Vol VII: The Need for Increased Access to Early Behavioural Intervention Programs for Autism Spectrum Disorders

The prevalence rates of ASD have drastically increased in the last decade. For instance, while in 2000 one in 150 children had been diagnosed with ASD, this proportion has increased to one in 110 in 2006, and to one in 68 in 2012 (6,7). Some have attributed this rapid increase in prevalence rates to increased capacity in diagnosis as well as to ASD’s characterization as a ‘spectrum.’ Even when these confounding factors are taken into account, however, experts maintain that an increase in the true prevalence rates of ASD cannot be ruled out, suggesting environmental toxins, genetic factors, and advanced maternal age as potential culprits (2). Certain vaccines were also originally incriminated, but the evidence in favour of the vaccination hypothesis has since been refuted (8,9).

In Quebec, a diagnosis of ASD can be made by a psychiatrist or a psychologist, and patients are then usually referred to the Centre de Réadaptation en Déficience Intellectuelle (CRDI) of their local Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS). Services provided at the CRDI are tailored to each patient’s needs and can include accommodation consultation, management, and early childhood intervention (10). The CRDIs are the only publicly-funded organizations delivering services to patients with ASD in Quebec; though certain non-profit organizations also offer services to patients and their families, their funding is usually dependent on philanthropy and hence their sustainability is often uncertain (2). There are, as well, private resources accessible to families who can afford them. Yet, with the recent increase in ASD prevalence in Quebec, all of these resources have experienced a rapid surge in demand. Unfortunately, government funding of CRDIs has not followed the increasing ASD prevalence and patients now have to wait an average of two years before accessing any type of services in the province. Even in the private system, waiting times have been rapidly increasing. In fact, in some jurisdictions, seeing a psychiatrist or psychologist for diagnosis can now take up to twelve months, resulting in a three-year wait for ASD patients and families before interventions can be initiated (11). These delays have not only had detrimental impacts on the quality of life for patients and their families, but they have also negatively affected the potential efficacy of early interventions on social adaptation and functioning level (3-5, 12).