When it comes to the care of a child needing behavioral support it is his or her family who spend the most time and have the biggest impact. The family is where that child lives and will live for at least 30 years.  Who will be the constant?  The parents.    

A child with autism leaves home, goes to school, comes home, goes to clinic, goes to therapy.  Where is the parent in all this?   The parents are not trained; they are only told what to do.  Being only told what to do and not trained what to do is not the way we learn best.    In addition, the parents are already overwhelmed by the needs of their beloved child.   How are they going to have the mental band-width to learn new things when their family is both traumatized and in almost daily crisis.  This is not the model of care that will make the difference we all hope to see.  This is not the fault of anyone.  It just happens to be the current system of care that we all assume is the best system of care.  It is not.

The proposed change in the reimbursement rates will reinforce this only minimally effective system of care.  The revolutionary beauty of the old system of going into family homes for up to 20 hours a week is that this does make a difference. The research of the last 20 years proves this.   Going to the homes is harder work than being in the schools or in a clinic setting; yet, that is where the most effective learning takes place.

Please continue to support the work in the homes.  It is needed there more than anywhere.  Let the reimbursement rates be highest for the skilled and courageous professionals who are willing to drive the back roads and the dirt roads.  As they enter the homes of families of children with autism they bring hope and they bring the skills necessary to  create essential and lasting changes in the life of that child and in the life of that family.