Carelon’s Autism Specialty Services helps members learn constructive life skills

Autism spectrum disorder: how treatment makes a difference

When individuals receive early intervention treatment for autism spectrum disorder (ASD), the treatment can greatly improve their development and result in better overall outcomes.¹ Children experiencing ASD who are between 2 and 5 years old can significantly improve their communication, social interaction, and movement skills with therapy.²

Autism Specialty Services is part of Carelon Behavioral Health’s Children, Youth, and Family Services (CYAFS) systems of care program. The program fills a growing need for care, as one in 36 children in the United States currently experiences ASD, up from the previous rate of one in 44.³
 

Carelon Behavioral Health’s Autism Specialty Services

The program provides board-certified child and adolescent psychiatrists offering services to members that significantly reduce the maladaptive behaviors and overall program costs associated with ASD.

“Our team is composed of clinicians who make rounds twice daily presenting ASD cases to various medical directors and psychiatrists who specialize in applied behavioral analysis,” says Manny Gonzalez-Abreu, PhD, LMFT, ABA Shared Services, Carelon Behavioral Health. Applied Behavioral Analysis (ABA) is a therapy based on the science of learning and behavior. ABA’s goal is to help individuals increase constructive behaviors and decrease ones that are harmful or that affect learning.⁴

“We have a clinical team of 12, which includes two doctoral-level supervisors. They make cases, presenting to the rest of the team. We also have an administrative team processing authorizations and connecting providers with members,” says Gonzalez-Abreu.
 

How does the program work?

“We receive an initial assessment from a primary care provider as to what skills their patient is missing. The goal is to have the individual fill these gaps with constructive skills learned through therapy. The care provider creates a treatment plan and sends it to our team. We ensure that it is appropriate for the individual’s learning speed, with measurable goals,” says Gonzalez-Abreu.

A client receives individualized therapy based on their specific needs. “Clinicians work with members to help them develop the skills they need to function in their everyday lives. Younger children receive more intensive therapy,” explains Gonzalez-Abreu. “Treatment options can also include group therapy, in which individuals develop their social skills.”
 

Who does the program serve?

Gonzalez-Abreu says, “While our program can and does serve individuals of all ages, it primarily serves children 3 through 8 years old. We also serve children 8 through 12. All program participants require an ASD diagnosis. The earlier participants can get a diagnosis, the better, so that they can get into treatment.”

Case management is the second part of the program, working directly with families touched by ASD. The program provides families education about diagnosis, assists with access to community resources and provider referrals, and facilitates coordination of care. Case management also helps adolescents and young adults transition to adulthood with education and resources.
 

What is unique about Autism Specialty Services?

Gonzalez-Abreu points out the peer aspect of the program. “Our program is similar to a peer-to-peer network in that we partner with the care providers who serve our members. We also offer consultations to our care providers, delivering to them useful feedback. We make suggestions on options to explore and on educational resources,” says Gonzalez-Abreu.
 

How does the program define progress and success?

The program emphasizes ongoing, consistent communication. “We solicit feedback and ask that the care providers resubmit their findings every six months,” says Gonzalez-Abreu. “We look for progress on their patients’ goals, the barriers they are facing, and what they are doing to master them. That way we can see goal mastery and progression.”