Prevalence of Autism Spectrum Disorder – What you should know

On April 27, 2018, the Centers for Disease Control and Prevention (CDC) released a new report on the prevalence of autism spectrum disorder (ASD) in the United States. The prevalence estimates show an increase from 1 in 68 children from the previous report in 2016 (Christensen, Baio, Van Naarden, Braun, et al., 2016) to 1 in 59 children in the current report.  The CDC established the Autism and Developmental Disabilities Monitoring Network (ADDM) in 2000 to provide prevalence estimates of children diagnosed with ASD.  ADDM releases surveillance data every two years.  The data for the current surveillance were collected at sites in 11 different states using health and educational records of children 8 years of age.

The results of the ADDM report suggest the increase in prevalence of ASD may be due, in part, to the identification of ASD in children from diverse racial and ethnic backgrounds.  Previous ADDM reports noted a disparity in the prevalence of ASD with more Caucasian children identified with ASD than black or Hispanic children. The racial, ethnic, and socioeconomic disparities in children diagnosed with ASD has been highlighted in numerous empirical studies (e.g., Durkin, Maenner, Christensen, Daniels, Fitzgerald, Imm, Lee,…Yeargin-Allsopp, 2017; Mandell, Wiggin, Carpenter, Daniels, DiGuiseppi, Durkin,…Kirby, 2009; Tek & Landa, 2012).  Later identification of ASD results in a delay to accessing effective treatment.  Empirical research over the years consistently finds early intervention to be effective at increasing a variety of adaptive skills. It is important to remember that the American Academy of Pediatrics recommends that all children in the U.S. be screened for ASD at 18 and 24 months.

There is no cure for ASD. However, interventions based on the principles of applied behavior analysis (ABA) have been shown to have a beneficial impact on individuals with ASD.  Decades of research indicate that ABA-based interventions can increase communication and adaptive skills and decrease challenging behavior.  Although early intervention is critical, adolescents and adults benefit from ABA-based interventions.  The key is to identify a qualified professional (i.e., Board Certified Behavior Analyst or BCBA) with training and experience working with individuals ASD to work with your family.  A qualified BCBA will be able to develop a well-rounded program to meet the needs of your child and your family.

To access the 2018 ADDM report visit the website https://www.cdc.gov/ncbddd/autism/addm-community-report/index.html

To learn more about the Autism and Developmental Disabilities Monitoring (ADDM) Network visit the website https://www.cdc.gov/autism/

Reliable resources:

– Dr. Hanna Rue

Christensen DL, Baio J, Van Naarden Braun K, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2012. MMWR Surveill Summ 2016;65(No. SS-3): 1 -23.

Durkin, M.S., Maenner, M.J., Christensen, D., Daniels, J., Fitzgerald, R., Imm, P., Lee, L.C.,…Yeargin-Allsopp, M. (2017). Autism spectrum disorder among US children (2002-2010): Socioeconomic, racial, and ethnic disparities. American Journal of Public Health, 107, 1818-1826.

Mandell, D.S., Wiggin, L.D., Carpenter, L.A., Daniels J., DiGuiseppi, C., Durkin, M.S., …Kirby, R.S. (2009). Racial/Ethnic disparities in the identification of children with autism spectrum disorders.  American Journal of Public Health, 99, 493-498

Tek, S. & Landa, R.J. (2012) Differences in autism symptoms between minority and non-minority toddlers. Journal of Autism and Developmental Disorders, 42, 1967-1973.

Planning a Fun and Safe Summer for Kids with Autism

Summer is officially here and along with the joy of concluding another school year, comes the challenge of navigating so many unscheduled, unpredictable and unexpected elements of the season.

Here are some helpful tips for planning your family’s summer activities that we hope will help create more fun and reduce the stress:

Maintain Some Structure
Try to maintain your child’s typical eating and sleeping schedule as much as possible. It’s not easy to stick to a schedule during summer, especially as this is a time when you want to let go a bit and relax. If you can maintain the basic structure of your child’s routine, you are less likely to have an overwhelmed child and the disruptive behavior that results.

Theme Park Programs
Visiting theme parks is a summertime family favorite but it also can bring a host of challenges for any child on the spectrum. Many parks offer Ride Accessibility Programs or Fast Pass programs for individuals with disabilities. If this is not an option for your family, there are other strategies such as planning your route ahead of time, splitting up (one parent goes with one child to an attraction while the other parent goes with another child to a different one), and bringing noise cancelling headphones to give your child a sensory break, etc.

Prepare in Advance
Travel requires specific preparation for children on the spectrum. It is important to familiarize your child ahead of time with the destination using photographs, videos etc. If your child has never flown or stayed in a hotel before, practicing these on a small scale (a one-hour flight first and a one-night stay at a local hotel are a really good idea).

Travel Safety
It is really important to understand a lot about where you will be staying during your vacation and the level of security of those locations. For example, if you are renting an apartment or home, it is critical that you check that each door has a lock and that the perimeter of the house is secure. Check whether your child can exit the location unassisted and be aware of what you need to do to secure the premises.

It Takes a Village
While vacationing, introduce your family.  Families who share with those around them, (especially in unfamiliar places like vacation destinations) about their child’s special needs tend to experience a more accommodating and supportive community. Helping others understand how they can help, can make your experience more relaxed and enjoyable.

Get Support From Your Team
Remember to use what works for your child while planning your family’s activities.  If you are working with an ABA provider, ask for assistance with goals that support a specific outing or trip.

Here are some additional resources to help make your season great for the whole family:

Watch our Parent Video: Summer Activities for Kids with Autism in Your Community

Structural Racism and its Impact on ABA: Disparities in Diagnosis and Treatment

LEARN is committed to fostering a culture that embraces what makes us each unique—be it race, ethnicity, gender/gender identity, sexual orientation, religion, national origin, disabilities/abilities, or socioeconomic background. LEARN aims to acknowledge the lived experiences and diversity of perspectives of our staff and welcomes our teammates to share their stories to help foster conversations about diversity, equity, and inclusion in our communities.

By: Jasmine White, M.S., BCBA, Behavioral Concepts (BCI)

Today, the topics of diversity, equity, inclusion, and equality are at the forefront of many organizations. The long-standing impact of structural racism and its influence on society can no longer be disregarded. People of all creeds are speaking out against injustices and the need to promote inclusion. The dialogues on disparities have led me to reflect on the field of applied behavior analysis (ABA) and the community which it serves. To what extent has structural racism impacted ABA as a practice? Are ABA practitioners able to identify biases within the field? What is the impact on the provision of services? How does it influence diagnosis? The literature on structural racism has shown that even the most well-intended person can possess biases, we are not immune. Therefore, it is our time as a community to gain an understanding of how structural racism has affected the field of ABA.  

Here at LEARN, it is our goal to contribute to a brighter future for all, which means bringing to light sensitive topics that are impacting the communities we serve. While this may be an uncomfortable conversation, it is needed for the development of cultural humility in ABA practice. LEARN’s focus is twofold, call attention to and create a constructive conversation around disparities in diagnosis and treatment related to diversity, equity, and inclusion. As an organization that serves a diverse population, it is our responsibility to bring attention to the disparities experienced by those we serve and to be a part of the solution towards lasting change. 

Ethnicity is known as belonging to a specific racial, national, or cultural group and observance of that group’s customs, beliefs, and or language. Depending on ethnicity, one may have a life exposed to more inequalities. For racial and ethnic minorities in the United States, these inequalities include health disparities, such as higher rates of chronic disease, lower life expectancy, and decreased quality of life compared to the rates among non-ethnic minorities.

Ethnicity also has a direct impact on how early autism is identified, evaluated, and diagnosed. Research shows that not only do Black and Latino children with autism spectrum disorder (ASD) receive their diagnosis and start intervention at an older age than White children with ASD, but they also less frequently receive evidence-based interventions. For Black and Latino families, this directly impacts service opportunities, outcomes, and quality of life. According to the Center for Disease Control, studies have shown that implicit bias, lack of access to healthcare services, and non-English primary language are potential barriers to the identification of children with ASD. The research established that Black and Latino children receiving ABA services were more likely to score lower on caregiver reports of health care quality than their White counterparts, including areas of access to care, referral frequency, number of service hours, and proportion of unmet service needs.  

As a community, we must investigate ways to expand access and resources to those who so desperately need services. Identify areas of structural racism and work to reduce and eliminate them from ABA practice. Train our practitioners to identify and bracket implicit biases. Find communication methods so that all families can have a voice regardless of the primary language spoken. Explore ways to have open and honest networks of communication so that we can continue to have conversations that evoke change. Here at LEARN, we hope to be a part of the solution to these disparities so that we may create an environment where there is equity in access for those we serve.  

Discover more about LEARN Behavioral’s Diversity, Equity, and Inclusion initiatives. Let us find ways to work together to increase awareness and improve access to the communities we serve. Together, we can achieve more.

LEARN pledges to create a community centered around trust, respect, tolerance, and empathy. Read more about LEARN’s DEI journey in our 2021-22 DEI Annual Report and find out how we are investing in our clinicians’ cultural competence and increasing the diversity of our clinical team. Together, we’re better.

Jasmine is a BCBA and has worked with BCI for four years. She recently graduated Magna Cum Laude with a Master of Science in ABA from Bay Path University in Longmeadow, Massachusetts. Jasmine is currently conducting her thesis on Implicit Bias in ABA and is looking forward to expanding multiculturalism research in the field.  

Addressing Health Equity in ABA Treatment Part I: A Black Mother’s Experience

LEARN is committed to fostering a culture that embraces what makes us each unique—be it race, ethnicity, gender/gender identity, sexual orientation, religion, national origin, disabilities/abilities, or socioeconomic background. LEARN aims to acknowledge the lived experiences and diversity of perspectives of our staff and welcomes our teammates to share their story to help foster conversations about diversity, equity and inclusion in our communities.

By: Asia Johnson, BCaBA, Autism Spectrum Therapies

Asia Johnson (she, her, hers) is an Assistant Behavior Analyst in AST’s greater New Orleans, Louisiana region and the co-chair of LEARN Behavioral’s DEI Employee Resource Group.

Walking on her tiptoes was interesting but cute. Rocking back and forwards raised my eyebrows. But the repetitive “I’m going to stop, I’m going to stop,” felt like weights pulling on my heart.

I had never heard the word autistic before. Little did I know that in a matter of months, the diagnosis of autism spectrum disorder (ASD) would be commonplace. I would sit in my living room with tears in my eyes and my phone in hand watching my daughter attempt to self-regulate. I felt helpless. For days this cycle would continue, leaving me uncertain if I was a good mother. I revisited each trimester of my pregnancy, actively attempting to re-evaluate anything I may have done wrong.

A mom of two with limited resources but a Medicaid card ready to go, I assumed it would be a walk in the park to get my daughter evaluated. I naively thought they would immediately tell me what was causing the concerns and provide tools to assist her. I imagined myself falling backwards into a hammock free from the weight of the world only to fall through the very net I assumed would hold me up. I was told there would be a nine-month wait before I’d receive a call about the evaluation. I was devasted. Even more, devasted to learn that if I had private insurance, I could have achieved a diagnosis in a few weeks.

As a Black woman who experienced medical malpractice during my pregnancies, I was on edge. I wasn’t sure I could trust clinicians to have my best interest at heart, let alone my child’s. With the pending evaluation, I wanted help but preferred help from someone who looked more like me. I kept wondering how a white female could relate to my child or me. Culturally we are different, from the way we comb our hair to how we greet another person.

When diagnosis day finally arrived, I was elated to put a name to all the restless nights. My daughter was diagnosed with autism spectrum disorder. I left that day with reassurance that I was indeed on the right track. But as I toured different facilities, I did not see anyone that looked like us. This feeling left me disappointed. No one in my family had walked this path, so I had no help with guidance or insight, but I was determined to obtain some help. As a parent, we are tasked with some minor and some major decisions to make on our children’s behalf; making the natural choice to seek applied behavior analysis (ABA) services was a significant decision in my eyes.

While I was grateful and relieved to finally have a diagnosis, I soon had a new concern. I quickly learned that the field of ABA lacked diversity within leadership roles. The most recent demographic data report by the Behavior Analyst Certification Board (BACB), reports 70.05% of certificants are white, with the remaining identifying as Latinx (10.56%), Asian (6.85%), Black (3.93%), Pacific Islander (0.38%), and American Indiana (0.28%).

My daughter’s primary struggle was with receptive communication. She could speak but would often talk at people. Her conversations would lead to questions she overheard on television: “Did you know your heart is located in your diaphragm?” However, my child was rarely truly interested in the actual response; if she was, she didn’t wait long to receive the answer before jumping in with another medically driven question. It seemed as if her focus was on the oohs and ahhs or the “wow, how smart” conversations that would follow.

ABA was described to me as a treatment option using empirical studies to promote behavior changes among people living with autism spectrum disorder (ASD). ABA included various treatment settings, and my daughter was provided two options. Option one was to have a behavior technician come into our home. The clinician explained how they would use ABA practices to decrease her comorbid diagnosis of sibling rivalry. Option two was an after-school social skills group to target her ability to reciprocate verbal responses when communicating with others. However, both did not resonate with my lifestyle nor my views as a Black parent, especially with the syntactic structures and linguistics I noted in our brief conversation. I often wondered if my family’s values would be accepted or would I have to have a practitioner come into my home and encourage their societal norms, and that was not something I was willing to accept. As a single mom, I also pondered how I would be able to bring my daughter to a social skills group while working a full-time entry-level job.

I wasn’t wrong to worry. Research shows that Black Indigenous Persons of Color (BIPOC) families and those of low socioeconomic status may encounter issues with inappropriate treatment delivery because of different cultural perspectives. I knew BIPOC families receiving treatment from white practitioners could often face implicit biases because of the country’s systematic racism, which frightened me. Unfortunately, the data says  white clinicians are likely to make assumptions regarding treatment based on stereotypes and their own lived experiences, leading to inaccurate recommendations. So, I did not move forward with ABA services. I did not feel any facility I visited had clinicians who knew how to properly teach my brown-skinned child how to speak the English language, consistent with my families’ syntactic structures.

This pivotal moment in my life shifted my perspectives and my professional journey. I decided that I could (and would) become the Black clinician I once sought. My journey has been harrowing, and often times I still feel like I remain the elephant in the room. But today, there is a peek of light at the end of the tunnel.

When parents embark on a journey designed to make socially significant changes in their child’s life, resistance is likely to happen when approached by a white clinician – especially in southern regions. The south has been known for racial divides and limited resources for Black communities. Southern states have long represented large Black populations and are often referred to as the Black Belt.  Nonetheless, Black patients continue to fight a battle for health equity and justice. ABA services are no different; the Journal of Autism & Developmental Disorders found that African-American children with autism were diagnosed an average of 1.4 years later than white children and spent eight more months in mental health treatment before being diagnosed.

BIPOC patients deserve support in their fight for equal services. BIPOC patients deserve consideration when forming effective treatment plans. After a long road to a proper diagnosis, families should not face additional challenges in teaching their children the tools necessary for productive and responsible citizenship consistent with their cultures.

My goal as a clinician has always been to inform the world of societal differences that may impact treatment modalities. One example is the lack of acknowledgment often witnessed when practitioners teach verbal and behavioral skills. Often, Black individuals are forced to code-switch. When practitioners not familiar with the cultural nuances in language, work in some homes, they may dictate using what they are familiar with. Code-switching is exhausting, yet many Black individuals are forced to use the “standard language” society deems acceptable in a field focused on effective treatment. As a Black woman, I’m aware of this struggle (and have had to do it in my own life and work). I’m even more aware and conscious that it may be more challenging for those who are autistic to change their behavior readily, let alone the spoken language they are accustomed to hearing.

My experience as a Black Medicaid recipient who crossed various obstacles with my daughter’s diagnosis and treatment process encouraged me to seek out a company devoted to expanding diversity when I finally received my certifications. I am now a Black clinician striving for continued growth with ABA services in the south. I am hopeful for change as I continue to acknowledge cultural differences within my treatment plans.

LEARN pledges to create a community centered around trust, respect, tolerance, and empathy. Together, we’re better.

Launchpad Learning Program: Bridging the Gap Between ABA and School

Introducing Launchpad: Guiding Young Learners Towards Group Success!

Our Launchpad program is an exciting opportunity for children with autism ages 2-6 who have made remarkable progress and skill development in a 1:1 environment and are ready to take the next leap toward thriving in a group setting.

Our program offers a balanced blend of supportive group interaction and one-to-one instruction. We understand the importance of a smooth and successful transition from early intervention and comprehensive 1:1 ABA services to group settings and have designed our program to bridge that gap.

Reach out to your local ABA provider to learn more about the Launchpad program.

Wisconsin Early Autism Project Opens New Learning Center in Sun Prairie, WI

We’re excited to announce we have expanded our reach in Wisconsin with the opening of a new Wisconsin Early Autism Project (WEAP) Learning Center in Sun Prairie this past April. This center represents our commitment to providing children with autism spectrum disorder (ASD) the resources and support they need to develop essential life skills in a nurturing, group environment. Our mission is to find success for every child with autism in our care by providing compassionate, contemporary applied behavior analysis (ABA) therapy to help them reach their potential.

The WEAP Learning Center in Sun Prairie offers a learning-rich environment that supports the unique needs of each child. Our center-based services are complemented by home and community-based services as well as social skills programming. We understand that every child has unique needs and interests, and we’re committed to providing tailored treatment that respects the varied needs, values, and cultures of every family we serve.

To celebrate the opening of our new Learning Center, we hosted an open house where the public and families were invited to tour our bright and airy new facility, speak with our leadership team, and participate in a range of fun, summer-themed activities. It was a festive occasion that brought the autism community in Sun Prairie and throughout Wisconsin together. The event was topped off with an official ribbon-cutting ceremony, which was organized in collaboration with the Sun Prairie Chamber of Commerce.

We’re proud to have served children with autism for over 25 years and our dedication to serving the autism community is steadfast. Our commitment to the welfare of our clients has allowed us to be one of the leading providers of ABA therapy in Wisconsin and the country. We take enormous pride in providing positive outcomes for children and families and are committed to continuing to provide exceptional care to all those we serve.

If you’re interested in learning more about our services or finding a WEAP location near you, please visit our website. We look forward to serving the autism community in Sun Prairie and throughout Wisconsin in the years ahead.

“We are excited to offer center-based learning on the east side of Madison in Sun Prairie and the surrounding communities. Our new location has reduced the commute time for some families traveling to the west side center and created an opportunity for new families to access services.

Our staff and families love our fresh, new, bright center, which features large clinical spaces and group learning areas. Plus, kids can get lots of physical activity in our gym and outside at our playground. Many families have already taken advantage of our Saturday Squad program for weekend fun for their children. I encourage interested families to reach out to schedule a tour.” – Christine Laurent, Clinical Director

Autism Spectrum Therapies (AST) Opens 5 New Learning Centers

With over 20 years of experience providing compassionate, contemporary ABA therapy to children with autism, we’re delighted to share that we opened five new AST Learning Centers this past summer and fall in Fresno and San Marcos, California; Goodyear, Arizona; Albuquerque, New Mexico; and Clackamas, Oregon. Each new center held an open house that included an official ribbon-cutting with their local Chamber of Commerce and opportunities for families to tour the facility, speak with the leadership team, and participate in fun activities. These new locations offer a supportive, learning-rich environment where children with autism can work on individual skills in a group setting.  

We couldn’t be more excited to support more families in the communities we serve. To learn more about where our services are located, find a location.  

Best Autism & ASD Podcasts + Autism Podcasts for Parents

In a year when the pandemic kept many families at home and on their screens, many Americans turned to podcasts to fill their downtime. At LEARN Behavioral, we’re no exception.

We recently reached our 100th podcast milestone on All Autism Talk, where we’re connecting the autism community one podcast at a time. In celebration of today—International Podcast Day—we’re launching a new podcast with Temple Grandin discussing her latest book, Navigating Autism: 9 Mindsets for Helping Kids on the Spectrum. We’re also bringing you 10 of our highly popular episodes:

1. Temple Grandin – Parenting Kids with Autism

In one of our most-listened-to podcasts, Temple Grandin, PhD, an American scientist and animal behaviorist who has been a trailblazer for people with autism, shares advice for parents raising kids on the spectrum. Drawing from her experiences growing up with ASD, she talks about everything from sensory overload and excessive screen time to the need for more 1950s-style “old-fashioned methods of parenting” full of “teachable moments.”

2. Female Life on the Spectrum – Insights from Jennifer Cook O’Toole

Jennifer Cook O’Toole was diagnosed with Asperger’s syndrome at age 35 and is raising three children on the spectrum. She’s the author of seven award-winning books, including Autism in Heels: The Untold Story of a Female Life on the Spectrum. In this engaging and, at times, humorous podcast, she explains why diagnosis has been widely missed in girls and women.

3. Addressing the Cultural Needs of Families with Autism

Corina Jimenez-Gomez, PhD, a behavioral scientist at Auburn University, and Lauren Beaulieu, PhD, a behavior analyst for Newton Public Schools in Massachusetts, team up on this podcast to talk about cultural competency and the importance of cultural responsiveness in ABA. They bring personal experience to the conversation, with Corina sharing stories of her experience as a mom and Venezuelan native, now living in Alabama, and Lauren discussing her marriage to an Italian immigrant. Both say relationship-building is an important part of navigating what can sometimes feel like a clash of cultures.

4. Early Identification of Developmental Delays in Children – Dr. Sharief Taraman

Dr. Sharief Taraman is a neurologist at Children’s Health of Orange County (CHOC). In this episode, he discusses how diagnostic screening can help identify developmental delays in children. Early identification and diagnosis, he says, can help families get the right treatment right away.

5. What to Expect from ABA Service Providers – with Dr. Hanna Rue

Hanna Rue, PhD, Chief Clinical Officer at LEARN Behavioral, eases parents’ minds in this conversation about what they can expect when it comes to applied behavior analysis (ABA) providers. How do providers apply our understanding of how behavior works to real situations? How do they help increase behaviors that are helpful and decrease those that are harmful for learning? Listen in to learn more.

6. The Role of Genetics in Autism, Explained

Wendy Chung, MD, PhD, director of clinical research at the Simons Foundation Autism Research Foundation, works as a molecular geneticist and physician and is something of a genetic detective who traces an individual’s symptoms to a particular genetic anomaly. In this podcast, she breaks down what we know about the causes of autism.

7. Autism Resource Mom – Autism Support and Information from the Best Expert, a Mom

A mother’s intuition and drive to advocate for her kids can make her the best expert when it comes to her child’s care. That’s something Debora Smith understands to the core. She’s raising a son on the autism spectrum, and she founded Autism Resource Mom, a nonprofit organization that helps families navigate the complex world of autism. Listen in to find out how she’s turned her passion into helping others.

8. Autism, Aggression, and Self Injury – Exploring a Mother’s Journey with ECT

More than a decade ago, Amy Lutz and her husband, Andy, struggled with a predicament no parents want to face: how could they safely keep their autistic 10-year-old son living at home any longer, considering his violent rages? Amy, a founding board member of the National Council on Severe Autism, discusses their exploration of the controversial procedure of electroconvulsive therapy, or ECT.

9. Making Social Skills (and Minecraft) More Accessible for Kids with Autism

As a single father, Stuart Duncan has been all about his kids. His oldest son has autism, and Stuart noticed that kids on the spectrum need a space online where they can play games without getting bullied. So, the Canadian dad quit his job to create Autcraft, a Minecraft server for kids with autism. His virtual community has given people on the autism spectrum the self-confidence to socialize on a safe gaming platform.

10. Medical Insurance for Autism Treatment – Understanding the Changing Landscape

Will your health insurance cover your child’s autism treatment? In this podcast, Amy Weinstock, Director of the Autism Insurance Resource Center at the University of Massachusetts, breaks down tools that can help families find out whether they are covered.

Find dozens of more episodes from All Autism Talk wherever you get your podcasts, including Apple Podcasts, Google Podcasts, Spotify, Stitcher, Amazon Music, or on LEARN Behavioral’s website at www.learnbehavioral.com/allautismtalk.