By Samantha Russo, PhD student

“An entire generation of our nation’s most vulnerable citizens is about to leave the entitlement-based
world of special education and enter the already overwhelmed and under-funded world of non-
entitlement adult services” (Gerhardt & Lainer, 2011).

Children with autism grow up to be adults with autism. Students who receive 1:1 funding are
supported in workshops with 1:3 or even worse 1:6 staffing ratios. These same children who have a
team of clinicians (behavior analysts, behavior specialists, staff that are pursuing a master’s degree),
turn 21 (maybe in some states, 22) and lose all of this. Caseloads for clinicians double sometimes triple
when they move from children’s services to adult services. So what do we do?

Clinicians need to work to fade these supports before students turn 21. The student that goes
out to work with two staff needs to get ready to go out to work in a group. Students need to learn skills
that are going to be valuable in the adult world that will lead to some sort of employment. Stop doing
inset puzzles with 18 year olds. Start working on functional leisure skills. Teach students to watch a
movie or listen to music without engaging in challenging behavior. Teach students to color or do a
crossword puzzle. Teach students to collate, fax, scan, file, shred, sweep, clean, stuff envelopes, and
mail documents. Find more functional activities.

And for those in adult services, fight the evidence based practices fight. Yes, your caseload is
probably terrible; yes you probably have no resources. But, don’t let this define the work you do as a
clinician. Complete the functional behavior assessment; write an evidence based behavior support plan
that takes function into account. Work to train the staff to get even a little bit better at following a
schedule, or running NCR, or prompting effectively. Take it one client at a time and make a difference
with that client.

We can’t snap our fingers and make funding appear out of nowhere. We aren’t going to change
laws and policies overnight. But it doesn’t make these clients, these adults any less worthy of the
services they need.

References:
Gerhardt, P.F., & Lainer, I. (2011). Addressing the needs of adolescents and adults with autism: A crisis
on the horizon. Journal of Contemporary Psychotherapy, 41, 37-45.