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Every day, Ileana Sadin picks up her 5-year-old son Julian from kindergarten in Denver and drives him to a therapy clinic. Julian has autism, and his pediatrician has prescribed 35 hours of applied behavior analysis, or ABA therapy, per week to help Julian communicate.

But Julian doesn’t get nearly that many hours of therapy. At most, he gets 10 a week after school.

Denver Public Schools has refused his parents’ request for a private ABA provider to work with Julian in his kindergarten classroom, even though the family’s private insurance would pay for it.

Without ABA therapy in school, Julian’s parents worry he is losing skills. Before he enrolled in public school, an ABA therapist helped Julian participate in lessons at his day care, his parents said. Julian learned the alphabet and could count to 20 in English and Spanish.

When Julian transitioned to public school, his parents were told, “‘He’s making progress. He can count to 10 now,’” Julian’s father, Joshua Kurdys, recalled. “He could count to 20 a year-and-a-half ago. That says something to me.”

A 2022 state law was intended to make it easier for students to get ABA therapy in schools. But ultimately it was watered down to require only that districts have a policy that addresses how a student with a prescription for “medically necessary services” receives those services in school.

Parents and advocates say that has led to an uneven experience for families across school districts and less support for students, some of whom end up quietly lost in the shuffle while others end up in a loop of frustration, explosive behavior, and suspension from school.

While DPS is following the letter of the law, parents and advocates allege, it’s not following the spirit. Advocate Meryl Duguay called DPS’s policy and process “a show to get to a no.”

Meredith Fatseas, the Denver district’s director of mental health services, said the district looks at each student’s case individually and that its process is “rooted in inclusive and equitable practices.”

“When requests come in, we are taking them seriously,” Fatseas said. “It’s not a rubber stamp.

“We are committed to the obligation of meeting students’ individual needs in the education setting, which is why we’ve taken a stance of owning this process,” she said.

Data shows DPS says no more often

ABA uses rewards to reinforce behavior. It’s often recommended for children with autism to help them communicate, interact with others, and manage frustration.

DPS’s policy says the decision of whether to allow an outside ABA therapist into the classroom is up to the team that develops a student’s individualized education program or IEP. An IEP lists goals for students with disabilities and the services the school district must provide.

If parents disagree with anything in the IEP, their recourse is to file a due process complaint with the state, which many families see as daunting and potentially costly.

Data obtained by Chalkbeat in an open records request shows that last school year, DPS, the largest school district in the state with 88,000 students, received 28 requests for ABA therapy in school and granted only three, or about 11%.

Other big Colorado districts said yes more often. Jeffco Public Schools, Douglas County School District and Cherry Creek School District granted all of the requests for ABA therapy they received last school year. Aurora Public Schools granted half the requests it received in the last three years.

Fatseas said Denver’s rate doesn’t take into account approvals made through a second, long-standing process that allows parents to request a private provider work with their child during non-instructional time only, such as art class or recess. The requests are meant to be for services that are not medically necessary.

Those types of requests are made at the school level, and the district doesn’t track how many are received or granted by individual school principals, Fatseas said.

Bill set out to find “a path to yes”

Families’ frustration drove the 2022 Colorado state law. Originally the bill, known as HB 22-1260, would have required districts to allow ABA in school.

“When parents approach schools with a prescription, they are often told no,” state Rep. Meg Froelich, who sponsored the bill, said at the first hearing in April 2022.

“We are here to find a path to yes,” said Froelich, a Democrat who represents Englewood, Sheridan, Cherry Hills Village and part of Denver.

But now, Froelich said, it’s clear that the law isn’t always working as intended.

“We’re a local control state, so the prevailing wisdom is you can’t tell school boards what to do,” Froelich said in an interview. “We tried to write (the bill) that the path can’t be, ‘We don’t do that here.’ But there are too many ways the school can essentially say no while appearing not to.”

At the first hearing on the 2022 bill, one parent told state lawmakers her son was suspended from his suburban school district 12 times in a four-month span for behavior that could have been addressed by ABA therapy. Another testified that her son’s school said she was welcome to pull him out of class to go to his ABA clinic but then held him back a grade for missing too much school.

The few parents who said their children had gotten ABA therapy in the classroom said it happened because of a lawsuit or a mistake.

Meanwhile, school officials said allowing outside ABA providers into classrooms could be a liability and would be disruptive and distracting to the student receiving the therapy and their classmates. ABA therapy could also interfere with other special education services, they said.

“We aren’t allowed to give up our services so an outside provider can come in to give their services,” said Lisa Humberd, then the executive director of special education for Widefield School District 3 and now head of the Consortium of Directors of Special Education.

Providers testified that’s not how ABA therapy works. It’s not a separate therapy delivered in an office, they said, but supports the student to participate in classroom lessons.

ABA therapy is controversial. Nationwide, some parents have accused ABA providers of being overzealous or even abusive to their children, and some autistic adults have said the premise of ABA therapy forces people with autism to conform to societal norms in a harmful way.

But the controversy didn’t seem to play a role in Colorado lawmakers’ decision. The objections of the school districts did. To appease them, Froelich amended her bill. Instead of requiring districts to allow medically necessary services in school, the bill required districts to have a policy.

“I think we will probably revisit this if parents are finding they can’t quite get what they need or the policy isn’t addressing certain circumstances,” Froelich told fellow lawmakers in 2022.

Two years later, Froelich is frustrated.

In her mind, IEP teams should not be making the decision about whether to allow ABA therapy providers into the classroom. She has asked the Colorado Attorney General’s Office to issue an opinion to that effect. A spokesperson said they’d received the request and are looking into it.

Froelich has also asked the Colorado Department of Education to issue new guidance. A spokesperson said the department is “working with districts and other stakeholders to review how the current guidance might need to be clarified or updated.”

In kindergarten and still without therapy services

Chalkbeat spoke with three families whose children have a prescription for ABA therapy. All three requested an outside ABA provider be allowed to serve their child in the classroom, at the expense of their private insurance. All three were denied by Denver Public Schools.

Two of the families did not want their names used in this story for fear of retaliation by the district.

All three families said they went through DPS’s process. As described by Fatseas, the district’s director of mental health services, the process involves an evaluation by a board certified behavior analyst, or BCBA, who works for the Denver school district.

The district’s BCBA interviews the student’s pediatrician and their outside ABA therapist. The BCBA also observes the child at school, reviews their records, and collaborates with other special education teachers and school-based providers to write a recommendation for the IEP team.

Fatseas said ABA theory is baked into the interventions that all Denver school-based mental health staff use with students, even if they’re not providing one-on-one ABA therapy. With requests for outside ABA providers to come into the classroom, Fatseas said the question the district tries to answer is whether the service is necessary for the student to make progress toward their IEP goals.

In Julian’s case, DPS said it wasn’t.

Julian is a sweet 5-year-old whose mother describes him as agreeable. He struggles with communication, social skills, and learning, but he doesn’t lash out in frustration.

Unlike some children with autism, Julian can speak. But his speech is mostly phrases he’s memorized. On a recent drive to his after-school therapy, Julian sat in his car seat with a banana and a chocolate milk, marveling at the trucks on the highway.

“UPS truck!” he said. “That’s a big one! Orange semi truck! That’s a big one!”

According to IEP documents provided to Chalkbeat by Julian’s parents, DPS rejected the family’s request for an outside ABA provider because Julian was making progress without one. But his parents wonder if Julian could be making more progress with help from an ABA therapist.

Advocates said it’s a common concern.

“The bar is so low, they’re not considering what a student is actually capable of and should be achieving,” said Duguay, who does not work with Julian’s family but has worked with several other families whose requests for ABA have been denied.

In IEP meetings, Julian’s parents pushed back. But so far, DPS has stuck to its denial.

“I don’t know how we can say with a straight face he doesn’t need ABA therapy,” Sadin, Julian’s mother, said in one IEP meeting, according to a recording provided to Chalkbeat. She was reacting to test scores that showed Julian was in the bottom first percentile for academic skills.

“He has such problems with communication, it’s not easy to elicit what he usually knows,” she said in the meeting. “Not to harp on the ABA, but this is what ABA is about.”

Melanie Asmar is the bureau chief for Chalkbeat Colorado. Contact Melanie at masmar@chalkbeat.org .

Chalkbeat is a nonprofit news site covering educational change in public schools.

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Originally Published: October 3, 2024 at 9:05 a.m.