Should ABA therapists be allowed in Michigan schools to aid kids with autism?

Parents of students with autism say their private behavior technicians should be allowed in public school
School groups are opposed to the idea
Roughly 13.5% of students with a disability have autism spectrum disorder in Michigan

For 14-year-old Michael Chami, the “Guess Who?” board game is more than just a game. It’s also a way for his registered behavior technician to help him practice how to describe other people.

Chami sees his technician about 12 to 15 hours a week after school for applied behavior analysis support. The technician works with a board certified behavior analyst that observes Chami weekly and works with Chami’s mother, Angela Khater, on how to help him with communication skills.

Khater is one of many parents and advocates fighting to have this type of support take place at Michigan’s public schools. Parents say requiring schools to allow these technicians in the school would be better for students, their peers and teachers.

“We don’t want these kids to have a crutch in a school,” Khater told Bridge Michigan. “We want them to be independent. So we want to work with them one-on-one so that they can gain these independent skills so we can fade out.”

Under House Bill 5044, school districts would be required to let students receive treatment during the school day if it is medically necessary. In recent weeks, several proponents of the bill have spoken about how much of a difference applied behavior analysis therapy, often referred to as “ABA,” has made in their children’ s lives.

Some parents are already willing to pull their children out of classes so they can receive therapy off-site.

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The ABA industry is valued at $4 billion nationwide and expected to grow. Allowing sessions to take place in schools could give the industry an additional boost by increasing the number of parents who arrange such services for their children. The therapy sessions are covered by health insurance and provided by outside companies.

“You have a for-profit entity (whose) model is built around billable services…we don’t have that model,” Eric Hoppstock, superintendent of Berrien County Regional Education Service Agency, told Bridge.

School groups oppose requiring that therapists be allowed in. They say there are logistical challenges, and when a private behavior technician works with a student, the goals may not be aligned with the education goals school officials have already laid out for the students through individualized education programs, or IEPs.

“What is medically necessary that you would provide that is so distinctly different in the schools than what we already provide?” Hoppstock asked.

Khater, who is also a board certified behavior analyst, sees it differently: “I often wonder: Are they hiding something? Why don’t they want us in? Why wouldn’t they want something that doesn’t cost them anything in their schools that would help these children?”

ABA in classrooms and clinics

Schools may hire board certified behavior analysts (BCBAs) or registered behavior technicians (RBTs) to oversee behavior programs in schools. But advocates want this to go a step further by having them directly in the classroom with a student as the student is instructed by a teacher.

Parents say current accommodations for these behavior experts vary school-to-school and district-to-district.

Some parents pull their children out of part or all of the school day to make time for this therapy. Statewide, 35.8% of students with disabilities are chronically absent, meaning they missed 18 or more school days in a year.

“Every day that a student is out of school, every hour, gaps in learning are growing and opportunities with their peers are being minimized,” said Michigan Department of Education office of special education assistant director Rebecca McIntyre. “So we really need to focus on having ABA supplement education and not replace it.”

McIntyre spoke Wednesday at a House Education and Workforce Committee, which has held several public meetings on the bill. The bill has not yet received a vote. MDE officials urged lawmakers to not pass the bill, instead giving schools more time to implement guidance released by MDE and the Michigan Department of Health and Human Services in May about these services.

A young man sits beside an adult on a couch. — James Macon, founder and owner of OBM Consulting, works with Michael Chami, 14, who has autism, in his home in Dearborn. Chami’s mother is advocating to allow applied behavior analysis support directly in her student’s classroom. (Jeffrey Sauger for Bridge Michigan)

“When a physician or other provider has determined medical necessity for ABA therapy, there can and should be a coordination of therapy with the district so the child can access the ABA therapy they are entitled to and maximize the full school day they are also entitled to,” the guidance says. “Private ABA therapy is funded through private insurance, the parents or other sources, but is not funded by the district. Therefore, although districts have an obligation to provide a full school day, a district is not required to provide a place for an outside provider to provide private ABA therapy.”

Michigan based its guidelines on a model developed by Virginia. “They’ve worked really hard to support the guidelines and not move into a place where there is more restrictive legislation about what schools have to do, because the goal is collaboration and working together,” Amy Matthews, a Grand Valley State University professor and director of the Statewide Autism Resources and Training (START) Project, told legislators at Wednesday’s hearing of the Michigan House Education and Workforce Committee.

She said in some states “there is a lot of tension between the private providers and schools. It’s not always been a productive relationship. We don’t really want to go there. We really want to look at how do we work well together.”

But some say students with disabilities do not have time to wait for school districts to consider whether or not to follow the guidance.

“A big sigh comes out of me when I hear anyone in a school system say wait and see, especially with kids with disabilities,” Heather Eckner, director of statewide education for the Autism Alliance of Michigan, told Bridge. “They don’t have time for us to wait and see.”

Committee chair Rep. Nancy DeBoer, R-Holland, said “if the children were receiving all the care they need in these settings, parents wouldn’t be clamoring for a bill as they are.”

A growing movement

The push to allow these practices in schools comes more than a decade after the state began requiring insurance plans it regulates to provide coverage for ABA therapy.

There are 223,100 students receiving special education in the state including students in private schools or homeschooling who receive special education services by a public school. About 13.5% of the students have an autism spectrum disorder diagnosis.

Colorado passed a similar law in 2022 that requires school districts to adopt a policy on how students can receive medically necessary treatment. But Chalkbeat Colorado reports that advocates and parents say the opportunity to have ABA in schools still varies by district. For example, Denver Public Schools only approved three out of 28 requests for the therapy, according to the outlet.

The proposal in Michigan would require districts to report how many requests for treatment they granted or denied to the state.

In Indiana, Medicaid covers ABA therapy with the coverage being “very valuable” but the rising costs being “unsustainable,” said one state agency official, according to the Indiana Capital Chronicle.

The road ahead

In Holly, Lisa Havneraas, said ABA therapy gave her 10-year-old son “the life that he has now.”

Havneraas said her son can communicate wants and needs at school, home and public settings.

At one point, she pulled her son out of his traditional public school after he wasn’t able to have ABA therapy support in schools. Now, he attends a charter school in Holly that allows him to have ABA during the school day. ABA, Havneraas said, “doesn’t replace school but it made school possible for him.”

DeBoer, the state representative, told Bridge 500 parents have reached out to her office about the bill. She said the bill is a priority but several considerations need to be worked out before passing it.

“I want to be measured and careful with what we do,” she said.

Autism diagnosis rates have increased in recent decades.

“I don’t understand the growth in the numbers but I do know every child has intrinsic worth and we are responsible to be the best they can be and reach their full potential as much as we can and inspire them,” DeBoer said.

A woman and young man embrace. — Angela Khater is the clinical director for Individualized Outcomes for Autism. She wants her son Michael Chami, 14, who has autism, to have his private behavior technicians allowed in his public school. (Jeffrey Sauger for Bridge Michigan)

For Khater, the mother in Dearborn, she wants to see Michigan follow the creed of ‘students first’, a motto that State Superintendent Glenn Maleyko used when he led Dearborn schools and continues to use in his new state role.

“If they really want to put students first, then they would do this for our children. Because it is evidence-based, it’s proven to work and it’s proven to help our kids.”