university funding from the state, the University of Southern Mississippi received a gift for investment in Autism Education from Secretary of State Delbert Hosemann and his wife, Lynn, that was matched by the Gertrude C. Ford Foundation.

“This generation — as maligned as they are in the media — has this huge sense of helping the community that wasn’t there for my generation in the ’80s,” Moore said. “I think seizing on that want to help could help bridge access across the state.”

  • Otis

    … and yet Mental Health in Mississippi keeps getting cut.