Shortage Of Autism Specialists Means Some Families Have To Wait For Therapy

Feb 10, 2016

Justin Reitz working with his Registered Behavior Technician Kaitlyn Byrn. Photo by Anh Gray.

About 7,000 young people have been diagnosed with autism spectrum disorder  in Nevada.  While there is no cure, research shows Applied Behavior Analysis can help. But in the Silver State, there are less than 300 specialists certified to provide that type of one-on–one work. Reno Public Radio’s Anh Gray explores why more of these professionals are needed.

Telling a good joke is an art form that teenager Justin Reitz is trying to master.

Justin Reitz: "Why did the eggs crack?"

Kaitlyn Byrn: "I don’t know, why?"

Justin Reitz: "They’re hatched."

Kaitlyn Byrn: "Let’s try that again."

Justin Reitz: "Why don’t you tell an egg a joke?"

Kaitlyn Byrn: "I don’t know, why?"

Justin Reitz: "They might crack up."

Kaitlyn Byrn: "Good job."

Autism is a developmental disability that can cause communication and behavioral problems. That’s why Kaitlyn Byrn, a Registered Behavior Technician, or RBT, is helping Justin to develop social skills like telling jokes.

Justin is the dark-haired middle son of Carol and Art Reitz. Like many households, Carol is busy with a bevy of afterschool responsibilities, one of which is overseeing the therapy Justin began about six years ago.  

“It basically looks at the behaviors and kind of shapes how you want your child to learn and interact within the family,” Carol Reitz says.

Justin attends middle school during the day. In the afternoons, one of several RBTs come to work with him at home. For the Reitz family, the time commitment is six days a week for a total of 15 hours.

Carol Reitz explains that Justin has low to middle functioning autism and that he also has vocal stereotypy. That’s a condition common to autism in which a person makes noises that are nonfunctional speech.

“It’s one of the target behaviors that we do work on,  it’s unfortunately one of the ones that are hard to eliminate, but we work on shaping positive behavior and being able to reinforce when he’s doing a good job,” Byrn says.

The type of work Byrn is doing with Justin as an RBT is like a tutor, utilizing evidence based behavior modification.

Dr. Shannon Crozier is the Director of the University of Nevada Las Vegas Center for Autism Spectrum Disorder. She says the Nevada Department of Education has identified that there are about 7,000 young people diagnosed with autism and there aren’t enough RBTs to serve them.

“There are currently 274 registered behavior technicians in Nevada,” Crozier says. “A shortage of RBTs is really going to affect kids and families across the state at every level.”

Crozier says the reasons for the shortage are complex. For one, the RBT certification is new and that profession is still growing. Crozier says another problem is that at the start of this year, a new Medicaid-sponsored autism program began reimbursing nearly 2,000 eligible families for this service, which creates more demand.

“It’s going to be very difficult for newly diagnosed children to get access to services,” Crozier says. “A shortage for Nevada is really going to be felt very strongly and intimately by the individual families who are struggling to find people who are going to come and work with their children.”

Parents and autism advocates have also criticized the program saying that the approximately $30 Medicaid reimbursement rate is about $10 too low and won’t attract new and quality people to the field. Medicaid officials say it’s a fair market rate.   

But Crozier says the combined issues exacerbating the shortage make it so families must wait to get the help they need.

Like the help that Justin has been getting every week from one of his RBT Kaitlyn Byrn.

Kaitlyn Byrn: "Time to work. What are we working on today?"

Justin Reitz: "Cause and effect."

Kaitlyn Byrn: "Cause and effect. Alright Justin. The boy was sleepy so he went to bed.  Why did the boy go to bed?"

Justin Reitz: "The boy was tired."

Kaitlyn Byrn: "He boy was tired. Good job."

This logical thinking skills lesson is one of several that Byrn will use to help evaluate Justin’s developmental progress.

“We take data each day and we add up his percentages and then when he gets a high score, we move on to the next target,” Byrn says.

After a series of lessons, Justin takes a five minute break and heads to his backyard where we find his father Art Reitz busy tinkering on a family hot tub.  When asked about the progress Justin is making with ABA therapy, Art says it has made a difference.

“Before, it was a lot of frustration with Justin. He would be real frustrated because he wasn’t able to do those simple tasks and be able to communicate with us,” Art Reitz says. “Now he is able to put sentences together and gives us his wants and needs, so it helps out the family unit tremendously.”

For some other families in Nevada, because of the RBT shortage, many have already been waitlisted to receive the therapy that they too hope could make a difference for their child .

Carol and Art Reitz  are also the co-founders of the JUSTin Hope Foundation. Their goal is to help families in Northern Nevada affected by autism.