Workers who take care of children at Connecticut’s therapeutic autism centers aren’t required to undergo background checks that include a review of child abuse records, which is one of several gaps in oversight of these centers cited in a new report from the state’s Office of the Child Advocate.
The Monday report proposes a series of changes to state law that would give centers that provide applied behavior analysis, also known as ABA, for children with autism access to the results of investigations into allegations of child abuse or neglect.
The centers offer therapeutic services to children with autism that aim to encourage positive behaviors and improve social skills. Parents typically drop their children off for a few hours for services. The autism centers aren’t regulated in the same way as similar facilities such as child care centers or group homes.
Other facilities have regulations for the types of discipline that can be used and there are disciplinary actions the state can take against a license for violations. But autism centers don’t have the same types of regulations, according to the report.
And these facilities don’t have access to information about the outcomes of the state Department of Children and Families’ investigations. DCF has a lower burden of proof than law enforcement when substantiating an allegation of child abuse or neglect, so someone could be on the state’s child abuse registry, but not convicted of a crime.
DCF operates under strict privacy policies, meaning that not all types of facilities have access to the registry.
“We think that’s critically important in terms of child safety and creating a framework,” acting Child Advocate Christina Ghio said. “And if you look at the report, we did make some very specific, concrete, immediate, statutory recommendations.”
The Office of the Child Advocate reviewed state law and records from four ABA providers for services offered in the summers of 2022 and 2023.
They found a few similarities to child care facilities in that many children took naps and had snacks while they were at the autism centers. The median age for the children served was between 4 and 8 years old, and the providers accepted both Medicaid and private insurance.
The child advocate’s office found no laws that required that providers conduct background checks for their employees, although most providers did. The report found one instance in which DCF found that allegations of physical and emotional neglect against an ABA employee were substantiated.
The office also found an instance in which someone reported to DCF that an autism center staffer was making a child hold a plank position and yanking and pulling on the child. They were also withholding food.
The allegations didn’t meet DCF’s standards for abuse, but there wasn’t another agency designated to ensure that the center was following regulations that would limit use of food or humiliation tactics as discipline.
The report referred to legal protections to provide oversight of autism centers as “a patchwork.”
“As a result, children with significant disabilities, many of whom are non-verbal, spend large portions of the week in environments that mirror child care centers in many ways, without the same level of oversight,” the report says.
DCF Deputy Commissioner Michael Williams said in an interview that there hadn’t been many reports of abuse or neglect at the autism centers, but that DCF supports any measures to ensure children are safer.
He said the department regularly communicates with the Office of Early Childhood as a matter of practice.
“There should be oversight and protection of what happens in those systems, regardless of what it is,” Williams said. “That’s for children in general, because they are the most vulnerable in our society. Children who have extreme complexities, such as medical complexities and autism, and other types of complexities, the protections for them should be enhanced.”
The child advocate recommended several statutory changes that would make the Department of Public Health the go-to agency for complaints or concerns about the autism centers, ensure that background checks can include the results of DCF investigations and require that people working for licensed behavioral analysts report suspicions of abuse or neglect to the state.
Ghio said she also wants to see a task force created that would include several state agencies, the parent of a child with autism and experts in ABA services, among other officials. The task force would research and find out what other systems should be set up for oversight and to ensure kids are safe at the centers.
“Our view was really that you needed a group of people to come together with all of their different lenses, to look at what kind of framework makes sense,” Ghio said.
The report added that any new oversight framework “should be cognizant of the critical importance of ABA services and should not be overly burdensome or costly.”
Children’s Committee ranking member Rep. Anne Dauphinais, R-Killingly, said she wanted to review the report before commenting but “I … obviously want our autistic children protected.”
Children’s Committee ranking member Sen. Henri Martin, R-Bristol, said he was interested in looking at the issue.
“The Child Advocate’s findings merit a bipartisan review for potential action in order to create oversight in a system that currently has none,” Martin said in a statement. “We appreciate the good work the Office of the Child Advocate does to protect vulnerable Connecticut kids.”