Fredericton's Autism Expertise No. 2: Pediatric Autism Rehabilitation Services - Stan Cassidy Centre for Rehabilitation

Fredericton has seen the development of autism expertise unmatched in Atlantic Canada.  The UNB Applied Behaviour Analysis Certificate Program (BACB Approved) is  one prominent example of that expertise.  In its earlier form as the UNB-CEL  autism invention program it was the foundation of NB's internationally recognized early autism intervention services program.  Another important example of Fredericton autism expertise is The Stan Cassidy Centre Autism Team which provides rehabilitation services for children with autism. The staff includes a Behaviour Analyst. Clinicial Dietician, Occupational Therapist, Social Worker, Speech-Language Pathologist, Developmental Pediatrician and an Educational Liason:  

I don't honestly know why the Stan Cassidy autism rehab services are restricted to children only and are not provided to adults with autism.  While autism is usually visible in childhood ( my autistic son Conor received his autism diagnosis the day after his second birthday ) it is a neurological disorder which does not magically disappear at age 16 or 18. There is no valid reason to exclude autistic adults from treatment or assistance but at present autistic adults are still excluded from autism rehab or treatment services in New Brunswick.

The Stan Cassidy autism team itself provides valuable services to autistic children.  I have talked to parents who speak of long wait periods for receipt of services which indicates the level of demand for those services (and the need for an expansion of those services). 

Despite the importance of autism rehab services a decision was made to close the autism team, to shut it down. That decision was reversed as a result of parent autism advocacy and a review by  River Valley Health, a reversal that has allowed the Stan Cassidy autism team to continue providing pediatric autism consultation services:  

October 4 2005

Rehab centre to treat autistic kids 

The Daily Gleaner

Children with autism will continue to be treated at the Stan Cassidy Centre for Rehabilitation. The board of directors of River Valley Health last week reversed a decision made earlier this year - at the administrative level - to stop treating children with autism who do not have a physical disability. The policy was to take effect in 2006. "We're elated," said Luigi Rocca, president of the Autism Society of New Brunswick. "We weren't at all happy with the original decision," he said.

Autism is a serious neurological disorder that typically appears during the first three years of life and has a profound effect on communication, social interaction and sensory integration. Autism, an incurable condition believed to be genetic in origin, affects about one in 500 individuals worldwide and is four times more common in boys than girls. Intense behavioural therapy has been found to help improve social and learning abilities, but experts say that for most autistic people, the condition continues to have some impact throughout life. The original decision to discontinue treatment of some children with autism was announced in May. At a recent meeting of more than 30 stakeholders from across the province, John McGarry, president and CEO of River Valley Health, apologized for the lack of dialogue that led up to that May announcement. 

The Stan Cassidy Centre for Rehabilitation is a tertiary care centre that provides services to children across the province in rehabilitation including speech language pathology and occupational therapy. Diane Morrison, senior vice-president of River Valley Health, said the centre has treated children with autism for many years and built up a level of expertise. "They were looking at their resources and how the resources were being utilized," she said about the initial decision. "Like most services there was more demand than you have the resources to meet." Children with autism represent about 20 per cent of the case load at the centre and required more than 20 per cent of resources to treat, she said. Morrison said it was initially thought that that children with autism could be better served elsewhere, particularly children without a tertiary rehabilitation requirement. If a child with autism did have an accompanying rehabilitation requirement they would still have been seen at the centre, she aid. Morrison said the meeting with stakeholders was positive. Following that meeting, and after further discussion within the organization and at the board table last week, the decision was made to continue the service, she said. 

The board motion to continue the service also called for the creation of a provincial working group to develop recommendations that will help ensure the Stan Cassidy Centre's autism services are sustainable and integrated into treatment across the province. Morrison said it was concerns about sustainability that prompted the May announcement. She said if the centre has just one speech language pathologist and one occupational therapist then the service is fragile. "We need to make sure that we can put in place plans for sustainable service," she said. "We are trying to take systemwide approach to this." Morrison declined to comment on whether the regional health authority would need additional funding from the province to make the autism service sustainable. "I don't want to presuppose the recommendations to come out of the working group," she said. Another meeting with stakeholders is planned for Oct. 14. 

Rocca said the dispute has highlighted the overall lack of resources allocated to autism in New Brunswick. The Stan Cassidy Centre for Rehabilitation does not have enough resources on its own to deal with autism, he said. Rocca said that stakeholders are pleased that when they complained they were taken seriously by officials at River Valley Health. He said they quickly reversed their decision and did not let it drag on for months. "We are starting a meaningful dialogue," said Rocca. "We will be involve in finding a solution. "We hope we get the same response from the provincial government."

(NOTE :The figure of 1 in 500 persons mentioned in the Gleaner article as having autism worldwide in 2005 is now assessed at 1 in 68 by the CDC in the United States a widely accepted authority; with much debate over how much of that increase was attributable to increased awareness and changes in diagnostic criteria).

The provincial government response sought by the autism community was ultimately delivered by former Health Minister (now a Justice of the New Brunswick Court of Appeal) Brad Green:

Health

PROVINCE TO FUND DEDICATED AUTISM TEAM AT STAN CASSIDY CENTRE FOR REHABILITATION (06/08/17)

NB 1149

Aug. 17, 2006

FREDERICTON (CNB) - The provincial government has approved a proposal from River Valley Health for ongoing funding to establish a dedicated team at the Stan Cassidy Centre for Rehabilitation to provide services to children with autism, Health Minister Brad Green announced today.

"The creation of an interdisciplinary team of health-care professionals with a specific mandate to serve children experiencing severe autism symptoms was recommended by a provincial working group that included community representatives," Green said. "I am very pleased to announce that annual funding beginning at $350,000 will be provided by government to support this specialized team."

Green said government recognizes that the provision of services to children with complex autistic spectrum disorders requires the specialized expertise of a team of care providers.

"The specialized team will comprise one full-time professional with specific autistic spectrum disorder expertise in each of the following: developmental psychology, occupational therapy, speech language pathology, dietetics, and applied behavioural analysis," Green said.

The team will offer functional assessments as well as design, model and perform interventions for children who have the most complex forms of autistic spectrum disorders. It will work closely with families, pediatricians, extramural and hospital-based therapists, educators and all autism support groups to ensure that services are well integrated. Part of the team's mandate will include education, consultation and support to health-care professionals in the province.

"We are very pleased by this decision, and look forward to making a significant contribution to the well-being of children faced with the challenges of autism," said Dr. Ron Harris, administrative director of the Stan Cassidy Centre for Rehabilitation. "The presence of a dedicated team with the highly specialized skills needed to address the challenges is a great step forward for New Brunswick."

Green said that funding for the team is over and above the $2.8 million the provincial government has been investing annually since 2003 to provide services for preschoolers with autistic spectrum disorders.

The Stan Cassidy Centre for Rehabilitation is the only facility in the province with teams of highly specialized health-care professionals and the equipment and technology required to treat patients with complex neurological disorders.

The new Stan Cassidy Centre is located beside the Dr. Everett Chalmers Regional Hospital in Fredericton, and opened in June. It was built at a cost of $28 million.