Although Medicaid is the largest public payer of behavioral health services, information on access and utilization of services is lacking, and no data on the frequency of service use or types of services provided for children with autism spectrum disorders (ASDs) are available. As states move toward managed care approaches for their Medicaid program, services information is critical. Behavioral health service data for children with autism spectrum disorders were collected from a state Medicaid Managed Care (MMC) program and analyzed from fiscal years 1995 through 2000. Findings revealed that the number of children who received services over time increased significantly; however, the rate of service use was only one tenth of what should be expected based on prevalence rates. The mean number of service days provided per child decreased significantly, about 40%, and the most prevalent forms of treatment changed. Day treatment vanished and medication and case management increased disproportionately to the number of children served. Explanations and implications of the findings are presented as well as recommendations for future research.
Squirrel monkeys were exposed to response-independent, fixed-frequency shock that produced biting attack upon a pneumatic hose. Attacks decreased within and across sessions at low intensities and high frequencies of shock, but increased within and across sessions at higher intensities and lower shock frequencies. Stimuli paired with shock, when presented alone, came to produce biting, and stimuli correlated with shock parameters that produced increases in responding within sessions produced similar increases when presented alone. Further experiments showed that continuing exposure to shock also produced lever pressing or chain pulling, with longer shock exposure again producing higher response rates. Whereas biting generally decreased throughout the intershock interval, manual responding generally increased as shock time approached, but immediately before shock was often suppressed. Following shock, biting attack predominated over manual behavior. The results suggest a possible explanation for the extreme resistance of avoidance behavior to extinction, and may also partially explain the persistence of responding during schedules of response-produced shock. Relationships of the present findings to naturalistic observations of relations between fleeing, freezing, and fighting performances are discussed.
Squirrel monkeys were periodically exposed to brief tail-shocks in the presence of a rubber tube connected to a pneumatic switch. Biting attack upon this tube was found to be a decreasing function of time since shock delivery and a direct function of shock intensity and duration.These results parallel findings in investigations employing more "naturalistic" social situations, indicating that attack against the inanimate and animate environment -is a direct function of the intensity of an aversive stimulus. The results also demonstrate that frequency of biting attack as a datum is sensitive to several experimental manipulations.
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