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Appendix
ACES Introduces Comprehensive Quality Index Measures of Excellence for Autism, a First-of-its-Kind System to Improve Timely Access and Client Outcomes
Leverages unified, scalable platform and enterprise business intelligence to track and drive improvement in clinical practices and individual outcomes
IRVINE, CA - August 31, 2022 - ACES 2020, LLC (“ACES” or “the Company”), dedicated to enhancing the quality of life for individuals and families impacted with autism or other special needs, today released its first Comprehensive Autism Quality Index Measures. The Center of Excellence (COE) is a time-proven and collective measure of performance excellence for Applied Behavior Analysis (ABA) clinics.
Ashley Drag, Senior Vice President of Clinical Services and Innovation at ACES, said, “Our families deserve the highest quality autism care that has their well-being at the center. The ACES Care Model is designed to provide personalized treatment plans, integrated ABA services and social support for individuals and their families. The Center of Excellence will help us ensure quality across the organization to continuously enhance all components of our care, with the goal of improving outcomes for every client we serve.”
Five individual clinical parameters are weighted and combined into a comprehensive and aligned COE Index. This simplified and common clinical weighting system allows for clinical differentiation, standard quality measurement among ABA clinics and excellence in clinical care.
Combined clinical parameters include: 1) timely access to support and services, 2) comprehensive assessment bundle, 3) established medical necessity, 4) engaging client experience, and 5) meaningful ABA outcomes. The index employs a scoring system for each of the five clinical indicators to establish the relationship between individual/family satisfaction with ABA services, quality of life indices and individual progress towards optimal independence. The COE Index informs clinic leaders of the greatest areas of need based on the leading indicator metrics.
Kristin Farmer, ACES CEO and Founder, said, “For decades, ACES has deeply focused on elevating standards in the treatment of autism. The Center of Excellence model helps us do that with intentionality and structure as we grow to serve more communities nationally across America. Our nationally recognized Clinical Advisory Board has carefully reviewed and endorsed the COE rigor and approach, which draws upon best practices in the autism field as well as best practices in measuring and operationalizing quality in leading healthcare companies across America.”
ACES Center of Excellence Index
Timely Access
Business Days from authorization received to direct service provided
Assessment Bundle
% clients assessed using comprehensive ASD sensitive assessment bundle
Medical Necessity
Client adherence to medically necessary and authorized treatment
Client Experience
Client Net Promotor Score and client satisfaction survey response rate
ABA Outcome
% of clients with stable or rising Vineland ABC Scores
ACES Quality ABA Care Model With Goal of Reaching Independence
Compassionate and Person-Centered Delivery of Care
| 1 | Timely Onboarding |
ACES Welcome Center
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| 2 | Assessment |
Evidence-Based Assessment Bundle
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| 3 | Prescription Level | |
Prescription LeveTreatment Plan & Level for Medically Necessary ABA Requested for Authorization |
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| 4 | Treatment Delivery |
School Community In-Clinic
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| 5 | Population Health Management |
Delivering multi-disciplinary interventions on high-risk patients to improve outcomes and cost
Care Team Alignment Huddles |
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| 6 | Transitions in Care |
Transitions During Care Provide Our Clients with the on-going support they need within and outside of ACES
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Compassionate and Person-Centered Delivery of Care
Care Model Introduction
We have committed to providing hope and delighting our clients and their families with fun, individualized autism solutions for every stage of life. For over 25 years, we’ve partnered with individuals and their families to offer personalized, time-proven care to change the lives of clients of all ages. The comprehensive approach to care begins with an engaging onboarding and assessment experience, whole-family programs with access to specialty services, and transitions to the natural environment at their full potential.
Providers at ACES prioritize coordination of care, and work closely with each family to ensure that their ABA Treatment is integrated into their lives. Caregivers are the experts of their children and family, and we value their input through regularly offered workshops and trainings to assist them with their needs using a consultative approach to parent training.
All components of the ACES Care Model are person-centered, where the client is empowered to take charge of their own health by full participation and input to their ABA experience.
Our purpose is to create a more inclusive society for people with autism, so that every person has the opportunity to live their best life.
Clinical Parameter One
Timely Access
The first clinical parameter is timely access to ABA services.
We noticed it when he was around 19 months. We got him referred when he was around 24 months. It took about 8 months to get in for testing. We went three times for testing. He was almost four years old when he got diagnosed.” - Parent of 4-year old son with ASD
The Autism and Developmental Disabilities Monitoring (ADDM) Network reported that the average age for childhood diagnosis of Autism Spectrum Disorder (ASD) was approximately four and a half years (4 years, 4 months) in 2021. However, 30% of children who met the ADDM Network surveillance case criteria for ASD did not receive a medical diagnosis of ASD by 8 years of age, delaying access to needed services. All too often this is the story for many families in need of receiving ABA services. Timely access to quality care is a top priority reflected in the COE Index.
Timely access to care involves prompt onboarding for referrals leading to the design and completion of comprehensive evaluations of critical domains, development of effective treatment plans, and delivery of needed services. Research confirms children with ASD who gain early access to high-quality ABA services (e.g., 18-30 months), experience greater improvements in ASD symptoms, as well as improvements across intellectual, communication, adaptive, and social behavior functional domains compared to children referred to a less intensive community-based treatment group (e.g., community programs such as speech, occupational therapy, non-comprehensive ABA, or early intervention groups) (Dawson G., et al. 2015). By providing families timely access to care, individuals experience a reduction of socially restrictive behaviors, increases in skill acquisition, and more rapid quality of life improvements.
ACES has a dedicated Welcome Center to assist families with timely access to ABA services through high touchpoint support and seamless transitions into care. Through this supportive onboarding experience, ACES provides direct ABA therapy treatment in less than 15 days1 from the date of authorization.
Additionally, caregivers gain immediate access to Caregiver Collaboration Workshops to receive support for any challenges they may be facing. From the initiation of services, caregiver involvement and training are customized to meet the unique needs of the family. Caregivers work with the ACES Caregiver Collaboration Network Specialists to support the needs of the child and family to navigate real-life challenges, such as responding to challenging behavior, potty training, and social challenges. Caregivers report 95% satisfaction with workshop experiences. It is important to note that early caregiver engagement in ABA services is essential to a positive therapy experience.
Roadmap to Starting ABA Services Through ACES Welcome Center
Clinical Parameter Two
Assessment Bundle
ACES assessment bundle metric in the COE Index is designed to ensure that every individual entering ABA treatment with ACES receives a full ACES assessment. Comprehensive assessment leads to the development of high-quality, effective treatment plans based upon the individual’s strengths and needs, ACES confirms the first assessment appointment for 99% of all clients in less than 15 days2 from authorization.
Over 30 empirically validated assessment tools are available as part of the assessment bundle.
The assessment bundle is tailored to address the unique needs of the individual being assessed.
Common bundle components include behavior, language, and communication, social, cognition, and adaptive domains. Other areas include sleep and feeding concerns. A thorough caregiver interview, records review, and structured observations are incorporated into the assessment process to enhance and inform treatment planning. Ongoing assessments are an integral part of the treatment planning and review processes to ensure treatment effectiveness and optimal outcomes for individuals.
The complexity of ASD requires assessment and treatment planning that is dynamic and responsive to the evolving needs of the individual and their family. ACES is committed to providing the highest level of care resulting in improved independence and positive quality of life outcomes for the entire family.
Beginning the process for accessing ABA therapy can be a challenging time for families. ACES values every day that passes during the assessment process and works diligently to initiate services as quickly as possible.
Assessment Bundle
Clinical Parameter Three
Medical Necessity and Client Adherence
The medical necessity metric of the ACES COE index measures adherence to and effectiveness of medically necessary treatment through full utilization of prescribed ABA therapy services. Treatment adherence positively relates to improved treatment effectiveness and positive outcomes.
The primary goal of ACES ABA therapy is to facilitate meaningful and effective responses to treatment that generalize across all environments and improve the overall wellbeing of the individual. For this to be attained, there must be adherence to the ABA therapy treatment plan.
The first step in treatment adherence is the creation of individualized treatment plans based upon established medical necessity. Once the provider and the care team (including the caregiver and the participant) identify the plan for treatment, an internal review is held to ensure the treatment will be authorized by funding sources to avoid unnecessary delays in access to treatment and prevent gaps in care for the family. Over 99% of all ACES ABA treatment plans are authorized by payors, with payor audit scores also above 97%.
Comprehesive Treatment
Available on Telehealth
With the impact of Covid-19, ACES successfully implemented Telehealth programming for 2,739 clients. Prior to participating in telehealth sessions, clients were assessed using the ACES Telehealth Decision Tree Risk and Feasibility assessment. Clients and their caregivers participated in Parent Training, Program Supervision, and 1:1 direct session via telehealth with a 92% satisfaction rate, and 100% authorization approval rate from insurance providers. Of the clients who engaged in telehealth during the highest COVID restriction period, comprehensive treatment domains continued using virtual care with 86% showing stable or improving trends.
“Our ACES team has been awesome, and we are so grateful for them helping our child maintain her skills during this difficult time of uncertainty. Home sessions are essential to keep my child engaged.” - ACES Parent during COVID lockdown
It should be noted, however, that clients who continued in-person services during the COVID lockdown, had a higher rate of prescription fulfillment than those who did telehealth alone. Clients who receive direct services on telehealth only had a utilization rate of 39.87%. Clients who received direct services in-person only had a utilization rate of 92.5%. Clients who receive both direct services in-person and on telehealth had a utilization rate of 82.63%.
The third parameter of medical necessity and client adherence will ensure that clients are provided continuity of care, with engaging services that will be used to improve their overall wellbeing.
Clinical Parameter Four
Client Experience
The fourth clinical parameter of the COE Index is Client Experience. Over the past few decades, client experiences have gained a prominent place in research on quality of care (Abbeduto et al., 2004; Tint et al., 2016). The perception of the client is instrumental for informing clinical practices of excellence. Client satisfaction and treatment experiences highlight areas in need of improvement, inform individual provider selection, and impact access to treatment.
Additionally, in the field of ABA, client experience can be equated to Social Validity which is the appropriateness and acceptability of ABA interventions as both process and outcome measures (Kazdin, 1977; Wolf, 1978). Thus, the ABA intervention will address socially significant goals. Those involved in the interventions must feel that it is socially acceptable and will produce socially important outcomes for them.
As a part of the COE Index, ACES uses a net promoter score (NPS) combined with client and overall satisfaction surveys (CSAT/OSAT) to monitor client delight and address needs and prioritize areas identified for improving the experience of families.
ACES has the only known Net Promotor Score in the ABA industry of +32.
The survey consists of 5 categories with approximately 30 questions ranging from onboarding experience to clinical care experience to give us a full view of how our care is being experienced.
Statistical analysis of the comprehensive survey showed that the effect size was greatest for the following experiences:
- The team is well trained
- The team helped me better interact with my child
- The team is committed to the success of my child
- I am happy with the progress my child is making
- I trust my ACES Clinical care team
- My child has plenty of opportunities to socialize with peers
- I am satisfied with my Parent Training
- ACES Is easy to work with
- The team openly communicates with me about my child’s progress
Caregivers receiving ACES ABA services report the highest satisfaction with their care teams, including interactions with supervisors. They report feeling valued as a member in their child’s ABA experience, such as having questions answered clearly in a way that is understandable. Caregivers ACES report being happy with the progress their child is making overall. Additionally, caregivers report ACES as committed to the success of their child, and they trust their ACES care team.
Important insights are garnered from the client and family experiences. Incorporating client and family efficacy metrics ensures that our comprehensive care model is responsive to the needs of our clients and their families. For example, caregivers who participate in our specialty service lines see increased progress (increase in treatment goals met) and have higher satisfaction than families who do not (Q1 in-clinic clients resulted in a rating of 45 while in-home rated 15). The question then becomes, how can ACES care teams support families with the majority of ABA therapy sessions provided in the home environment?
It is well known that client satisfaction directly impacts clinical outcomes, client adherence to treatment planning and therapy, efficient and client-centered delivery of quality healthcare services (Prakash, B., 2010). The clinical parameter of the client experience provides the most valuable information: How are families experiencing ACES care?
Clinical Parameter Five
ABA Quality and Outcomes
The fifth parameter of the COE Index is ABA Quality and Outcomes. ABA Quality is measured in the ACES digital Quality Performance Indicator (QPI) tool designed by clinicians, for clinicians, to provide treatment programming feedback using systematic checkpoints across 11 areas of treatment including: Treatment efficacy, caregiver engagement, therapeutic relationships, treatment plan effectiveness, provider time management, and overall session design. This comprehensive QPI is administered by senior clinicians on the care team with proven ability to produce positive treatment outcomes for families. The results of the ongoing QPI evaluative process identify areas of the therapy and services cycle in need of support, course correction, or improvement and leads to greater client impact in response to treatment.
The ABA Outcomes parameter uses standardized assessment scores and treatment goal progression from empirically validated tools to measure client progress and response to treatment in the areas of cognition, motor skills, expressive communication, receptive communication, social, adaptive skills, quality of life, parent stress, and family well-being.
Initial findings are consistent with the existing literature, (Karolyn, 2005; Vietze, 2018) indicating that early intervention is critical for more significant treatment gains. Specifically, clients less than six-years-old (N=836) made more significant gains in all domains compared to any other age cohort using the Vineland Adaptive Behaviors Scales- Third Edition (Adaptive Behavior Composite average change of 3.2, compared to ABC average of 1.3 for children 6 years and older4) from initial assessment to second assessment after treatment (N=434).
Additionally, clients less than six years of age (N=836) made the greatest gains in average changes of the subdomains communication and socialization with 5.8 compared to children 6 years and above (N=434) with an average change of 2.1 and average change of 3.8 compared to 0.6 for the children over six years old respectively. In the area of daily living, the children over six years old made greater gains over the 0-5 cohort. Both cohorts were measured prior to starting ABA services, and again after six months of ABA treatment. It is hypothesized that clients in the 6 years and older cohort made more gains in daily living skills due to the increased opportunities for skills within that age range. Most children in the cohort of 0-5 worked on skills that take longer amounts of time to master (e.g., toilet training) vs skills in the older age range, such as sitting for a meal.
Longitudinal studies are currently being conducted to track client response to treatment across episodes of care to discharge from services. It is hypothesized that significant gains in standard scores /measured by the Vineland Adaptive Behavior Scale-third edition. will be obtained at a faster rate in the cohort less than six years of age than in the children six years or above cohort.
Average Change in Composite Standard Score Post Clients First 6 Months of ABA Treatment (N= 1,270)
Average Change in Sub-Domain Standard Score by Age Post Clients First 6 Months of ABA Treatment (N= 1,270)
In a recent literature review, Towle et al. (2020) described that 12 out of the 14 studies reviewed have at least one finding where earlier age of starting intervention was a statistically significant predictor of better developmental functioning and/or diagnostic status outcome in children with ASD.
"Kolb (2011) argues that such positive outcomes “relate to the early neuroplasticity of the brain with the birth-to-three period is considered peak neuroplastic phase due to the rate of synaptic formation. The human brain is not functionally mature at birth, but requires extensive interaction with the environment (i.e., experience) for elaborated synaptic connections and cortical specialization in combination with genetically programmed neuromaturation. Early intervention can be seen as highly specialized experience that may shape, and even correct patterns being formed during the birth-to-three period.”
It is important to note that ACES serves individuals of all ASD classification types (levels 1, 2, and 3) with and without comorbid diagnoses across the lifespan. Further analysis is needed to show correlation between treatment response of the various subtypes.
Other measures should be considered to measure response to treatment including but not limited to parental stress, quality of life, treatment goals met, overall family wellbeing, accessibility of an individual's ecosystem to name a few. The fifth parameter of the COE Index will aggregate all assessment measures provided to ensure an integrated approach is taken when monitoring the response to treatment of individual clients and cohorts of clients.
Conclusion
Five individual clinical parameters are weighted and combined into a comprehensive and aligned Center of Excellence (COE) Index. This simplified and common clinical weighting system allows for clinical differentiation, standard quality measurement among ABA clinics and excellence in care. ACES COE is published quarterly, with real-time access to the scoring matrices using a unified, scalable platform for self-service and enterprise business intelligence between quarters. This allows providers to monitor and respond quickly to critical metrics. Additionally, each category includes a series of associated micro-metrics (totaling over sixty clinical metrics) to provide a comprehensive view of quality in each respective category. Insights into COE metrics with critical mass are necessary to benchmark performance and set goals for continuous improvement in the delivery of the highest quality, mission-driven ABA therapy services provided by ACES.
Appendix
ACES Clinical Advisory Board
ACES Clinical Advisory Board Members consulted on the design and implementation of the Center of Excellence framework. Meet our Clinical Advisory Board Members here.
ACES Founder and CEO (Chief Executive Officer), Kristin Farmer said, “We are privileged to have the opportunity to work with leading experts in the autism field who have extensive experience in and understanding of evidence-based ABA strategies, and who also share our passion for providing high-quality ABA therapy grounded in research. Working with these innovative leaders who have led advances in the treatment of individuals with autism will equip ACES even better to provide the best possible outcomes for our clients and help to improve ABA services across the country.”
Dr. Mohit Kaushal, M.D.
- Senior Advisor, General Atlantic
- Previous Member of the White House IT task force
- FDA Safety and Innovation Act Workgroup of the Health IT Policy Committee
- National Committee on ital and Health Statistics
- ER Physician
- Adjunct Professor, Stanford University
Dr. Susan Nichols, Ph.D., BCBA-D
- Interim Executive Director, UNT Kristin Farmer Autism Center
- More than 20 years of experience in ABA
- Special education teacher in public school districts
- Professor in undergraduate and graduate courses in the department of Special Education at the University of North Texas
Dr. Heather Hughes, Ph.D., BCBA-D
- 20 years of experience working with individuals with ASD
- Executive Director, Special Programs at Eagle Mountain-Saginaw ISD
- Prior Associate Director of the UNT Kristin Farmer Autism Center
- Prior public-school administrator and Special Education Teacher
Dr. John M. Dougherty, Ph.D.
- Co- fonder TEACCH Autism Program, University of North Carolina
- Over 40 years of experience with individuals with ASD
- Speaker
- Diagnosis and treatment of ASD
- Prior private practice and consultation on quality clinical sacial services
Dr. Peter Gerhardt, Ed,D.
- Executive Director, EPIC School in Paramus, NJ
- More than 40 years of experience using ABA for adolecents and adults
- Author and co-author
- Speaker
- Co-chair af the Scientific Caouncil for the Organization for Autism Research
Learn More About The Center of Excellence Parameters
Timely Access
Centers for Disease Control and Prevention. (2018). Spotlight On: Delay Between First Concern to Accessing Services. Retrieved from https://www.cdc.gov/ncbddd/autism/addm-community-report/index.html
Dawson G, Jones EJ, Merkle K, Venema K, Lowy R, Faja S, Kamara D, Murias M, Greenson J, Winter J, Smith M, Rogers SJ, Webb SJ. Early behavioral intervention is associated with normalized brain activity in young children with autism. J Am Acad Child Adolesc Psychiatry. 2012 Nov;51(11):1150-9. doi: 10.1016/j.jaac.2012.08.018. PMID: 23101741; PMCID: PMC3607427.
Kanne SM, Bishop SL. Editorial Perspective: The autism waitlist crisis and remembering what families need. J Child Psychol Psychiatry. 2021 Feb;62(2):140-142. doi: 10.1111/jcpp.13254. Epub 2020 May 8. PMID: 32384166.
Lord C, Charman T, Havdahl A, Carbone P, Anagnostou E, Boyd B, Carr T, de Vries PJ, Dissanayake C, Divan G, Freitag CM, Gotelli MM, Kasari C, Knapp M, Mundy P, Plank A, Scahill L, Servili C, Shattuck P, Simonoff E, Singer AT, Slonims V, Wang PP, Ysrraelit MC, Jellett R, Pickles A, Cusack J, Howlin P, Szatmari P, Holbrook A, Toolan C, McCauley JB.
The Lancet Commission on the future of care and clinical research in autism. Lancet. 2022 Jan 15;399(10321):271-334. doi: 10.1016/S0140-6736(21)01541-5. Epub 2021 Dec 6. PMID: 34883054.
Smith-Young J, Chafe R, Audas R. "Managing the Wait": Parents' Experiences in Accessing Diagnostic and Treatment Services for Children and Adolescents Diagnosed With Autism Spectrum Disorder. Health Serv Insights. 2020 Jan 27;13:1178632920902141. doi: 10.1177/1178632920902141. PMID: 32063709; PMCID: PMC6987484.
Validated Assessments
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing, 2013.
Filipek PA, Accardo PJ, Ashwal S, et al. Practice parameter: screening and diagnosis of autism. Report of the quality standards subcommittee of the American Academy of Neurology and the Child Neurology Society. Neurology 2000;55:468-79.
Hodges H, Fealko C, Soares N. Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Transl Pediatr. 2020 Feb;9(Suppl 1):S55-S65.
doi: 10.21037/tp.2019.09.09. PMID: 32206584; PMCID: PMC7082249.
Perry A, Flanagan HE, Dunn Geier J, Freeman NL. Brief report: the Vineland Adaptive Behavior Scales in young children with autism spectrum disorders at different cognitive levels. J Autism Dev Disord. 2009 Jul;39(7):1066-78. doi: 10.1007/s10803-009-0704-9. Epub 2009 Feb 21. PMID: 19234777; PMCID: PMC2759870.
Pugliese, C.E., Anthony, L.G., Strang, J.F. et al. Longitudinal Examination of Adaptive Behavior in Autism Spectrum Disorders: Influence of Executive Function. J Autism Dev Disord 46, 467–477 (2016). https://doi.org/10.1007/s10803-015-2584-5.
Medical Necessity
Behavior Analyst Certification Board. (2014). Applied Behavior Analysis Treatment of Autism Spectrum Disorder: Practice Guidelines for Healthcare Funders and Managers (2nd ed.). Behavior Analyst Certification Board. (2019). Clarifications Regarding Applied Behavior Analysis Treatment of Autism Spectrum Disorder: Practice Guidelines for Healthcare Funders and Managers (2nd ed.).
Papatola, K.J., Lustig, S.L. Navigating a Managed Care Peer Review: Guidance for Clinicians Using Applied Behavior Analysis in the Treatment of Children on the Autism Spectrum. Behav Analysis Practice 9, 135–145 (2016). https://doi.org/10.1007/s40617-016-0120-5
Smith, I., Koegel, R., Koegel, L., Openden, D., Fossum, K., & Bryson, S. (2010). Effectiveness of a novel community-based early intervention model for children with autistic spectrum disorder. American journal on intellectual and developmental disabilities, 115(6), 504–523. https://doi.org/10.1352/1944-7558 115.6.504 Virués-Ortega J. (2010). Applied behavior analytic intervention for autism in early childhood: metaanalysis, meta-regression and dose-response meta-analysis of multiple outcomes. Clinical psychology review, 30(4), 387–399. https://doi.org/10.1016/j.cpr.2010.01.008
Vismara L., & Rogers S. (2010). Behavioral treatments in autism spectrum disorder: what do we know?. Annual Review of Clinical Psychology, 6(1), 447-468. https://doi.org/10.1146/annurev.clinpsy.121208.131151
Wong, C., Odom, S., Hume, K., Cox, A., Fettig, A., Kucharczyk, S., Brock, M., Plavnick, J., Fleury, V., & Schultz, T. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45(7), 1951–1966. https://doi.org/10.1007/s10803-014-2351-z
Client Experience
Abbeduto L, Seltzer MM, Shattuck P, Krauss MW, Orsmond G, Murphy MM. Psychological well-being and coping in mothers of youths with autism, Down syndrome, or fragile X syndrome. Am J Ment Retard. 2004 May; 109(3):237-54. doi: 10.1352/0895-8017(2004)109<237:PWACIM>2.0.CO;2. PMID: 15072518.
Al-Abri R, Al-Balushi A. Patient Satisfaction Survey as a Tool Towards Quality Improvement. Oman Med J 2014 Jan; 29(1):3-7.
Tint A, Weiss JA. Family wellbeing of individuals with autism spectrum disorder: A scoping review. Autism. 2016 Apr;20(3):262-75. doi: 10.1177/1362361315580442. Epub 2015 May 6. PMID: 25948599.
Johnson, M. Interactive Specialization: A domain-general framework for human functional brain development. Developmental Cognitive Neuroscience, Volume 1, Issue 1, 2011, https://doi.org/10.1016/j.dcn.2010.07.003
Kolb B, Gibb R. Brain plasticity and behaviour in the developing brain. J Can Acad Child Adolesc Psychiatry. 2011 Nov;20(4):265-76. PMID: 22114608; PMCID: PMC3222570. Mazefsky, C.A., Williams, D.L. & Minshew, N.J. Variability in Adaptive Behavior in Autism: Evidence for the Importance of Family History. J Abnorm Child Psychol 36, 591–599 (2008). https://doi.org/10.1007/s10802-007-9202-8
Miranda A, Mira A, Berenguer C, Rosello B, Baixauli I. Parenting Stress in Mothers of Children With Autism Without Intellectual Disability. Mediation of Behavioral Problems and Coping Strategies. Front Psychol. 2019 Mar 8;10:464. doi: 10.3389/fpsyg.2019.00464. PMID: 30906274; PMCID: PMC6418028.
Reynolds AM, Soke GN, Sabourin KR, et al. Sleep problems in 2- to 5-year-olds with autism spectrum disorder and other developmental delays. Pediatrics 2019;143:e20180492 Rice D, Barone S Jr. Critical periods of vulnerability for the developing nervous system: evidence from humans and animal models. Environ Health Perspect. 2000 Jun;108 Suppl 3(Suppl 3):511-33. doi: 10.1289/ehp.00108s3511. PMID: 10852851; PMCID: PMC1637807.
Schwartz IS, Kelly EM. Quality of Life for People with Disabilities: Why Applied Behavior Analysts Should Consider This a Primary Dependent Variable. Research and Practice for Persons with Severe Disabilities. 2021;46(3):159-172. doi:10.1177/15407969211033629
Silva LM, Schalock M. Autism Parenting Stress Index: initial psychometric evidence. J Autism Dev Disord. 2012 Apr;42(4):566-74. doi: 10.1007/s10803-011-1274-1. PMID: 21556967.
Towle PO, Patrick PA, Ridgard T, Pham S, Marrus J. Is Earlier Better? The Relationship between Age When Starting Early Intervention and Outcomes for Children with Autism Spectrum Disorder: A Selective Review. Autism Res Treat. 2020 Aug 3; 2020:7605876. doi: 10.1155/2020/7605876. PMID: 32832154; PMCID: PMC7421097.
About Autism Comprehensive Educational Services
ACES is dedicated to enhancing the quality of life for individuals and families impacted with autism or other special needs. Founded in 1996 by Kristin Farmer, ACES provides comprehensive, professional services to maximize individuals’ potential in the home, school, clinic, and community using accepted teaching and ABA therapeutic methodologies. ACES operates in more than fifty markets in eight states, serving thousands of clients in Arizona, California, Colorado, Hawaii, North Carolina, Oklahoma, Texas, Utah, and Washington with a long track record of outcomes.
Media Contact: Ashley Drag, M.S., BCBA 1-13-13934 adrag@acesaba.com
ACES Quality Index Measures of Excellence Improves Timely Access to High Quality ABA Therapy
ACES Is Setting the Standards
ACES Quality Index Measures of Excellence Improves the Assessment Experience for families and Leads to Measurable Outcomes.
Medical Necessity and Adherence
Increased Demand for Applied Behavior Analysis Therapy Highlights Need for Personalized Treatment Plans and Targeted Outcome Goals .
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1 Data reflects assessment to tratment client receiving and participating in services from January 2021 through July 2022.
2 Data reflects assessment to tratment client receiving and participating in services from January 2019 through July 2022.
3 Data reflects payor audits from January 2020 through July 2022 of clinical documentation, on going treatment planning, services delivery, discharge, and transition planning.
4 Data reflects client cohorts between agesages 6 to adulthood. When looking at assessment results from initial assessment to the first assessment after a 6 month initial treatment period.
