April 8, 2014 Panel Presenters:
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Dr. Kevin Stoddart, The Redpath
Centre, Toronto, ON
Tom Jackman, Autism Society Canada
& Autism Society Newfoundland
Dr. Marc Woodbury Smith, Hamilton
Health Sciences, Hamilton, ON
Moderator: Margaret Spoelstra, Autism
Ontario
Panel: Exploring
Support Needs for
Adults and Eligibility
Criteria for
Developmental
Services
Economic Costs
“Although autism is typically thought of as a disorder
of childhood, its costs can be felt well into adulthood.
The substantial costs resulting from adult care and lost
productivity of both individuals with autism and their
parents have important implications….. the lifetime
per capita incremental societal cost of autism is $3.2
million. (page 343) “
“The Lifetime Distribution of the Incremental Societal Costs of Autism”. Michael L. Ganz, MS, PhD- Arch Pediatr
Adolesc Med. 2007;161:343-349
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Key Message regarding eligibility
• Implement standard
eligibility criteria to
services for adults with
ASD based on their
functional needs rather
than intellectual
functioning through an
Ontario- wide cross
sector policy framework
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Key Historical Initiatives in Ontario
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2008 - Position Paper on Bill 77:
Presentation to Standing Committee
on Social Policy
2008: Autism Ontario launches
“Count Me In” list for adult issues
2009 – Established: Inter-ministerial
Working Group for an Ontario
Strategy for Adults with ASD
2009 – Report to Minister of
Municipal Affairs & Housing:
Ontario’s Long Term Affordable
Housing Strategy
2009 – IMWG presents educational
conference to Ontario Government
leaders across 8 ministries
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2010 – Joint presentation of MCSS
and OPAAA at Woodview Conference
2013 Survey results released through
Diversity Report
Key Historical Initiatives in Ontario
• 2013 – Ontario Ombudsman
launches investigation into
Developmental Services
• 2013-2014 – Ontario
Parliamentary Select
Committee reviews
Developmental Services
• 2013 – “Ending the Wait
Report” on housing
• 2014 – Release of HCARDD
Atlas on the Health of adults
with Developmental
Disabilities
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Mental health problems among adults with ASD
Marc Woodbury-Smith, McMaster University
The argument for specialist mental health services:
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Mental health problems are common in this population (particularly
depression and anxiety);
The core features of ASD and its additional developmental
comorbidities impact on the symptomatic presentation, aetology and
treatment of mental health problems in this population;
Psychopharmacological and psychological treatments may not
necessarily mirror those offered in generic services.
Therefore, specialist, team based, expertise is required.
Supports
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Housing
Employment
Doctor
Financial
Community
Family
Challenge
There is very little infrastructure established for
services to people with ASDs who do not have
an intellectual disability, leaving them without
services or services to meet their needs
Autism Society of Newfoundland and Labrador
Elaine Dobbin Centre
Housing - Stella Burry
Employment and
meaningful day activities
Targa Newfoundland
Community
Summary
Establishing a best practices service delivery model
for individuals on the autism spectrum within the
current framework will serve only those
individuals who have concurrent intellectual
disabilities and will not meet their specialized
needs.
Both specialized services and enhanced community
service capacity are needed to meet the service
needs of the entire adult ASD population.
Moving Forward:
Multiple Systems
Integration
Knowledge and
Information
Identification and
Mobilization
Comprehensive and
Effective Service
Provision
Multiple Systems Integration
The Networks of Specialized Care should be used to promote better
cross-systems service coordination.
Consideration should be given to a clinical electronic records exchange
system for ASDs, and a centralized patient database.
Ensure accessibility through individualized funding, creation of
new/expanded services, and public-private partnerships.
Successful life transitions in multiple sectors must be an area of focused
interministerial collaboration and cooperation.
The mandate of the IMWG should be strengthened and their efforts
communicated more broadly.
Comprehensive and Effective Service Provision
Service funding must be tied to continuing quality assurance and
evaluation, expected in other sectors.
Successful models of service provision in the literature, and occurring
throughout the province, need to be examined.
Increase to the Passport/SSAH funding and other funding streams
must be provided for those not eligible for DSO.
Integrated residential and life skill support models should be
developed for those lacking basic requisite life skills.
To guide Ministries in the delivery of effective services an ASD Expert
Advisory Committee should be established.
Knowledge and Information Identification and Mobilization
Adult ASD Centres of Clinical and Research Excellence need to be
established in all regions of the province.
Current research and best practices should be at the forefront of
professional training, using e-learning in collaboration with professional
associations/colleges.
Training/consultation can be provided that would enable CMHOs to
provide transitional services to adult MH sector.
Adult mental health service providers urgently need training in
assessment and intervention with this group.
Comprehensive training of physicians must occur by expert medical
colleagues, well-versed in adult ASDs.
Discussion and Questions