NHS Human Services in Pennsylvania has created “autism schools” to set a new standard for integrating the best of behavioral health and educational service delivery models to meet the varied needs of students with an autism spectrum disorder (ASD). Results of the NHS approach encompass improvements in communication, life skills, social development, and academic skill building, thereby maximizing each student's potential.
Identification of Need
Over the past decade, the national increase in the number of children diagnosed with ASD has become the focus of much discussion, debate, and concern. Estimates suggest that an ASD diagnosis occurs with 1 in 166 births. This trend has been described as reaching epidemic proportions. ASD has no known cause, no known cure, and no one proven treatment method. Thus, individuals with ASD and their families can face a lifelong struggle to access needed supports and services.
In Pennsylvania, the two systems that primarily support this rapidly growing population are the public school districts and the mental health/behavioral health and rehabilitative services (BHRS) system. These two systems do not approach service delivery in a comprehensive fashion and have not implemented any innovations in service delivery, thus resulting in a lack of alternatives. The diverse needs of children with ASD also have created a financial burden and depleted resources from both the educational and BHRS systems. Lack of funds, insufficient alternatives, and a disjointed system have contributed to inconsistent service quality, poor outcomes, and misappropriation of funds.
Many of the most challenged children have not had successful educational experiences because of the lack of staff adequately trained to support children with ASD. In addition, a generalized educational curriculum does not meet their needs. State policy makers have struggled with the goal of having the public education system develop programs to educate these special students.
Families and educators long have recognized the need to bridge the service delivery gap between behavioral health and educational services in the face of limited resources and trained personnel. NHS has embraced invaluable family feedback as the grassroots driver of needed service modifications, as families are a key to defining quality services.
Dedicated to meeting the comprehensive, complex needs of children with ASD, NHS created advisory boards comprised of key stakeholders (consumers, parents, siblings, advocacy groups, payers, and educational representatives) to continually gather feedback on existing service procedures, review outcomes, and identify presenting service needs within the autism community. As the urgent need to bridge this service delivery gap became more apparent, NHS partnered with the advisory boards to define the fundamental parameters of an ideal educational and behavioral program. Through a concentrated training and modeling program, NHS has created a comprehensive infrastructure that represents a cultural shift in educating students with ASD.
To implement this program, NHS has developed four private, licensed “autism schools” across Pennsylvania for students ages 5 to 21. Educational funding is through the home school district of the child, and behavioral health services are funded through Medicaid. Students typically present with behaviors/needs that preclude them from participating in traditional mainstream activities. One of the schools, located in Carlisle, represents a joint partnership between a consortium of school districts and NHS. The schools are designed to serve between 30 and 60 students.
The schools incorporate a skills-based hierarchy curriculum developed specifically for the learning styles of students with ASD. The program maintains the flexibility and adaptability to interlace with each student's individual academic strengths, behavioral needs, and daily living skills. The schools have multiple tracks to accommodate a broad spectrum of needs, from students with severe maladaptive behaviors to those with communication and social deficits (i.e., Asperger's disorder).
A primary goal for all students is to transition into the least restrictive setting possible while maintaining independent levels of success. For some students this means eventually returning to a mainstream classroom. Although a separate setting, the autism schools offer inclusion activities in mainstream public school settings and in the local community as part of the weekly curriculum, giving students the opportunity for skill acquisition and generalization.
NHS provides a comprehensive, competency-based training program to educate the autism schools' professional team. Consultative sessions offer additional resources to teachers in mainstream schools for identifying compensatory strategies that maintain a student in the least restrictive setting. Outcome measures, such as success on individual educational plan (IEP) goals, have been identified for programs. A standardized assessment tool is used to allow staff to benchmark progress, modify treatment and educational approaches, and develop best practices. We also conduct parent, student, and home district satisfaction surveys, and data are fed into our continuous quality improvement process.
The autism schools have set a new standard for blending both the mental health and public education systems. NHS embraces and supports these unique students, rather than viewing them as a financial and resource burden.