While many providers do not accept Medicaid coverage, CARD is committed to serving Medicaid patients, increasing access to treatment in communities that had limited or no access in the past.
PLANO, Texas (PRWEB)
September 07, 2021
Researchers at the Center for Autism and Related Disorders (CARD) published guidance to the field of applied behavior analysis (ABA) to promote equitable clinical care for all patients with autism spectrum disorder (ASD). Individuals with ASD, a population already at risk for marginalization, face racial discrimination in their procurement of diagnostic and treatment services. Compared to White patients with ASD, people of color with ASD are more likely to experience delays in diagnosis and the timely initiation of evidence-based treatment services, as well as decreased treatment hours. Given the enduring benefits of early, intensive ABA treatment, these disparities have a devastating impact on the long-term prognosis of people of color who have ASD.
CARD’s mission includes a social justice initiative to ensure access to services for all individuals with ASD, regardless of race, national origin, age, gender identity, or socioeconomic status. While many providers do not accept Medicaid coverage, CARD is committed to serving Medicaid patients, increasing access to treatment in communities that had limited or no access in the past. In support of its diverse patient population, CARD dedicates training, quality assurance, and research initiatives to deliver inclusive and effective treatment services to all demographics.
In Guidance for Behavior Analysts in Addressing Racial Implicit Bias, a recent peer-reviewed article published in Behavior Analysis in Practice, CARD researchers Catherine Jaramillo, MS, BCBA, and Karen Nohelty, M.Ed., BCBA, explored the role clinicians play in inequitable service delivery. Beyond the systemic disparities faced by people of color regarding access to health care and insurance coverage, the behavioral assessments used to diagnose and treat ASD rely heavily on clinicians’ behavioral observations and clinical judgment. As Black, Indigenous, and Hispanic clinicians are underrepresented in the field, people of color who are diagnosed with ASD are predominately treated by White clinicians. Implicit biases held by clinicians may contribute to disparities in treatment.
“Viewing implicit bias as an unconscious process seems to imply that there is no course of action for remediation,” said Nohelty, CARD’s director of research. “However, behavior analysts are in a position to enact meaningful change and reduce discrimination in their practice.”
In pursuit of equitable care for patients with ASD, CARD researchers explored existing literature and provided guidance to help behavior analysts assess and reduce their implicit biases. Implicit biases are one’s underlying attitudes towards a racial group and the stereotypes one unknowingly associates with that group. Implicit biases held by clinicians may elicit unintentional discriminatory behavior that impacts patient care. As race and culture play an integral role in human behavior (e.g., sleeping, dressing, feeding, greeting, etc.), clinicians should be trained to discuss their patients’ cultural preferences openly and, where appropriate, consider those preferences in the development of a patient’s treatment plan.
In lieu of reliable tools to assess a clinician’s implicit biases, potential prejudices may be identified by collecting data on measurable behaviors. Data collection may be carried out via self-evaluation or by another clinician. According to the authors, taking action to improve self-awareness is the first step in enacting meaningful change. Whether working with patients, caregivers, or staff, clinicians should evaluate differences in their behavior (e.g., vocal behavior, facial expressions, and body language) and clinical practices (e.g., reinforcement delivery, use of restraint, and caregiver collaboration) when interacting with people from different racial groups. Subsequently, well-established ABA strategies known to alter behavior may be harnessed to reduce clinicians’ biased behaviors.
CARD recognizes that failures in the health care system are contributing to inequitable clinical care for people of color in the autism community, and CARD is taking the lead to eliminate disparities in the provision of ABA treatment. Addressing clinicians’ implicit biases is just one step toward achieving equitable clinical care for all individuals with ASD.
References
Jaramillo, C., & Nohelty, K. (2021). Guidance for behavior analysts in addressing racial implicit bias. Behavior Analysis in Practice. https://doi.org/10.1007/s40617-021-00631-2
About Center for Autism and Related Disorders (CARD)
CARD treats individuals of all ages diagnosed with autism spectrum disorder (ASD) at treatment centers around the globe. CARD was founded in 1990 by leading autism expert and clinical psychologist Doreen Granpeesheh, Ph.D., BCBA-D. CARD treats individuals with ASD using the principles of applied behavior analysis (ABA), which is empirically proven to be the most effective method for treating individuals with ASD and recommended by the American Academy of Pediatrics and the US Surgeon General. CARD employs a dedicated team of trained professionals across the nation and internationally. For more information, visit centerforautism.com.
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