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Some ABA Clinics Close, Move To Telehealth To Keep Social Distance

A behavior therapist works with a child who has autism spectrum disorder. She has her hands over his hands, guiding him to color.
Daylina Miller/WUSF Public Media
A behavior therapist works with a child who has autism spectrum disorder.

Behavior clinics that serve children on the autism spectrum were already facing closures because of changes to the state Medicaid system and costly licensure requirements.

To cut costs and continue to serve as many children as safely as possible, some behavior analysis clinics are taking advantage of relaxed telehealth rules during the coronavirus pandemic.

RELATED: Up To Half Of ABA Clinics Could Shut Down With Licensure Requirement, Lawmaker Says

Parents can sign into a HIPAA-secure phone app and therapists will coach them through exercises with their children.

"The parents can log into the meeting, and we are able to see and hear everything that goes on within the session,” said Brittany Harger, co-owner of Creative Behavior Solutions in Largo.

The clinic is currently serving 16 children this way, a major reduction in the number of children they typically see. Most of these were because parents didn’t feel comfortable in the role of therapist, even with oversight from the clinic.

“Some of the feedback I've gotten is that it's just the idea of being the therapist is overwhelming right now,” said the clinic's other owner, Adrianne Smith. “And it's easier for them just to say no for the time being, and then work really hard once the clinic is back open to catch those kids up doing what they have to do while in person with us.”

Or, Smith said, parents said it was too much time spent in front of a screen on top of virtual schooling.

Other children’s behaviors were deemed too severe to be helped in this format.

Harger said telehealth is helping them save money, which will keep them in business in the long run and allow them to eventually hire back staff they had to lay off.

"Being able to make these cuts that we've had to in closing the physical doors will enable us to be able to reopen, keep all of our staff safe, keep all of our kiddos safe,” Harger said.

The owners hope they can get some money through the Coronavirus Aid, Relief, and Economic Security Act” or the “CARES Act,” and have applied for bridge loans to help them stay afloat.

Many of the employees at the clinic, including registered behavior technicians, are not credentialed in a way that allows them to do this kind of telehealth work. Employees who were laid off were given a choice to go on unpaid leave, but many chose to leave their jobs so they qualify for unemployment benefits. Harger says they’ll be welcomed back when their doors re-open.

These clinics are deemed essential businesses and some have stayed open with reduced staff and clients.

But Smith said the hands-on nature of the therapy and small clinics make it impossible for a lot of places to abide by the six-foot social distancing guidelines.

“So even if we are an essential service, we're not essential for their safety and their medical quality, which is really important to us.” Smith said.

Smith said they do expect a backslide of behavior issues since the children are unable to stick to their normal therapy routine. She expects they'll have to work extra hard to catch them up when they come back. 

Harger said some clinics in the state will be forced to close their doors permanently because the small businesses can’t keep enough clients to stay open.

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