-0 . -1‘-"Q *.-\ University of Hawai‘i at M a¯noa Department of Special Education • College of Education Wist Hall • Room 120-A • 1776 University Avenue Honolulu, Hawai‘i 96822 808-956-5599 • Fax: 808-956-4345 • [email protected] Testimony on HB 1269: Relating to Autism Spectrum Disorders Thank you for allowing us to testify. I am Mary Jo Noonan, PhD, BCBA, LBA, and Chair of the Department of Special Education, University of Hawaii at Manoa. HB 1269 rightfully notes that “multiple professionals are qualified to treat autism,” and “that the need for evidence-based treatments for autism spectrum disorders cannot be filled by licensed behavior analysts alone.” We ask that the wording in this bill be changed to recognize that licensed special education teachers are professionals who are qualified to treat autism and are well-trained in behavior analysis. We are concerned with the current wording of this legislation and statute because it restricts the practice of licensed special education teachers—licensed professionals who have behavior analysis clearly within their scope of training and practice. In turn, this legislation prevents the College and other University of Hawaii System (UH) Special Education Teacher Education programs from delivering our accredited and state approved teacher education programs. Specifically, the current legislation does not allow UH Special Education programs to prepare special education teachers to conduct behavioral assessment or to design and implement interventions based in applied behavior analysis. Without applied behavior analysis in their training, special education teacher candidates who graduate from UHM and other state approved programs will not meet state licensing requirements (they will not be completing an accredited program) and will not be prepared to pass the Praxis state licensing exam which includes questions on applied behavior analysis. Given the extreme and chronic shortage of licensed special education teachers in our state and the need for autism services, it is in the interest of the state of Hawai‘i to allow the University of Hawaii and other state approved programs to fully implement its accredited and state-approved special education teacher preparation programs. The license and recognized scope and practice of special education teachers in the state of Hawaii must be respected and supported. The current bill, HB 1269, and the law it is amending, Act 235, Session Laws of Hawaii 2015, do not do that. The specific changes in wording in HB 1269 that we are requesting are as follows: P. 4, line 20: “Autism service provider” may include licensed special education teachers, licensed behavior analysts, licensed psychologists,….. P. 8, lines 13-14: (1) Is licensed by a state licensure board in a profession that practices in behavioral health or education; and… P. 8, line 18: “Autism service provider” may include licensed special education teachers, licensed behavior analysts, licensed psychologists, …. An Equal Opportunity/Affirmative Action Institution Thank you for considering our testimony on the qualifications of special education teachers to provide autism services, and the impact of this legislation on special education teacher training in Hawaii. An Equal Opportunity/Affirmative Action Institution HB 1269 FOR HEARING 2/14/19, 9:31 AM Dear Representatives, Mizuno, Cachola, Creagan, Decoite, C. Lee, Ohno, Say, Wildberger, Hashimoto, D. Kobayashi, and Matayoshi I am writing in support of HB 1269 that seeks to expand the availability of treatment for individuals with ASD in Hawaiʻi by clarifying that licensed mental health professionals from a variety of backgrounds can provide these services with amendments to include FASD. FASD is associated with secrecy and shame, quite possibly due to its preventable nature and the stigma attached to it. Alcohol is legal accessible therefore it is not surprising that the research stated that 1 in 20 first graders do have FASD. According to a study questions, if this shame is the reason for its marginalization of the children and families with FASD in general? While Autism Spectrum Disorders has increased public awareness, availability of therapeutic services and much recognized. (Barker, Kulyk, Knorr, & Brenna, 2011). Language and communication disorder are common neurodevelopmental symptoms associated with FASD as are the intellectual disability, memory impairment, motor impairment, and sensory which is side by side similar to Autism. The range and severity of impairments exhibited by individuals with ASD and FASD are both physical and neurodevelopmental each with a specific diagnosis. FASD has its cause specified, and Autism does not- both are Developmental Disabilities that equally need support and services. FASD diagnosis is processing disorder, learning disability, and attention-deficit/ hyperactivity disorder almost the same with Autism Spectrum Disorders (Astley, 2010; Kodituwakku & Kodituwakku, 2014). Somewhere between 1% and 4% of all children worldwide are reported to have an FASD. The neurodevelopmental impairments associated with FASD came with significant social costs across the lifespan in the form of increased medical, educational, and vocational support and lost productivity (Lupton, Burd, & Harwood, 2004; Popova, Lange, Burd, & Rehm, 2015). I have worked with Children with Autism as a Registered Behavioral Therapist under ABA Guidelines, and in my observations, FASD is a Developmental Disability equally as severe as Autism which needs to be included and treated the same as Autism. Mahalo Nui Loa, Darlyn Chen Scovell RBT, MA Reference Astley, S. J. (2010). Profile of the first 1,400 patients receiving diagnostic evaluations for fetal alcohol spectrum disorder at the Washington State Fetal Alcohol Syndrome Diagnostic & Prevention Network. Canadian Journal of Clinical Pharmacology, 17(1), e132–e164. Barker, C., Kulyk, J., Knorr, L., & Brenna, B. (2011). Open Inclusion or Shameful Secret: A Comparison of Characters with Fetal Alcohol Spectrum Disorders (FASD) and Characters with Autism Spectrum Disorders (ASD) in a North American Sample of Books for Children and Young Adults. International Journal of Special Education,26(3), 171–180. Retrieved from http://search.ebscohost.com.libproxy.edmc.edu/login.aspx? direct=true&db=eric&AN=EJ959010&site=eds-live Kodituwakku, P., & Kodituwakku, E. (2014). Cognitive and behavioral profiles of children with fetal alcohol spectrum disorders. Current Developmental Disorders Reports, 1(3), 149–160. https://doi.org/10.1007/s40474-014-0022-6 Thorne, J. C. 1. jct6@uw. ed. (2017). Accentuate the Negative: Grammatical Errors During Narrative Production as a Clinical Marker of Central Nervous System Abnormality in School-Aged Children With Fetal Alcohol Spectrum Disorders. Journal of Speech, Language & Hearing Research, 60(12), 3523–3537. https://doi- org.libproxy.edmc.edu/10.1044/2017pass:[_]JSLHR-L-17-0128 COMMITTEE ON HEALTH Representative John Mizuno, Chair Representative Bertrand Kobayashi, Vice Chair Conference Room 329, Hawaiʻi State Capitol Thursday, February 14, 2019, 9:31 am HB1269: OPPOSE Honorable Chair Mizuno and Vice Chair Kobayashi, We appreciate the opportunity to submit written testimony on this measure. Together For Our Keiki (T.F.O.K.) is a non-profit advocacy group whose mission is to advocate and create an inclusive community for our keiki by empowering parents and educating local stakeholders. In regards to HB1269, we stand in opposition to this measure. The bill attempts to expand the ​ ​ medical ABA provider network to decrease wait lists. While we agree that we need to remove barriers to services, extending the provider network to professionals who do not have ABA in their education, training, and competence would create new concerns for consumers. These changes would place a vulnerable population at greater risk of harm, which we do not believe is the intention of the Committee Chair. Many students are unable to access their medically and educationally necessary ABA services during their school day. There does not appear to be a lack of providers, but rather a lack of providers working for or contracting with the Department of Education (DOE). Because providers are unable to provide services for students during the school day, there is a backlog of clients in the afternoons and evenings. This barrier would be better addressed by continuing to work with the DOE to hire adequate licensed behavior analysts (LBAs) and registered behavior technicians to meet the needs of their students. Thank you for the opportunity to testify in opposition to this measure. ​ ​ Mahalo nui loa, Lara Bollinger, M.S.Ed, BCBA, LBA Behavior Analyst and Law Student President and Founding Member Together For Our Keiki [email protected] Testimony IN STRONG SUPPORT of HB1269 RELATING TO AUTISM SPECTRUM DISORDERS COMMITTEE ON HEALTH Rep. John M. Mizuno, Chair Rep. Bertrand Kobayashi, Vice Chair DATE: Thursday, February 14, 2019 TIME: 9:31 a.m. PLACE: Conference Room 329, State Capitol 415 South Beretania Street The Hawaiʻi Psychological Association (HPA) strongly supports HB1269 which amends “Luke’s Law” – now HSR Section 431:l0A-133 - the statute requiring health insurers to provide treatment for Autism Spectrum Disorders (ASD). The purpose of this bill is to help ensure access to necessary behavioral health services for the treatment of individuals with ASD by licensed professionals with adequate training and competence. It seeks to expand the availability of treatment for individuals with