ABA Therapy, Medicaid, & LCSWs

ABA Therapy, Medicaid, & LCSWs

What is an LCSW?

A licensed clinical social worker (LCSW) is a state-certified social worker with at least a master’s degree in a social work program. Each LCSW must also pass a national examination. LCSWs have extensive professional training in their field (minimum of 2 years & 3,000 clinically-supervised hours after receiving a master’s) and specialize in mental health.

The mental health aspect of social work is what separates an LCSW from other social workers. 

How do LCSWs Help with ABA Therapy?

LCSWs work with clients to secure services from the state they are certified in. This includes securing Medicaid coverage for ABA Therapy and related services. LCSWs work doesn’t stop at securing health coverage, however; they also oversee case & client management and evaluate progress.

LCSWs are able to make recommendations and keep an eye on if their recommendations are working as intended. LCSWs are able to do the following in tandem with ABA therapy and services:

  • Case Planning & Management
  • Implementing and overseeing ongoing cases
  • Evaluations of case progress
  • Recommendations based on evaluation results
  • Social skills groups to support the social goals of ABA therapy
  • Supporting the entire family unit with resources and community outreach

LCSWs talk to both the families of clients and the BCBAs (or other certified behavioral health professionals) to create a clear picture of a client’s needs.

LCSWs & Medicaid

Medicaid plans typically cover both social work and mental health services. An LCSW working with Medicaid is able to secure coverage for ABA therapy services. LCSWs are able to make great recommendations due to their mental health expertise, which includes:

  • Mental health treatments & programs
  • Clinical supervision of ABA treatment plans
  • Family & social functions
  • Interpersonal relationships
  • Systems–both systems theory and first-hand experience
  • Family intakes
  • Family education (working with families to understand treatment programs)
  • Outreach

ABA Therapy from IABA Consultants

IABA consultants is now accepting All Kids Medicaid! 

Medicaid Clinic Timeline:

  • Oak Lawn: Current
  • Naperville: May 2022
  • Glenview: Summer 2022
  • Managed Care Plans: Summer 2022

Dates are tentative and may be subject to change.

For details and coverage information, find the location closest to you and give us a call or send us an email.

If you have questions regarding autism treatment, education, or plans to use ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Autism Diagnosis Criteria Reference

Autism Diagnosis Criteria Reference

Note: This short article was primarily put together for reference. The actual process for diagnosing ASD is much more complex than just the steps and areas of note published in the DSM-5. Only medically-licensed professionals are able to properly diagnose ASD and any co-occurring conditions. This article is meant for reference use only and is not intended to provide medical advice.

Getting a proper autism (ASD) assessment or diagnosis may seem complicated, but in reality, only a few specialists need to be contacted in order to set up an evaluation. Autism diagnoses can only be given by a select group of medically-licensed professionals. The professions that can give an autism diagnosis include:

  • Developmental Pediatricians
  • Pediatric Neurologists
  • Child Psychiatrists
  • Child Psychologists

The American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes guidelines professionals use to look for signs of ASD.

What is Observed for an Autism Diagnosis

The DSM-5 specifies five areas that need to be evaluated for an ASD diagnosis.

Persistent Deficits in Social Communication  and Social Interaction Across Multiple Contexts

The first area observed by doctors looking at a potential ASD diagnosis focuses on social issues. Please note that this is a list for reference–only medically licensed professionals can make a proper diagnosis for ASD. There are a few specific things that need to be carefully observed:

  • Deficits in social-emotional reciprocity.
    • Abnormal social approaches
    • Failure to have a reciprocal conversation
    • Lack of sharing interests
    • Lack of emotions
    • Failure to respond to social queues and interactions
  • Deficits in nonverbal communicative behaviors.
    • Poor communication (nonverbal and nonverbal in tandem with verbal)
    • Lack of eye contact
    • Abnormal body language
    • Lack of facial expressions
    • Unable to interpret gestures
  • Deficits in developing, maintaining, and understanding relationships.
    • Difficulty adjusting to varying social situations
    • Difficulty with play or making friends
    • Lack of interest in peers

Restricted, Repetitive Patterns of Behavior, Interests, or Activities

Doctors look for specific patterns or combinations of behaviors, interests, and activities to help guide an autism evaluation.

  • Repetitive motor skills, movements, speech, or use of objects.
    • Repeated gestures or motions
    • Specific, repetitive organization
    • Repeated idiosyncrasies 
  • Insistence on sameness.
    • Inflexible to routine changes
    • Ritualized patterns
    • Rigid thinking or action patterns
  • Highly restricted or fixated interests.
    • Strong attachments or preoccupations with unusual objects
    • Excessive use or focus on a specific object
  • Hyperactivity to sensory input.
    • Indifference to pain or extreme temperatures
    • Adverse reactions to specific sensory stimuli
    • Excessive fascination with sensory stimuli

ASD Symptoms Over Time

ASD symptoms must be present in early development but may not manifest fully until social demands exceed limited capacities or are masked by learned strategies later in life. The DSM-5 notes that some symptoms of ASD can only become apparent later in life, as an individual is forced to interact with more of the world. These symptoms alone may not be enough for an ASD diagnosis if no symptoms were present in an individual as a child.

Significant Social Impairments

Records of ASD symptoms causing clinically significant impairment in social, occupational, or other areas of functioning. Medical professionals performing ASD diagnoses will look at social interactions and any impairments. Accepted social queues, communication, and other social stimuli will be used to evaluate.

No Evidence of Intellectual Disability

ASD evaluations must have evidence to rule out other diagnoses of intellectual disabilities. Although ASD frequently occurs alongside other intellectual disabilities, the diagnoses must be made separately. Social factors such as communication are commonly used to differentiate ASD from intellectual disabilities but are not always the case.

Use of Autism Diagnosis Criteria Reference

This short article was primarily put together for reference. The actual process for diagnosing ASD is much more complex than just the steps and areas of note published in the DSM-5. Only medically-licensed professionals are able to properly diagnose ASD and any co-occurring conditions.

The guidelines in the DSM-5 are also useful as a quick reference for things to notice in a young child’s development. Again, only medically-licensed professionals can diagnose ASD, but parents must take note of any developmental abnormalities as a child ages.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

What to do After an Autism Diagnosis

What to do After an Autism Diagnosis

If you have had a child diagnosed with Autism (or ASD), it can be tough to know what to do next. The developmental pediatrician or clinical psychologist that diagnosed your child may have given you some starting points for your child, but what else should you know?

Let’s take a look at things you should know about before considering certain developmental programs and options for your child.

Diagnostic Levels of Autism

The first thing you should take note of is the level of your child’s symptoms and abilities in regards to the autism spectrum. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists 3 levels of severity for autism spectrum disorder:

  • Level 1 – Requiring support. Level 1 is typically defined by inflexible behavior in multiple contexts, difficulty switching from one activity to another, and problems with organization & planning.
  • Level 2 – Requiring substantial support. Level 2 is typically defined by difficulty with changes to routines, repetitive behaviors that interfere with everyday activities, and distress or difficulty changing attention or actions.
  • Level 3 – Requiring very substantial support. Level 3 is typically defined by extreme difficulty coping with changes, restrictive or repetitive behaviors affecting many aspects of a daily routine, and major difficulties changing attention or actions.

Each diagnostic level of autism requires different plans for proper action to be taken. 

ASD Services

There are many services available to help individuals with ASD. Many of these services can work in tandem to create a cohesive plan to help with many aspects of autism. Some of the areas to start looking for help with a new autism diagnosis include:

  • ABA Therapy (only evidence-based)
  • Speech Therapy
  • Occupational Therapy.
  • Individualized Education Programs.

Many ASD service providers cover several of these areas and can help point you in the right direction for services they don’t provide. Having a plan with communication between service providers is essential for providing adequate care. If you need to see multiple therapists make sure they share reports with each other–using conflicting therapy methods and tools may not work as intended. Consistency and communication are necessary!

Working with ASD at Home

Aside from professional help, there are many things parents can do at home to help a child with autism learn and develop. These are general good practices to add structure and stability to the home life of a child with autism. Make sure to maintain good communication with any ASD service providers to ensure both you and the professionals are teaching your child the same thing!

Add Structure

Simply scheduling consistent activities on a day-to-day basis can greatly reduce negative reactions to change at home. Getting settled in a scheduled routine is a great way for a child to know what to expect each day. Scheduling can include chores, meal times, bedtime routines, playtime, learning time, errands, and anything else that needs to be done on a regular basis.

Use Visual Aids

Using visual aids can help children with autism learn and digest information more efficiently. Providing imagery for tasks or events can help a child understand what is happening or what they need to do. Using visual aids in tandem with a scheduling calendar is also a great tool that may be easy for a child with ASD to understand.

Learn & Control Sensory Issues

Many individuals with autism have certain sensory issues. These sensory issues can be triggered by any of the 5 senses. Learning what causes certain undesired behaviors or outbursts can help you avoid situations at home. Make sure that the whole family and any guests are aware of any sensory triggers.

Encourage Communication

Children with autism usually have a range of language limitations or delays. Due to their lack of verbal, complex, or social communication children with autism will often engage in problem behaviors to get their needs met. Learning small steps stones of communication with your therapy team and encouraging them with your child will help promote their self-advocacy, decrease tantrums, and increase their communication skills.

Follow through with Demands

Oftentimes, because of limited communication skills, children with autism say, “no!” with their behaviors in big ways. Parents are often, and rightfully, overwhelmed giving into their child’s behaviors because it is how they are communicating. However, as language is being promoted it is important to provide consistent boundaries to decrease tantrums and other harmful behaviors like self-injury. 

There are many other things that can be done to help with behavioral issues, but they should be given to you by your child’s ASD service provider(s). Making sure things stay on a consistent schedule and being aware of your child’s needs & triggers can go a long way in smoothing out life at home. It is important to only follow the recommendations of a Board Certified Behavior Analyst when choosing and implementing a behavior intervention plan.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Underneath the Bursts

Underneath the Bursts

This past week I wrote to you about setting boundaries with our children. In my blog, I wrote about the importance of boundaries for the emotional development of children. I also wrote to you about my own struggles in setting boundaries as a mama. One of the main reasons I struggle with setting boundaries for my own children is the (out)bursts that come with it.

It just so happens that as a clinician one of my primary areas of specialization is problem behaviors (the bursts). It’s what I went to graduate school to study over a decade ago. Over 10 years later and I can tell you the science of reducing problematic behaviors hasn’t changed. My own journey applying clinical skills at home, of course, has not (well, not totally). Today I’d like to write to you about both.

ABA & Bursts

Let’s start at the beginning with ‘burst science.’ Applied Behavior Analysis teaches us that social behaviors, both positive and negative, can be broken into units that can be studied. In studying units of behavior, BCBAs are able to identify the function of behaviors (why behaviors occur) and missing skills in the child they are studying. When it comes to reducing problem behaviors, behavior analysts are looking for why the behavior is occurring. This involves looking at what is happening before the behavior and what happens after the behavior.

While studying the environment before bursts occur, BCBAs look for a deficit in the child’s environment. What are they missing? Studying environments after bursts allow BCBAs to see if the child’s problem behaviors filled the deficit. If they did, the child is successfully using the problem behavior to get their needs met. This means the problem behaviors are being reinforced and will continue to occur. Magic I’m telling you. Magic.

You see, by studying what a child is seeking in a specific environment you can create interventions that fill the child up with what they are seeking to immediately decrease the problem behaviors. This isn’t a long-term solution, but it creates a short-term solution to make the days easier for the child and their families. While the child is being satiated BCBAs work on teaching new skills surrounding the child’s needs. This always looks like teaching functional communication skills, how to ask for exactly what you need.

Sometimes teaching specific skills can look like teaching patience and tolerance to ‘no’ when what the child wants isn’t good for them to have all the time. For example, if a child is throwing tantrums to get access to candy it’s damaging to have non-contingent candy all of the time. But if a child is tantruming for positive attention, we can fill them up without having to teach tolerance to no. Though we might have to teach waiting because sometimes mama (or papa) is busy.

The key to this remedy is to also remove reinforcement when a child is using their problem behavior to get their needs/desires met. If, in the scenarios above, the BCBA is providing candy (one piece) every 30 minutes and within 15 minutes the child hits to get access to the candy the BCBA cannot give the child the candy. If they do they will reinforce the hitting and take the motivation away from using words. It is here, in this little sweet spot of the behavior intervention, that bursts occur. Let’s talk about that.

Why Do Bursts Occur?

Underneath the bursts for children (and adults… more on that later) is fear that their needs/desires won’t be met. The bursts occur because, in the child’s mind, that very thing they want could become unattainable, their need won’t be met, and they will have to experience negative emotions. Dealing with both the fear of a need/desire not being met alongside psychologically negative emotions is tough stuff for a child. This right here? This is the hard part for parents and the sweet spot for teaching emotional resilience and intelligence.  

As a mama, I know firsthand how easy it is to give in. To not want to deal with the temper tantrum, the screaming, and the crying. We are human beings and crying children is not comfortable. When we give in as parents at a given moment it provides immediate relief to ourselves and our children. It also perpetuates the very behaviors we don’t want to see more of and does not teach our children how to deal with the big emotions. 

About a year ago Henry and I were at Dametrius’s football game and Henry wanted candy from the concession stand. I had packed snacks and knew sugar was on the menu later so I didn’t want him to have extra candy. I leaned down and told my little son, “no, not now we’ll have dessert at dinner”. Of course, in public, a full-on tantrum occurred. At that moment I thought how perfectly aligned this example was. You see at that moment I could have made a concession at the concession stand by just giving in. If I gave in Henry would happily watch the game and I wouldn’t have to be teaching Henry to breathe and tell me how he feels. But giving in also meant teaching my son to numb his emotions with food and that screaming works. So I stood my ground and worked with Henry.

You see under the bursts, as we are teaching boundaries. As children burst, their hearts need to know they can ride through negative emotions and still be safe on the other side. That nothing bad comes from feelings and that needs can be met in new ways. To me, as a clinician, I know that working through the bursts creates long-lasting, positive, change. As a mama, teaching my children to ride what is underneath the bursts is more valuable than any concession I could make at any given moment.



The Differences Between ASD and Social Anxiety

The Differences Between ASD and Social Anxiety

On the surface, social anxiety disorder and autism spectrum disorder (ASD) may look the same. Both people with autism and those with social anxiety can experience social situations differently than others.

While social anxiety and ASD can occur together, they are very different conditions. In some cases doctors even get the two mixed up, leading to misdiagnosis.

Let’s take a look at both the similarities and differences between ASD and social anxiety.

Similarities of ASD & Social Anxiety

A major similarity between social anxiety disorder and ASD is that both conditions look different in every person. With that said, there are plenty of similarities, including symptoms and treatment services offered. It’s also important to understand that social anxiety is not a form of autism and vice versa.

Similar Symptoms

One reason social anxiety and autism are sometimes confused is that some symptoms appear the same.

According to some educational psychologists, overlapping symptoms of autism and social anxiety disorder can include:

  • Limited social communication
  • Nervousness
  • Difficulty adapting to changing plans
  • Lack of eye contact

ASD & Social Anxiety Diagnosis

A psychologist can diagnose autism and/or social anxiety disorder using the Diagnostic and Statistical Manual of Mental Health Disorders 5th Edition (DSM-5). The DSM-5 is a handbook published by the American Psychiatric Association that helps healthcare professionals make diagnoses.

A healthcare professional will ask about symptoms and may observe a person in social situations before making a diagnosis. Sometimes a pediatrician or physician will recommend seeing a healthcare professional who can properly diagnose ASD, social anxiety, or other specific mental conditions. Ask your doctor for more information.

The DSM-5 diagnostic criteria for autism include:

  • Persistent differences in social communication, including but not limited to lack of back-and-forth conversations and differences in eye contact
  • Repetitive patterns of behaviors, such as lining up toys
  • Symptoms were present in early development, even if they went unnoticed
  • Symptoms interfere with daily functioning, such as schoolwork

The DSM-5 diagnostic criteria for social anxiety disorder include:

  • Fear of judgment in social situations
  • Consistent anxiety in social situations that does not fit the context
  • Avoidance of social interaction
  • Fear of social interaction that impedes day-to-day life
  • Having fear for at least 6 months (and the fear cannot be attributed to another mental health condition, such as panic or substance use disorder, or a disease like Parkinson’s)

Note that social anxiety can develop in children or adults.

ASD & Social Anxiety: Brain Functions

The amygdala, which affects the brain’s response to fear, may play a role in both ASD and social anxiety disorder. Research is still ongoing. Ultimately, however, brain functioning is very different in social anxiety and ASD. The neurological causes of autism aren’t yet fully understood.

Treatment for ASD & Social Anxiety

There’s no cure for social anxiety or autism. In addition, not everyone wants to “manage” or “fix” characteristics associated with autism. People can live fulfilling lives with customized support and treatment tailored to their goals.

Treatment and support options for ASD include:

  • Applied behavioral analysis (ABA) therapy
  • Occupational therapy
  • Social skills training
  • Cognitive behavioral therapy
  • Occupational therapy*

*Occupational therapy is often a first-line service for autism. It may also be used to help people cope with social anxiety in some cases.

High-Functioning Autism Vs. Social Anxiety Disorder

The current diagnostic process for ASD involves three potential levels of support needed:

level 1: requiring some support

level 2: requiring substantial support

level 3: requiring very substantial support

Autism is neurologically based, which makes it different from social anxiety disorder, regardless of communication abilities or any overlap in symptoms.

Differences Between ASD & Social Anxiety

The main difference between ASD and social anxiety is that autism is a neurodevelopmental condition, while social anxiety is a mental health condition. Experts say it’s essential to get the diagnosis correct.

Though a formal diagnosis is best made by a licensed professional, understanding the differences between social anxiety and autism can empower parents to seek an evaluation. Because autism and social anxiety are distinct conditions, they have nuanced symptoms and diagnostic criteria.

ASD & Social Anxiety Symptoms

People with autism and those with social anxiety alike may seem to avoid eye contact. Importantly, however, autistic people aren’t necessarily “avoiding” eye contact out of nervousness or fear. They’re simply not making eye contact in the first place, which is a distinct difference.

Researchers have suggested that individuals with autism look toward a person more slowly, while people with social anxiety look away faster. ASD is a spectrum, meaning people may communicate in different ways. Some may not speak at all, while others may engage in one-sided conversations or miss social cues.

On the other hand, people with social anxiety intentionally avoid conversations because of fear.

Social anxiety can be the result of trauma. A brain dealing with social anxiety may be compensating for something that happened or trying to prevent something from happening reoccurring. Social anxiety is different from autism because autism isn’t triggered by an event, experience, or trauma.

ASD & Social Anxiety Brain Functions

The amygdala may be implicated in both autism and social anxiety disorder, but current research supports the idea that autism is neurodevelopmental. There are comprehensive conclusions available concerning what causes ASD, but research is ongoing.

Social anxiety, on the other hand, is mental-emotional.

Please note that all of this information is for reference only. If you are concerned about your child, please contact your pediatrician or a mental healthcare specialist.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Originally Posted as How to Tell the Difference Between Social Anxiety and Autism at Healthline.com