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Sunday, March 7, 2021

Military Caregivers

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.  As many posts have discussed, the challenges are especially great for military families.

Britt E. Farley and colleagues have brief report at The Journal of Autism and Developmental Disorders titled "Identifying Concerns of Military Caregivers with Children Diagnosed with ASD Following a Military Directed Relocation."  The abstract:

Military families relocate three times more often than non-military families. Those whom have children diagnosed with Autism Spectrum Disorder face challenges related to inconsistencies in services, delay of services, and lack of continuity of care. The current study expands the limited research examining the experiences of military families with children with Autism by focusing on impact of relocation, specifically identifying potential causes of delays in services. An online survey of 25 military caregivers of children with autism suggests potential delays in service related to provider waitlists, obtaining new referrals, and lengthy intake processes. The impact of these inconsistencies is discussed in relation to child progress and the need for future research in this area.\

From the article:

Caregivers reported that they were able to locate ABA providers that accept TRICARE; however, they were not able to access these services promptly. Factors that infuence accessing services in a timely manner include obtaining a new referral, waitlist times, and completing the ABA intake process (i.e., new assessment and treatment plan). This delay in services is on top of the time spent moving from one location to another. The total lapse in services should be measured from the termination of one ABA provider services to the beginning of the next, based on the typical military experience. During this lapse in services the child is not only afected, but there is also no parent support or training. Additional research should focus on a comprehensive overview of experiences these individuals face during and following a PCS [permanent change of station]. Measuring time to move would include the time it takes to relocate the family from one base to another and often times can include temporary housing both at the current base and new base. When moving from one side of the United States to another, or from a domestic to an overseas base, there is a need to switch TRICARE regions or health plans. Once a family arrives at a new base a Primary Care Manager (PCM) may not immediately be available. The PCM provides the new referral, so if there is a delay seeing a PCM, then there is also a delay in obtaining a new referral. In some areas providers do not put individuals on their waitlist until they are physically in location; this could be due to the possibility of a change in orders. Additional components after being put on a waitlist would be time to be seen by a provider, time to complete new assessment, time to complete new treatment plan, time to obtain  TRICARE approval, and time to start the frst session.