Parents

The diagnosis of a child with autism has a wide impact on all circles surrounding them, first and foremost their parents and siblings. The Association sees parents and other close family members as the natural and most important partners for the construction and implementation of advanced intervention, so that each child will be able to realize his or her potential. The therapeutic teams of the Association create continuity between the work in the educational framework and the home, with delicate attention paid to the needs of the parents and their social and cultural characteristics. The Association offers parents professional care that includes guidance, support, and direction, enabling them to be involved in the therapeutic work with their child, and helping them make decisions in finding the right path for them to fulfill their parenthood.

FAQ

We recommend contacting the Kupat Holim Child Development Institute and asking for a developmental assessment.

Diagnostic procedures are available at child development institutes within the framework of health funds (Kupot Holim). Formal diagnosis consists of a multi-session process with at least two professionals: a developmental physician/neurologist/pediatric and youth psychiatrist, and a clinical/developmental psychologist. At the end of the process, the diagnosticians provide separate diagnoses with their respective signatures. There are parents who may wish to turn to doctors and psychologists privately. In the event that this is the case, it is even more important to make sure that they are professionals who indeed specialize in autism.

To date, there is no blood or genetic test that can indicate autism. Autism is often diagnosed using a variety of tools: questionnaires filled in by parents and kindergarten teachers, observations, and formal diagnostic tools – some designed specifically for identifying autism – such as the ADOS test. The diagnostic tools have undergone validation processes that make them reliable and accepted in the world.

The evaluators collect all the data and formulate an opinion based on the diagnosis of autism as defined in the DSM-5.

There are several things one can do:

– Read and collect information about autism. It is important to understand the criteria for diagnosis and how they are manifested in your child.

– Consider hiring a professional (usually a psychologist or a social worker with specific expertise) for initial counseling aimed at assisting the family in getting prepared.  A professional can help define needs, prioritize, understand options, start bureaucratic processes to gain rights, and help guide you in the decision-making process (regarding educational and therapeutic options). Social workers can be assisted by child development institutes, as well as social workers in rehabilitation/disabilities, who can be found in the social services department at the local municipality. Another option is to seek advice from organizations that specialize in counseling parents about their rights: Alut – Family Center, Kesher, and others.

– Applying to the National Insurance Institute (Bituach Leumi) for the purpose of gaining recognition and receiving government benefits for a disabled child (see below). This recognition constitutes the basis for exercising additional rights and for receiving government benefits and further support.

– Family preparation. It is imperative that these processes be carried out by both parents and that this stage will not be the responsibility of only one parent. It is worth thinking about whether and how to involve a member of the extended family, as well as what would be the best way to involve the child’s siblings.

-Counseling services for parents – Parents are the main figures in a child’s life. Therefore, while choosing an educational framework and treatment system, it is important that parents seek guidance to help them understand the child’s various needs and behaviors, and to deal with various dilemmas, differences and difficulties. Professional literature shows that parents who feel confident in themselves and their parenting skills and who allow themselves to undergo their own personal process lead to greater progress in their child.

Upon receiving the diagnosis many questions arise, such as – which framework would be best for the child? What treatments would the child need? What would help the child make the most progress? What part should the parents play in the process?

It is usually necessary to make such decisions within a short period of time in order to implement the principle of early intervention and to take advantage of the “window of opportunity” – the years in which the child’s brain is still developing, thus being susceptible to significant changes and influences.

In the decision-making process it is important to focus on the questions – what are my child’s needs? What type of support do they need and to what extent, in order to develop in the best possible way? What would suit them the most, and no less importantly – what suits us as a family?

For this process, we recommend that you:

  • Collect as much information as you can.
  • Find out about and check out your options.
  • Be involved in any chosen therapeutic process, not leaving it to the therapists alone.
  • Encourage open communication between family members about the situation, the process, and the decisions to be made.
  • Examine the training, knowledge, and experience of therapists. It is recommended to look into known methods as listed on the Ministry of Health’s website, rather than adopting multiple or non-research-based methods.
  • Set a clear timeframe and list of expectations for dealing with caregivers and professionals in order to be able to make periodic assessments and to enact changes if necessary.

Parents can choose whether their child will learn in the regular education system or in the special needs education frameworks. In order to be placed in either, parents must contact the Department of Education or Special Education at their local municipality, where they will be required to file in their request forms as well as diagnostic paperwork with the placement committee. If parents are interested in having their child learn in the regular education system with a special assistant, they must contact the special education department and ask for an integration committee to review their diagnostic documents.

We recommend consulting with the professional team that originally diagnosed the child; talk to parents whose children are already in special and regular programs; meet experts such as psychologists, social workers and educators; search for information that sheds light on the options and their implications. All of this is in order to get a clearer understanding of what the role of an integrating educational assistant is, how many professional hours are allocated for children, what training is given to the family, the scope of the basket of services provided in a special framework, etc.

There are a number of available frameworks:

 

  1. Rehabilitative day care center. Belongs to the Ministry of Welfare, operated by NGOs. The center is designated for toddlers aged 1-3. One must contact the social worker at the social services department with the appropriate diagnosis paperwork. Once a child’s eligibility for disability benefits is recognized by the National Insurance Institute, the social worker will file a request for care services for an autistic person from the Ministry of Welfare and will guide the parents through the placement committee process, which will determine eligibility for care in a local rehabilitating day care center. Please note that while committees convene year-round, sometimes the daycare centers themselves are at full capacity.
  2. Communication Preschools for children with autism. Operate under the Ministry of Education, Department of Special Education. Intended for ages 3-6. Diagnosis paperwork must be submitted to the special education department in the local municipality during the months for February – March. Once processed, parents will be summoned to appear in front of the placement committee, followed by placement in the appropriate preschool. This prerogative also includes transportation. In addition to the basket of services provided by the Ministry of Education, most of Israel’s communication preschools also offer a “health advancement basket” that is operated by non-profit organizations as an executive arm of the Ministry of Health, in accordance with an agreement with the local education system and municipal authority.
  3. External center. Treatment centers that allow children who are integrated in the regular education system to receive a “basket of advanced health treatments” in various municipal centers during the afternoon. There are a limited number of such centers in Israel.

Integration into regular framework with an assistant. Available both at daycare centers and preschools. At preschool age one can file a request with the Ministry of Welfare for assistant hours and can integrate the child into a regular framework, provided that the child attends an official daycare center (does not apply to children who go to private daycare centers). At preschool ages, parents must refer to the integration committee and act according to the approvals and instructions given by the local authority.

In therapeutic daycare centers, there are  three teams supervising the frameworks: on behalf of the Ministry of Welfare, on behalf of the Child Development Department of the Ministry of Health, and on behalf of the Autistic Service in the Ministry of Health Mental Health Department.

The Communication Preschools are accompanied by a regional supervisor for special education appointed by the Ministry of Education, as well as professionals from MATIA- the regional community support center, and the educational psychological service in the community. If a “health advancement basket” is provided by the preschool, a supervising team will be appointed by the autism services section in the Ministry of Health’s Department of Mental Health.

The basket includes 10.5 hours of direct therapy divided into 4 types of treatment: individual, group, examination and consultation by a physician (psychiatrist or neurologist), and counseling for parents.

According to the instructions issued by the Ministry of Health, as part of the direct therapy, each child must receive one weekly treatment by a speech therapist, one weekly psychologist, or a licensed social worker in the absence of a psychologist, and one weekly treatment by an occupational therapist. The rest of the hours will be filled will individual and group therapy sessions conducted by recognized licensed therapists according to the directives of the Ministry of Health and the kindergarten staff.

Each child is also entitled to 3.5 indirect hours – professional training hours for therapists and team meetings aimed at coordinating and maximizing the efforts for each child.

The basket includes 10.5 hours of direct therapy divided into 4 types of treatment: individual, group, examination and consultation by a physician (psychiatrist or neurologist), and counseling for parents.

According to the instructions issued by the Ministry of Health, as part of the direct therapy, each child must receive one weekly treatment by a speech therapist, one weekly psychologist, or a licensed social worker in the absence of a psychologist, and one weekly treatment by an occupational therapist. The rest of the hours will be filled will individual and group therapy sessions conducted by recognized licensed therapists according to the directives of the Ministry of Health and the kindergarten staff.

Each child is also entitled to 3.5 indirect hours – professional training hours for therapists and team meetings aimed at coordinating and maximizing the efforts for each child.

First, the parents must sign explicit consent documents to receive the treatment basket in its entirety. Second, the parents must sign medical waiver documents, which allow the team to be in contact with each other, the counselors and the Association’s management and control network, as well as receiving approval, payment requirements, and supervision from the Ministry of Health.

Parents must pay the co-pay due to the operating organization, as determined by the Ministry of Health.

It is important to know that the parents cannot choose what they will receive in the basket, and cannot ask to receive only part of it – the Ministry of Health defines how the basket is composed. The guidelines can be found on the Ministry of Health’s website.

It should be noted that consenting to receive the basket of care within the preschool’s framework means that the parents exhaust their eligibility for treatment for the child, and will not be able to receive additional paramedical treatments or funding for it within the framework of the health funds (kupot holim).

When it comes to choosing treatment methods, the most important thing is to read and examine each method: what is behind it, how effective it is, how much clinical experience it has accumulated, who it is suitable for, etc.

It is worth consulting various professionals and other parents, but it is equally important that parents examine which approach they themselves connect with the most and what they think will be appropriate for their child. Ultimately, adapting the therapeutic concept to both the child and the family and his or her natural environment may improve coordination and therefore progress.

Over time it is highly recommended to pay attention to the child’s process and see how they respond to the treatment and therapists. If parents feel that things are not going as expected, it is best to engage in dialogue and consult with therapists.

The Association does not operate according to one treatment approach, but rather applies different models in various frameworks approved by the Ministry of Health. Among these models are those that combine the DIR (FLOOR TIME) approach, the ABA (Applied Behavior Analysis) model, the social skills model currently being developed, and the Early Start Denver Model (ESDM) model.

The Association stresses the importance of addressing all areas of development, and providing professional and advanced support in the motor, sensory, emotional, communicative, linguistic, educational, and behavioral fields. We also consider the importance of supportive attitudes towards each child not only in places where he or she is having difficulty, but also to help them lead in their strengths.

Our professional staff sees room to relate and nurture emotional and functional components in order to strengthen the sense of security, self-worth and self-awareness, founded on the recognition that these are the basis of the child’s relationship with his or her environment and the basis of their ability to fully realize their development.

The Association employs therapists who practice known and recognized health professions approved by the Ministry of Health: psychiatrists or neurologists, occupational therapists, speech therapists, physiotherapists, psychologists, licensed social workers, behavioral analysts, and expression therapists.

A child who is diagnosed with autism by all the criteria (according to the instructions of the National Insurance Institute and the instructions published by the Ministry of Health), will be entitled to a 100% disability allotment benefit for a disabled child from the National Insurance Institute.

In order to claim benefits, you will have to fill out the application form, which can be obtained at the branches of the National Insurance Institute or downloaded from the Institute’s website. Two separate diagnoses should be attached to the form: one signed by a neurologist/developmental physician/psychiatrist, and another by a clinical/developmental psychologist. A diagnosis of ASD (autism), a list of the diagnostic tools used, and the criteria examined – should be specified explicitly in accordance with the Ministry of Health’s guidelines (which can be found in the Director General’s guidelines on the Ministry of Health’s website). After completing the forms, one must wait for a medical committee to convene. Parents may choose to be present (them and the child) or not.

If the committee rejects the request or only approves a partial allotment benefit, parents may file an appeal in accordance with the National Insurance Institute guidelines, which appear on their website.

Please note that at younger ages, the approval is usually temporary. One must look out for the renewal date and act to file for a renewal using the updated paperwork required by the National Insurance Institute.

Dependence Allotment: Children over the age of three who depend on others can receive an additional 17% of the disability benefit. For this purpose, contact the National Insurance Institute.

There are a number of discounts:

  • Discount on municipal taxes (Arnona). In order to receive this discount, contact your local municipality.
  • Up to 50% off of the fixed fee for a Bezeq landline.
  • Disabled parking permit and exemption from vehicle fee. For these benefits, contact the District Licensing Office.
  • Two income tax credits that can be divided between both parents. For these benefits, contact the tax assessor.
  • A person entitled to dependency allotments in addition to the basic benefits can also enjoy a discount on their electricity bills.
  • A discount on purchase when buying an apartment designated for the child’s residence.
  • Eligibility for a foreign caretaker. A child entitled to a disability allotment from the National Insurance Institute may sometimes also receive a permit to employ a foreign worker granted by the Ministry of the Interior. This permit does not include financing.
  • Children over the age of three can be approved for tutoring hours in which a person who is not a professional comes to the house in the afternoon to communicate and play with the child. The service is provided through the social services departments and eligibility is determined according to the family’s socio-economic situation. Contact your social worker. This service involves a certain co-pay.
  • Eligibility for up to three weekly hours of treatment by health professions through kupat holim. This entitlement is granted to a person who does not receive an advanced health basket within the framework of a communication preschool from one of the non-profit organizations. For these benefits, contact the kupat holim. The child is eligible until the age of 18.

The success of any program in advancing a child depends to a large extent on the professionalism of the working staff and on the fruitful cooperation between the parents and the caregiver, whether in an educational setting, in a therapeutic center, or at home.

It is important for the parents to be involved in the program and interact with the team in order to create continuity and coordination between the different parts of the day and the environments of the child’s life.

This part is not always simple or obvious, since everyone working with and close to the child usually has his or her own view of what would be best for the child. It is best to harness this goodwill for the sake of cooperation, and even conducting dialogue around issues and disagreements.

The Association provides many services, including:

  • Operates therapeutic day care centers for infants on the spectrum.
  • Operates an advanced health treatment basket in numerous preschools all over the country.
  • Operates the “In-School” program for school aged students in a number of regions in the country.
  • Operates a number of treatment centers for children integrated in regular and special education, who do not receive the advanced health treatment basket, which enables them to receive all treatments under one roof in a concentrated, professional manner.
  • Operates several professional diagnosis and treatment centers for children of all ages and adults on the spectrum, available for parents to approach privately.
  • Operates a discount scheme for families of children who attend communications preschools and receive an advanced health treatments basket, in order to make these baskets accessible also to families who cannot afford the co-pay required by the Ministry of Health. Eligibility is determined by a standard financial ability test.
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