AOTA Presidential Blog

At the Table

In my presidential addresses, I have emphasized that occupational therapists need to be at the table where policy and important recommendations are made. This year, I have experienced more intensively than in the past what it is like to be engaged in this kind of public service.

 

For example, I was appointed to the California Department of Managed Care Autism Advisory Task Force. AOTA and the Occupational Therapy Association of California successfully advocated to have occupational therapy listed in California Senate Bill 946 among the “behavioral health treatments” provided for individuals on the autism spectrum. The bill mandates that no later than July 2012, every health care service contract and health insurance policy that provides medical or surgical coverage shall also provide coverage for behavioral health treatment for pervasive developmental disorder or autism. 

 

In conjunction with this law, our task force is charged with two goals. The first is to identify the behavioral health treatments that are scientifically based and how their outcomes are monitored. The second is to determine the definition of an “adequate network of providers” and make recommendations on the qualifications unlicensed individuals must meet for provision of these services.

 

At the first task force meeting last week, I was impressed by the stature of the other members of the committee. Here’s an overview of the group:

 

Members-at-large

·    The former director of the California Department of Finance

·    A federal court judge with 27 years of experience in this role

·    A distinguished professor and dean of a law school

·    The former assistant secretary of the California Health and Human Services Agency

 

Health Plan Representatives (all physicians)

·    The chief medical officer for external affairs of United Behavioral Health

·    The chief medical officer of Blue Shield of California

·    The regional director of Pediatric Subspecialties and Pediatric Rehabilitation of Northern California Kaiser Permanente

 

Research Experts

·    The former executive director of the M.I.N.D. Institute, who is now professor and vice chair of psychiatry at the University of California, San Francisco

·    The Joseph Campbell Professor of Child and Adolescent Psychiatry at UCLA-NPI-Semel Institute

·    The director of the Anderson Clinic at Langley Porter Psychiatric Institute, UCSF

Advocates

·    A multiple award-winning attorney, who is founder of one of the largest African-American law practices in Southern California, author of The Everyday Advocate: Standing Up for Your Child with Autism and Other Special Needs, and appears on Dr. Phil, the CBS Early Show and numerous Fox News programs

·    The former Secretary of the California State Senate, who founded the support group Families for Early Autism Treatment (FEAT)

·    The co-founder and president of Autism Deserves Equal Coverage

·    The vice-president of State Government Affairs of Autism Speaks

 

I am included as a representative of treating providers. Among us are a developmental-behavioral pediatrician, a behavioral services provider who is a board certified behavioral analyst, and an occupational therapist (me!).

 

The task force is chaired by the director of the California Department of Managed Care. We have eight remaining meetings scheduled through August, when our report is due, and I anticipate this will be another broadening experience for me.

 

I would love to hear any tips you have on how I can be a highly effective member of this task force.

 

Posted: 21 Feb 2012 2:59 PM by Florence Clark | with 5 comment(s)
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Comments

Bill Wong said:

This really stumps me.  So, here goes nothing.

1. Bring some great studies that shows OT is an effective option for some people with autism.

2. Use the OTPF- and explain how OT can help people across the entire autism spectrum.

3. Mention AOTA's centennial vision- since autism is a highlighted area of our centennial vision.

4. Last but not least, I will say have an open mind when you listen to people from different perspectives- it might not be surprising that there could be some contrasting viewpoints within the task force.  But then, I will take sort of a middle of the road stance on the issue, as your opinion should mainly based on what OT does for clients in this population, then I will consider the rest of the perspectives and come up with what you should say accordingly.

# February 21, 2012 1:49 PM

Bill Wong said:

Add on to my earlier post-

Apparently the autism community has caught on about this, which I saw this on facebook earlier today.  One thing they expressed disapproval is that there are no individuals with autism on that task force.  They feel that having an ally (which they think OT is because of me) is not enough.

# March 5, 2012 8:38 PM

Emily L. Vaught - Chairperson, ASD said:

Florence, I hope that you will discuss the importance on the continuum of care and family education/training with regard to working with families of children on the Autism Spectrum! And, very importantly, sensory processing/sensory integration as a therapeutic approach! We, as OTs, know how vital this area is to manage behaviors, increase functional communication, and for modulation of the 7 sensory systems... But this is an area that is very unknown to the general public, and even other disciplines!

I know that you will represent us well on this task force, and I look forward to seeing the fruits of all of the hard work this team will produce for the ASD community.

Emily L. Vaught, ASD Chairperson

2012 AOTA Emerging Leader

# March 6, 2012 1:50 PM

Christopher J. Alterio said:

Dear Dr. Clark,

In my opinion AOTA missed an important opportunity in 2009 to advocate for the many evidence based interventions that OTs use for people who have autism when responding to the National Standards Report published by the National Autism Center.  

The 2009 AOTA response was a lengthy rebuttal focusing on sensory integration when there were MANY other examples of OT interventions that were supported by the document (including social stories, relation/interaction approaches, behavioral approaches, and functional skills training).  

I certainly don't mind seeing advocacy regarding our sensory research but if we focus the conversation too narrowly we will not send the message that OTs can use a number of different intervention strategies, many of which are well supported in the literature.

As a practicing clinician I have to fight the stereotype that all OTs do in pediatrics is sensory-based interventions.  That is an extraordinarily limited perspective on all that we do and I strongly urge AOTA to publicize the fact that OTs are trained in and in fact intervene with a number of different models.

As California is a large state there is a good chance that other states will look at the work done by this committee - and it could have broad impact.  This underscores the importance of advocating broadly for OT and not just advocating for sensory interventions.

One final point - I encourage strong advocacy for our qualitative research base as well - most qualitative studies were omitted from the NSP.  I am hopeful that with the help of Dr. Tomlin's work on the 'Research Pyramid' model that we have an opportunity and justification to increase awareness of our qualitative research base and the very critical role OTs play from a narrative constructional perspective in helping parents and families.

Thank you for your efforts.

Christopher J. Alterio, Dr.OT, OTR

# March 6, 2012 3:18 PM

Bill Wong said:

I think both qualitative and quantitative research are needed, Chris.  Also, where are the research for adults on the spectrum?  Plus, as I mentioned on Amy Lamb's blog the other day, the autism community is pretty concerned about the impending changes to DSM V.

I think our profession has made some great strides forward in the area of autism in a relative sense.  But in the autism community's eyes, I think they think we are still relatively short.  My view is right in the middle of those two.  Having been to the recent Autism West conference, I am happy about the profession's direction for autism.  However, we still have lots of work left to do.  It will be take a collaborative effort from the old vets and the young guns to make it happen.

# March 6, 2012 10:30 PM