DuBOIS — The way autism is diagnosed and treated has changed considerably in the 15 years since NHS Human Services first offered services for the disorder in DuBois.
Take the diagnosis of the disorder, for example, which the American Psychiatric Association rethought in 2013 for the most recent Diagnostic and Statistical Manual of Mental Disorders.
“It used to be broken into an umbrella,” Heather Magaro, senior director of clinical operations at NHS said. “Under the umbrella used to be several different diagnoses. You had PDD – pervasive developmental disorder – you had Asperger’s, which is probably your most commonly heard of, and you had autism.”
The DSM did away with these distinctions, instead reclassifying autism as a disorder with degrees of severity. It’s not something that NHS says altered how autism is treated through its Stepping Stones program, but program director Tom Woodrow said it has changed how treatment is presented.
“I think it gives us a better starting point, where in the past you really kind of needed to get to know the person you were working with to truly know where they fell and where they were at,” he said.
Stepping Stones, which is offered in 11 different offices throughout Pennsylvania, is a group treatment program for children and adolescents with autism. The NHS office in DuBois first started offering the program in 2003, and currently serves youth in Clearfield, Jefferson and Elk counties.
According to the most recent census conducted by the Autism Services, Education, Resources and Training Collaborative in 2011, there were 466 people with autism receiving service of some kind in Clearfield County, 119 in Elk County, and 202 in Jefferson County.
“It’s a recommended service like any other treatment,” Magaro said. She continued, “If you have diabetes and your prescribed insulin; If you have autism, you get prescribed certain behavioral services. Stepping Stones is one of those services.”
The program is offered to two age groups, one for children ages 3-7 and the other for children 8-14. Although the reconceptualizing of the disorder didn’t change how NHS addresses it, that doesn’t mean that treatment hasn’t changed at all over time.
For one thing, technology has changed how instructors and children can communicate. iPads and smart devices, Magaro said, allow children who are nonverbal and/or unable to communicate by sign language to communicate more easily than in the past.
The organization has also restructured its curriculum over time.
“Previously the lesson plans that we used were just developed on a day to day basis. Now they’re structured; every site across the state utilizes the same curriculum where there’s a theme of the week based on different topics that have shown to be important for kids with autism,” Magaro said.
These topics range from leadership skills to social cues that children with autism have more difficulty grasping than their peers, like the difference between “reporting” and “tattling.”
“We used to do a lot of imitation, a lot of drills. And we’ve really gone away from that,” Woodrow said.
Although the means have changed, the end remains the same. Children in the program aren’t recommended to stay in it for longer than two years, and are instead taught skills that can help them in social settings outside of therapy.
“Our goal is ultimately to get them in here, learn the skills they need, and start transitioning them back to a community based program like Boy Scouts, or some kind of club or activity where they can really be among typically developed peers,” Magaro said.