MR DOSZPOT: Thank you, Madam Chair. Under output 1.2, therapy services, budget book 4, page 376—and, minister, I direct this question to you—does the Department of Disability, Housing and Community Services have any employees who are a board certified behaviour analyst, BCBA, or a board certified associate behaviour analyst, BCABA? And if so, how many and in what roles?
Ms Burch: Thank you, Mr Doszpot, for that technical question. I might ask Ros Hayes if she can answer that or we might have to take that on notice. I am not quite sure. It was quite a technical descriptor of staff.
Ms Hayes: We do not actually use the ABA intervention method and therefore I do not keep a record of staff who are qualified in that area. But I am aware that one of the psychologists who work in our autism team does have those qualifications. But I am not sure at what level.
MR DOSZPOT: Are you aware how much it would cost to employ such a certified behaviour analyst?
Ms Hayes: As I say, we employ clinical psychologists and not people who are qualified in that because it is not an intervention technique that we use.
MR DOSZPOT: For each year of the last decade—and I know you probably cannot give me this answer instantly, but if you could give us a response I would appreciate it—how many children with autism accessed the services of, if not BCBA or BCABA therapists, other therapists employed by the ACT government?
Ms Burch: Did we not just say we do not use that?
MR DOSZPOT: That is why I said any other form of therapy.
Ms Hayes: Any other therapy? So the number of children with autism diagnosis who have accessed therapy services over the last 10 years, is that it?
MR DOSZPOT: By year for the last 10 years, yes. And I do not expect to have that answer now.
Ms Hayes: No. I can give you this year but I cannot give you the last nine years.
MR DOSZPOT: Sure.
THE CHAIR: So what is the answer for this year?
Ms Hayes: This year, there are 377 children with a diagnosis of autism who are accessing therapy services. And I would add to that that we collect that information by primary diagnosis. So for some people, the primary diagnosis may actually be an intellectual disability diagnosis rather than an autism diagnosis. And for some younger children, they may not yet have a formal diagnosis. They may still be in a group of children that we consider to be developmentally delayed, who do not yet have the diagnosis.
So the number is 377 plus some who would be—because you are probably aware, intellectual disability and autism are often co-morbid conditions—in another group in there. And for the little ones, a number of little ones will go on to get a diagnosis of autism.
MR DOSZPOT: And would you have an idea of how that compared to last year’s figures?
Ms Hayes: It is a slight increase over last year’s figures.
MR DOSZPOT: And does the department provide 1,000 hours per year of intensive autism-specific clinical intervention, which is apparently best practice according to the commonwealth health department for children with autism in the ACT?
Ms Hayes: No.
MR DOSZPOT: Okay.
THE CHAIR: What is the number of hours that each child would receive in clinical services?
Ms Hayes: We do not have a single program for individual children. So the amount of hours of therapy that they receive is very much dependent on individual needs and on the family situation and on what the family’s current issues might be. We will be working with the family intensely for a period of time, particularly around the time of diagnosis and immediately after that, particularly the first 12 months after diagnosis. Thereafter the number of hours of service will be variable, depending on what is happening for that child in that family, where they are with their schooling, where they are with particular family issues. Ours is not a prescribed program of intervention.
Mr Hehir: I think it is also worth clarifying that the 1,000 hours, which translates roughly from 20 hours per week—and I recall the previous answer—are actually not exclusively required to be with a therapist. It is actually intended to reflect work in the home that the family can do, work at school that the teacher can do, work in a variety of settings. It is important to make sure that people understand what are the appropriate responses. And I think we did actually clarify that with the authors of the report. The intent is that it does not actually have to be with a therapist. It is that a broad therapeutic approach is applied.
Ms Hayes: That is correct. So the report that said that 20 hours of intervention per week is ideal for young children with an autism diagnosis does not say that that has to be one-on-one therapy time. And in fact, there is quite a deal of research now that the most effective intervention is done by families and is done in circumstances where the child is naturally, rather than in a fairly artificial therapy environment, because one of the hallmarks of autism is an inability to generalise.
People with autism are very concrete so that “this is what I do in this situation” does not necessarily translate to “I do that in another situation”. So it is, in fact, much better for the therapeutic strategies to be implemented where a child is. And that is, in the ordinary circumstances—at home, at bath time, at mealtime, driving in the car, going to school, in all of those circumstances—parents are being consistent, utilising the right kinds of responses, being aware of how they will best help their child develop and deal with their disability.
MR DOSZPOT: So you are saying that clinical intervention broadly can encompass parental intervention as well?
Ms Hayes: Yes, because there is nothing particularly magic about what a therapist does. It is something that other people can learn to do as well. And effective intervention can certainly be done by families, and most is.
from http://www.hansard.act.gov.au/hansard/2009/comms/estimates21.pdf