Friday, July 16, 2010

You Reap What You Sow

Autism Ontario has appointment Dr. Joanne Reitzel to the Autism Ontario Board of Directors.  This has proven controversial to many parents because Dr. Reitzel is the clinical director for a regional autism program in Ontario.  Her primary job revolves around whether or not children continue or get booted from early intensive behavioural intervention services.  I wrote Autism Ontario on this topic, and I was pleasantly surprised with a reply from the chair of the board.  She acknowledged I wasn't happy about the appointment, but carefully explained the process of nominations and election, as well as conflict of interest.

Here is an older article excerpt, source here:
As parents across the province rally against wait times for an intensive and effective autism treatment, a Delhi father is demanding answers. David Mels has a five-year-old son, Adam, who is on the severe end of the autism spectrum. He doesn't speak, isn't potty-trained and his gross and fine motor skills are delayed. Adam was denied eligibility to the intensive behavioural intervention (IBI) therapy - a vigorous program funded by the government. The program helps children learn skills using repetition in a one-on-one setting. Mels appealed the decision made by a panel of regional clinical directors, psychologists and doctors at the Hamilton Niagara Regional Autism Intervention Program. The panel decided that Adam's autism was too severe for him to benefit from the therapy. "An independent party upheld their decision," Mels said. "But I want to know why he is ineligible. Show me the clinical and objective proof that says he won't benefit from this therapy. They have yet to show me that." The Autism Intervention Program Guideline, last revised in February 2007, says that intervention services are for children with "autistic disorder or a disorder considered to be towards the more severe end of the spectrum." Dr. Jo-Ann Reitzel, clinical director at the program, said IBI doesn't work with every child. "Every child with autism is unique," she said. "We do a thorough assessment of the child's development, physically and mentally, and identify the appropriate treatment that match the child's needs." If IBI isn't suitable, there are other therapies, although most aren't government funded. Mels believes the government is denying eligibility because it doesn't want wait list to grow. Dr. Joel Hundert, a psychologist with the Behaviour Institute, a private clinic that offers IBI therapy, said many parents feel the same frustration as Mels. "Because eligibility criteria is not objectively stated, it's hard for parents to understand why their children aren't eligible." He said the program is the preferred therapy for kids with autism. "It has hard research and measurable outcomes that proves its success," he said. But he added IBI therapy works best with children with a moderate case of autism. Mels said if he can't get help for his son within the year, he's going to sell everything and move his family to Alberta. "I've been looking into it and it seems they have more accessible funding out there," he said. He has explored private clinics like Hundert's but is unable to afford it without help from the government. "I'd rather move than go bankrupt," he said."
The reason parents are angry is because government assistance for autism in Ontario is focused around a narrow band of kids with moderate-severe autism.  If IBI does not work fast enough, the child is deemed too severe and is discharged.  If the child is too high functioning they are ineligible.  The claim is that "other more appropriate services" will be offered if IBI is not suitable but there's really nothing available, as mentioned by Dr. Reitzel in this excerpt and here in a research announcement.  I don't really get why non-intensive ABA is not offered to those on the very severe end of the spectrum.

So it this makes Dr. Reitzel an easy target.  She is just doing her job, and part of that is minimizing costs and easing the waiting list.  Every child discharged allows another to come off the waiting list, which is always a political hot potato in an election year.

I still feel that given her involvement in the politics of IBI in the province that she is not suitable to sit on the board.  However, there was democratic process, it was followed and she was elected.  I cannot disagree with this process and one can certainly not say Dr. Reitzel is not an expert on ABA therapy for autism.  I do hope she recuses herself from matters involving early intervention policy for Autism Ontario.

1 comment:

  1. Dr. Reitzel should explain to families why they are told there is a wait list at all, when she stopped service altogether in 1999 to 2000. Chedoke was not taking any children for IBI, servicing no one at all; yet telling parents they were on a wait list.