A Model for Regional Training and Service Delivery for Children with Autism

Background: Despite advances in early identification and treatment, it is difficult to estimate the extent to which we can successfully serve an entire population of persons with autism. We present examples of analyses conducted for the public schools in the state of Delaware that document meaningful progress towards this goal.

Objectives: To establish: (a) how many children with autism receive highly specialized educational services;  (b) how many educators receive training and support within a more specialized program, and (c) how many children and families receive other specialized supports.

Methods: We estimate the proportion of children identified and receiving services within the public school system relative to an estimated 1/150, and as a function of the child’s characteristics and type of program received. We also report the proportion of educators serving children within highly specialized programs, who have received training in essential elements of evaluation and ABA. We then present data on the delivery of respite and residential services statewide, as well as consultation and review regarding severe behavior problems.

Results: We have identified about one-half of the children likely to require relatively more intense and specialized programs, and most of these are enrolled in highly specialized programs. Though most staff members in such programs have additional training, training outside of this program is much more limited. Few children required some form of residential services, though respite was used by more than 20%.  Additional oversight was required for more than 15% of students demonstrating chronic and/or severe behavior problems.

Conclusions: Together, these results illustrate how programs with a regional mandate might establish goals for identification and treatment, and track progress towards ensuring equal access to highly specialized services and supports.  It remains, however, more challenging to identify and develop services for higher-functioning children.