Exploring a Neurodiverse Oasis: BI’s Metaverse Experience

Behavior Imaging is known for our dedication to telehealth solutions that focus on and extend beyond autism. We’re constantly exploring innovative technological advancements that improve access to healthcare and services for individuals with autism. Recently, we had the chance to be part of a ‘metaverse’ community experience, an opportunity we couldn’t resist.

Our co-founder, Ron Oberleitner, and his son, Robby, participated in the first-ever Neurodiverse Community ‘Virtual Pavilion’, a showcase of 3D art and self-expression for those with autism.

Collaborating with immersive technologist Kathleen Cohen on her community based project for the Surel’s Place art residency (Link to Project Overview), her aim was to bring together people from Indigenous and Neurodiverse communities to share in authentic storytelling fashion where the commonalities are found. Additionally with the help of designer Julez (Julio Gonzalez) of the Autism XR Institute (AXRI Website), ArtAbility Uidaho, and local arcade VR1; together they developed 1 of 5 3D environments among Kathleen’s dedication, each accessible via any device with WiFi capabilities.

With these collaborators, Behavior Imaging took part in a multi-user 3D environment in Spatial.io. Websites like Spatial.io are called Web-Based Meeting Platforms, early forms of Metaverse locations that allow viewers explore an interactive 3D environment. These platforms can be accessed via Web Browser, Mobile Phone, Augmented Reality, Mixed Reality, and Virtual Reality devices all in synchronous!

Using this interactive multiuser experience, Robby’s art was punctuated by hand-drawn letters, exquisite calligraphy, and nostalgic scenes from beloved classics like Barney the Dinosaur, offers a unique lens into his world. As you can see in these videos, Robby is reaching out with his hands and drawing a live 3D painting.

In this collaboration, the spaces developed were geared toward community storytelling among Neurodiverse and Indigenous organizations. Partnering with AXRI to develop the space dedicated to neurodiversity, we explored what’s possible in regards to non-verbal communication using a 3D paint tool in the VR headset! (Link: See the space for yourself here!)

At Behavior Imaging, our conviction is unwavering. We see technology not just as a tool, but as an ally – one that dismantles barriers, enabling those with autism to weave their narratives into the larger tapestry of our shared human experience. This metaverse initiative wasn’t merely a demonstration of VR’s capabilities; it was a testament to the collaborative spirit, innovative drive, and deep-rooted compassion that paves the way for transformative experiences.

We cordially invite each one of you to partner with us, stepping into the vast, limitless realm of emerging technologies. Let’s craft a world where every voice is heard, every talent is recognized, and every individual can flourish in their unique brilliance.

Stay engaged with Behavior Imaging for more insights and updates on our metaverse exploration, as we continually strive to harness the magic of technology for the betterment of the autism community.

#BehaviorImaging #VRforAutism #MetaverseEmpowerment #NeurodiversityCelebrated #AutismCommunityInnovates #spatialcomputing #Spatial #Spatialio #3D #3Dpainting #XR #VR #AR #MR #Immersivetechnology #Nonverbalcommunciation #Idaho

Meaningful Support for Autistic Students with Behavior Imaging

(updated and reposted from August 2016) Starting school presents a number of challenges for any child, including resuming ‘normal’ life after a once-a-century pandemic. Unfortunately, children living with autism are often given fewer options in the classroom. As autism prevalence rises, resources in the educational system can fail to meet families’ needs. Families in rural communities are often unable to connect with expert clinicians. And families in urban communities are faced with long wait-times and lack of timely access to diagnostic and intervention services. Behavior Imaging seeks to introduce more options for students living with autism through remote behavior assessments. Two recent studies by Emory University School of Medicine and CAIU (Capital Area Intermediate Unit) 

employed Behavior Imaging’s technology in the classroom. We’re hopeful that the clear and simple evidence of meaningful outcomes from these studies can make all the difference for both students and families.

student support autism teachers study meaningful outcomes

Emory School of Medicine’s Center for Leadership and Disability Study

Teachers who don’t have immediate access to expert clinicians face difficulties when serving the behavioral needs of their autistic students. The Emory School of Medicine’s Center for Leadership and Disability recognized the growing potential for web-based video sharing technology to address these difficulties. The school launched a study to determine the feasibility of using Behavior Imaging’s technology to conduct remote behavioral assessments. Five students (ages 7-13) and their respective special education teachers participated in the study. These teachers were able to record video of their students’ behavior using our secure, HIPPA compliant Behavior Connect™ website. Clinicians then viewed, analyzed, and tagged video evidence. At the end of the process, clinicians provided teachers with a report of assessment and treatment recommendations. Not only was the overall study successful, there were reported cost-benefits as well. Savings were approximated at 40% according to the final results. We’re thrilled that the outcome of this study allowed for more potential ease between students living with autism and their teachers.

The CAIU Study

CAIU’s study addressed a slightly different need using the same components. Behavior Imaging’s technology was used to facilitate inclusion for students with autism and behavior challenges. Paula Kluth writes about the inclusive classroom in her book, You’re Going to Love This Kid!

“If students will need specialized supports to succeed academically, then teachers need to see the learner functioning in the inclusive classroom to know what types of supports will be needed.”

In a two-year pilot study, CAIU implemented Behavior Technology in a series of classrooms to facilitate inclusion between teachers and students. Their defining need was as follows,

“The reduction of frequency, duration, and magnitude of severe behaviors is critical in order to increase the inclusionary opportunities for these students as well as movement from more restrictive to less restrictive educational environments.”

Behavior Imaging Systems were employed to both accurately assess severe behaviors in autistic students, and to identify replacement behaviors while developing effective Positive Behavior Support plans. The study’s outcome saw a solid decrease in aggressive behaviors from a specific student living with autism, as well as cost savings of nearly $1300. What’s more, users found the technology adoption of Behavior Imaging tools overwhelmingly simple.

A Meaningful Tomorrow

Though both studies target a different need, they also point to the same hopeful conclusion. Providing support for autistic students, no matter the level of education, is vital. Empowering their teachers with simple and effective tools is just as important. Whether providing an accurate diagnosis or finding ways for inclusion within the classroom, Behavior Imaging always strives to provide the meaningful outcomes for those supporting children living with autism. We’re confident that these two studies provide a positive way forward for teachers, families, and students.

outcomes support students autism technology study meaningful






NIH Grant to Transform Diagnosis System of Care

Through a new NIH Small Business Innovation Phase IIb Commercialization (5R44MH112470) grant, we are enhancing NODA(tm) to be the market’s first hybrid telehealth platform.

This grant will help NODA develop and test a new system of care to accelerate autism evaluations remotely to assist all stakeholders (diagnostic clinics, referring pediatricians and affected families) as shown in the following video (1 minute):

Project will connect Primary Care providers with referring diagnostic clinics electronically, through our collaboration with Total Child Health, Inc. and its popular CHADIS (chadis.comPediatric Autism Screening Software Platform. CHADIS is used by > 3,000 pediatricians to help them screen young children for autism during the family’s well-child visits.

BIS engineers will be also introducing BI LIVE(tm) in this project – a unique realtime telehealth tool that gives clinicians better clinical documentation during a video consult. Look more for this innovation in future posts.

Starting Spring 2021, a validation study will be taking place throughout Georgia (led by Emory Autism Center), and a multi-region comparative study will research NODA’s benefits compared to conventional InPerson assessments. Research sites will be in California (Children’s Hospital of Los Angeles), Arizona (Southwest Autism Research and Resource Center), Idaho and Eastern Washington (University of Idaho’s Center for Disability and Human Development). Ascend Behavior (Texas, Colorado, Arizona) will provide additional diagnostic clinic expertise as needed.

For more information about this project, please reach out to PI Ron Oberleitner at ron@behaviorimaging.com

If you like to see additional videos, go here  Video Gallery




Original Song Aims to Shine a Light on Telehealth and Autism

To raise awareness of the potential of telehealth to improve autism care — even during a pandemic, Behavior Imaging has partnered with musician Ned Evett to release an original song and video, “If You Shine a Light on Me.” The song is available on iTunes, and proceeds from downloads will be donated to Autism Speaks, to continue their advocacy and support for individuals with autism and their families. You can also watch the video below.

Download on iTunes HERE or Download on Amazon HERE

Telehealth and Autism

Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care. Telehealth technology can help overcome the obstacles of distance, access to specialists, and cost, so families and autism experts can work together to greatest success. The song and video are launching on World Autism Awareness Day 2018 to raise awareness not only for autism itself but also for a potential avenue of vastly improving autism care in the near future.


We have always been passionate that telehealth could help our kids be diagnosed earlier and help families access treatment easier.


“We have always been passionate that telehealth could help our kids be diagnosed earlier and help families access treatment easier,” said Ron Oberleitner, CEO and Founder of Behavior Imaging. “I believe Ned’s beautiful song will help shine a light on the health needs and the special gifts of children with autism and their amazing caregivers and experts.”


About Ned Evett

Ned Evett is a singer, songwriter, and one of the world’s foremost fretless guitarists. He has toured the United States, Europe, Canada, England, Ireland, Mexico, and Australia including a world tour with Grammy-nominated artist Joe Satriani. Also an illustrator and animator, Ned chose to apply his unique set of skills to this project because of his belief in the potential of telehealth to improve autism care.

“We all have a smartphone in our pocket that is capable of fantastic feats,” said Evett. “It seems clear that we must harness that technology to help individuals with autism and their families. Once I knew about the need for telehealth solutions, I knew I wanted to help spread the word.”

Learn more about autism and telehealth with Behavior Imaging’s remote autism diagnosis tool, NODA.

COVID-19 Leads to Telemedicine Expansion

The COVID-19 pandemic has changed every industry worldwide. While some industries are struggling to regain a sense of normalcy four months into the pandemic, the current state of the world could be a tipping point for the use of telemedicine. 

In March of 2020, all 50 states passed temporary actions of some kind to remove barriers to telehealth access. According to research done by Knowable Magazine, telemedicine usage jumped by nearly 20% between February and May of 2020. As state governors, insurance companies, doctors, and patients realize that telemedicine is here to stay, many are making efforts to make those temporary laws more permanent. 

Past, Present, and Future of Parity Laws

Telehealth parity laws have been a major barrier in the struggle for broad usage of telemedicine. These laws allow for reimbursement of telehealth services at the same rate of in-person care. As of 2019, 34 states had parity laws in place, 4 had proposed parity laws within the house or senate, and 11 states had no parity laws whatsoeverEven in states with parity, each set of laws is different, and parity does not always equal pay equity, which limits accessibility for patients on Medicare. (For more information on state-by-state parity, read our blog discussing pre-COVID laws here.)  

Telehealth Parity COVID-19

Telehealth Parity by State, image courtesy visuwell.io

In an article for Smithsonian Magazine, doctors and telehealth providers discuss what a post-COVID world means for telehealth. One of the doctors interviewed is Joe Smith, cardiologist, and coauthor of an overview of telemedicine in the Annual Review of Biomedical Engineering. 

“I don’t think we go back,” Smith stated in Smithsonian. “For a long time, hospitals have been the cathedrals of health care where patients have to come. But people are now seeing that they can get their health care in the safety and comfort of their own home.”  

Telehealth Taskforce

In late June, once it became clear the COVID-19 pandemic was far from over, a coalition of 340 organizations sent a letter to Congress urging leaders to make telehealth reform permanent. The letter asks Congressional leaders to focus on these priorities: 

  1. Remove obsolete restrictions on the location of the patient 
  2. Maintain and enhance the Department of Health and Human Services’ (HHS) authority to determine appropriate providers and services for telehealth 
  3. Ensure Federally Qualified Health Centers and rural health clinics can furnish telehealth services after the public health emergency ends 
  4. Permanently authorize HHS to issue temporary waivers during public health emergencies 

If passed, these reforms could increase access to telehealth care for millions of Americans.  

States Making Progress

In the meantime, a number of states are making advances on their own to make temporary policy changes permanent. 

Idaho & Colorado

On June 22, Idaho governor Brad Little signed an executive order to make the state’s temporarily loosened restrictions around telehealth permanent.  

“Our loosening of health care rules since March helped to increase the use of telehealth services, made licensing easier, and strengthened the capacity of our health care workforce, all necessary to help our citizens during the global pandemic,” Little said. “We proved we could do it without compromising safety. Now it’s time to make those health care advances permanent moving forward.” 

COVID-19 Telehealth

Idaho Governor Brad Little makes COVID-19 Telehealth laws permanent.

Idaho is still one of the 11 states still without telehealth parity, but this new executive order could lead to greater progress down the road. 

On July 6, Colorado also passed a permanent bill that expands Medicaid coverage for telehealth services, in a huge victory for rural health clinics and patients. This coverage will include speech therapy, physical therapy, occupational therapy, and pediatric behavioral health care.   

Tennessee & New Hampshire

In Tennessee, a state with parity laws but not “true parity”, Governor Bill Lee eased telehealth restrictions in March. Now, State Representative Robin Smith is attempting to pass a bill to make those measures permanent. Pay equity is the central dispute between the state House and Senate, which have yet to agree on the bill. 

New Hampshire is also attempting to make Governor Chris Sununu’s emergency telehealth order, which allowed all health care providers to offer services remotely and required insurers to cover them, permanent. The bill has passed the House and is now waiting to be endorsed by a Senate committee. 

The Future of Telehealth

In a time where the only thing known for certain is that nothing is certain, an expansion of telehealth laws nationwide could bring a bit of certainty to millions of Americans. Now that decision-makers are more fully realizing the benefits of telemedicine and engaging in previously un-had conversations about these benefits, we are hopeful telehealth parity could become law nationwide.  






Telehealth Reimbursement Progress by State

UPDATED 6/11/2020

In response to the COVID-19 pandemic that has swept the nation, many states have taken action to remove policy barriers to telehealth utilization. These policies include waiving of licensure requirements for telehealth and temporary expansion of telehealth Medicaid coverage.

The Center for Connected Health Policy has compiled a list of actions that each state has taken, which can be accessed at this link – COVID-19 Related State Actions. 

Already, several states are hoping to make this temporary expansion permanent.



Everywhere you look, there is progress towards telehealth reimbursement. New bills are being introduced, debated, and signed into law or vetoed. (But even the vetoed bills have a way of coming back around next session.Forty-two states and the District of Columbia have telehealth laws already on the books, but inconsistencies from state-to-state can still create challenges in reimbursement for services. 

Currently, 16 states maintain laws expressly addressing reimbursement of telehealth services, but only 10 of them offer true “payment parity,” meaning that providers outside those states may still have an uphill battle when seeking similar reimbursement rates for in-person and telehealth services. 

Source: 50-State Survey of Telehealth Commercial Payer Statutes 

These inconsistencies create extra work for providers to understand the rapidly shifting landscape. The good news, however, is that nationwide coverage of (and even parity for) telehealth services is no longer a distant possibility. 

Researchers at Foley & Lardner LLP released their 50-State Survey of Telehealth Commercial Payer Statutes in December 2019. According to Eric Wicklund, Senior Editor at mHealthIntelligence, the survey shows a surge of commercial payers jumping on the “telehealth bandwagon.” More from Wicklund: 

Among the bright notes, some 34 states now mandate coverage for asynchronous (store-and-forward) telehealth services, an up-and-coming platform that enables patients and providers to connect online at the time and place of their choice, free of the challenges of real-time audio-video. 

In this article we will summarize some of the most notable efforts to expand telehealth access and coverage by state. Some of these stories specifically involve reimbursement progress, while others show expanding acceptance for, and investment in, telehealth services. For a deeper dive on the status of telehealth reimbursement in your state, we recommend checking out the full survey.   

Please note, this blog was made possible, in part, by the tireless reporting of Eric Wicklund. We highly recommend following his work at mHealthIntelligence. 


Behavior Imaging Telehealth Reimbursement by State

More and more states are making efforts to expand telehealth coverage.


The California State Assembly will consider two bills this session that could drastically expand telehealth services. The first billAB 2007, pertains to federally qualified health centers (FQHC) and rural health centers (RHC). The legislative council’s digest described the bill:  

This bill would provide that an FQHC or RHC “visit” includes an encounter between an FQHC or RHC patient and a health care provider using telehealth by synchronous real time or asynchronous store and forward. 

The second bill, introduced on February 19th by Assemblymember Cecilia Aguiar-Curry, would establish a grant program for the purpose of establishing a statewide pediatric behavioral telehealth network. AB 2464 will likely be heard in committee next month. 


The Colorado General Assembly will consider a bill aimed at improving access and outcomes for underserved populations by allowing FQHC to be reimbursed through Medicaid for telehealth services. HB 20-1092 is very similar to California’s AB 2007. 


Maryland Health Care Commission (MHCC) is seeking grant applications for a telehealth system to improve care in nursing homes across the state. The announcement from MHCC requests applications that include a “clinical workflow redesign to ensure that telehealth becomes part of the standard of care.” The two-year $750,000 grant is not intended to fund technology development, but to creatively “pioneer the use of telehealth by nursing homes across the state.”  

New legislation will help providers serve underserved populations.


This session, the Pennsylvania General Assembly is considering SB 857, a bill to authorize the regulation of telemedicine and provide for insurance coverage. The bill was referred to the Rules & Executive Nominations Committee on November 21st, and it has seen no movement since then.  


The State of Washington has a telehealth champion in Republican State Senator Randi Becker. In 2020, she plans to resubmit telehealth bills mandating payer parity for telehealth services.  


At the end of November, Wisconsin Governor Tony Evers signed a law that requires Medicaid to reimburse for a host of telemedicine services, including store-and-forward applications. The final bill did not include a mandate for payment parity, but it still represented a significant expansion in telehealth access. 

National Signs of Progress

At the national level, there are more encouraging signs of telehealth advancementCongress is considering creating an Office for the Advancement of Telehealth to consolidate its federal telehealth efforts. As recently as last week, federal officials announced that the Department of Health and Human Services will be awarding grants to rural healthcare providers who seek to use telehealth to improve emergency services. 

As the creators of an asynchronous telehealth platform, we are encouraged by all of these signs of progress. As more states require telehealth coverage and increase the breadth of services covered, more patients will experience the benefits of seeing healthcare professionals remotely. For patients in rural and underserved areas, these policy changes could become an improvement in quality of life.  

For providers who need help seeking reimbursement for telehealth services, the Center for Connected Health Policy released a telehealth billing guide in January 2020. 

Behavior Imaging Named Among Most Promising Telehealth Solution Providers of 2019

At the end of 2019, Insights Care, a digital and print publication for the healthcare industry, recognized Behavior Imaging as one of the Most Promising Telehealth Solution Providers of the year. In the magazine feature about the award, Insights Care wrote about the importance of increasing patient access to the care of expert clinicians, especially for patients in underserved areas.

telehealth, early diagnosis, autism, solution, telemedicine

The telehealth solution is a useful alternative for early diagnosis.

Behavior Imaging’s remote behavioral assessments live on HIPAA-compliant, cloud-based platform. The technology is an example of asynchronous telemedicine. While synchronous telemedicine is the delivery of health information in real-time, asynchronous telemedicine creates more flexibility around the timing of care.

“Asynchronous telemedicine refers to the ‘store-and-forward’ technique, whereas a patient or physician collects medical history, images, and pathology reports and then sends it to a specialist physician for diagnostic and treatment expertise.”
– Oren J. Mechanic and Alexa B. Kimball

Behavior Imaging was recognized alongside other telehealth innovators including TeleDentists and General Devices, a telehealth service connecting EMS and hospitals. The leadership team at Behavior Imaging is honored to be named among other companies that increase access to care through telehealth.

Founders’ ‘Side-hustle’ focused on Farming and Adult Services

G-Louise Farm’s Journey:

Hey folks! We’re Sharon and Ron, ‘day-jobbers’ at Behavior Imaging, and simultaneously (nights, Fridays, and weekends) the heartbeat of G-Louise Farms. Back in 2017, we decided to sow something extraordinary—a farm that whispers stories of growth for special folks like autistic adults, not just focusing on crops and critters, but in the hearts of everyone, especially our friends in the autism / neurodiverse community.

Cultivating Unity:

We’re not seasoned farmers, just enthusiasts learning the rhythm of the land. ‘Fun Fridays’ and our sponsorships in Emmett keep the spirit alive. We’re more than hay and piglet sales. And we realize operations might run at a slight loss, but it’s a small price for the joy of learning and growing together to something bigger and sustainable..

Heartfelt Harvests:

Our hay? Treated like gold. Our animals? They’re treated like family, receiving the royal treatment. Picture this farm as more than just hay and farm products; it’s a stepping stone toward something grander, brought to you by people who are learning to be the very best versions of themselves. 

The Vision Ahead:

Dreams are taking root! Imagine affordable short-term and long-term rentals on the farm, where one’s new (temporary?) home opens the door to a cozy space for to contribute with like-minded people. And hey, there’s something magical cooking with our plans to offer vocational rehab services for 21st century farmers.

Why We’re Pouring Our Hearts In:

We’re not experts, just passionate souls learning from our own adult son, and taking each stride from the heart. Funding? Yep, that’s on us for now, but we’re extending an invitation. If you feel the heartbeat of our journey, want to chip in, or fancy a partnership, this isn’t just a business plan—it’s an adventure. Come ride the waves of growth with us.

See more on the G-Louise Farms Facebook Page: G-Louise Farm 


The Importance of Early Autism Diagnosis

Research shows that symptoms of autism spectrum disorder, or ASD, can appear as early as the first two years of a child’s life. Extensive neurological research has also demonstrated the importance of early childhood development. During the postnatal period, when a child starts to interact with the world around them, they start to form bonds with their environment and people close to them. These bonds, as well as their first learning experiences, deeply affect their future physical, cognitive, emotional and social development. There is no question that these early years are incredibly important for any child, and perhaps doubly so for a child living with autism. Unfortunately, many families face barriers to early diagnosis and potential treatment for a myriad of reasons. The ability to bypass these barriers and obtain an early diagnosis can provide a greater likelihood of an improved developmental trajectory in individuals living with autism. We’ll explore both the aforementioned barriers families face, as well as several differences early diagnosis can make.

The Barriers to Early Diagnosis Treatment

Families living in rural areas experience one of the biggest barriers to early diagnosis due to lack of access to proper diagnostic tools. Jeremy Hsu, a science and technology journalist for Spectrum News, estimated that for more than 1 million autistic children in the United States, there only about 8,300 child psychiatrists, 1,500 child neurologists and 1,000 developmental-behavioral pediatricians. Families without access to these clinicians are often cut off from important information about their early development and treatment options. Furthermore, a joint article by Eliza Gordon-Lipkin, MD, Jessica Foster, MD, MDH, and Georgina Peacock, MD, MDH for Pediatric Clinics of North America, states that a backlog of patients can cause wait times for families that can range anywhere between 3 months to 2 years. The importance of early childhood development can make any lag in care potentially harmful for families.

early childhood, development, early diagnosis, children, autism, telehealth

Early development milestones are key for children living with autism.

The Difference Early Identification Can Make

A child can miss out on several milestones, including a regular sleep schedule and consistently responding to questions, in as little time as a year from age one to two. Because autism can potentially affect a person’s interactions socially, at school, at work, or in other areas of life, some clinicians are of the opinion that early treatment options are more cost and time efficient than a “wait and see” approach. According to a 2013 article by Robert L. Koegel, Kristin Ashbaugh, and Jessica Bradshaw for the International Journal of Speech and Language Pathology, researchers also see the potential for secondary symptoms, such as aggression or self-harm, to arise in cases where primary symptoms are not addressed early on. Telehealth is now a widely recognized option for early diagnosis. Behavior Imaging tools like Behavior Connect and NODA can provide remote diagnostic options for clinicians and families to ensure these milestones aren’t missed.

The Fiscal Difference

fiscal difference, save money, early diagnosis, telehealth, savings

Early diagnosis has the potential to save families money.

Beyond the behavioral differences of early identification, there is also evidence to support a fiscal difference. Early diagnosis has the potential to save money for both those in need of care and medical providers. Some people individuals with autism desire and need long term support while others need very little at all. Every process is unique. People who require support well into adulthood are often faced with mounting prohibitive costs later in life. In a cost-benefit model from 1998, researchers attempted to predict cost savings by introducing early treatment to children living with autism for 3 years from the time they were 2 years old to school entry. Cost savings were estimated in the range of $187,000–$203,000 for children aged 3–22 years and between $656,000–$1,082,000 for those aged 3–55 years. Whether a family’s needs are short or long term, prohibitive costs shouldn’t stand in the way of support and treatment.

The Telehealth Solution for Early Diagnosis

telehealth, early diagnosis, autism, solution, telemedicine

The telehealth solution is a useful alternative for early diagnosis.

Telehealth tools like NODA and Behavior Connect are an incredibly useful alternative to traditional diagnostic tools. By capturing their child’s behavior using smart phone technology and sending data directly to a clinician, families can bypass exorbitant wait times. Multiple visits to a brick and mortar medical facility can also lead to mounting costs that can ultimately prohibit families from receiving a final diagnosis. We’re hopeful that telehealth can provide a step in the right direction by providing a cost effective option for early diagnosis by reducing these high cost visits. It’s our mission to ensure healthy early development for children living with autism by providing diagnostic options through telehealth.

















ascend, behavior, partners, families, first, NODA, telehealth, improved, solutions

Ascend Behavior Partners Puts Families First With NODA

When Jonathan Mueller, a founding owner of Ascend Behavior Partners, thinks about how to improve services to children with autism, he starts with a basic observation.

“Parents want the best for their kids. When they realize that their child has a developmental concern, panic can set in,” says Mueller. “We see a lot of parents incredibly hungry for answers and information.”

But far too many of these families will have to wait for the information they so fervently desire.

“It can take two years from when a parent has concerns to when they get the actual diagnosis,” Mueller points out. “That is exacerbated for families who have Medicaid.”

Delayed Assessment = Delayed Intervention

developmental, trajectory, early, intervention, autism, NODA, behavior

Improved developmental trajectory depends on early intervention.

Experts agree that an improved developmental trajectory depends on early intervention. Knowing this, providers like Ascend aim to identify — and eliminate — the reasons for such long delays. 

“When a family decides to seek help, it’s hard to navigate the system and access the resources. The healthcare world is complex,” Mueller points out. “A major cause of diagnosing delays for families is the shortage of providers – both licensed psychologists and developmental pediatricians.”

The facts bear out Mueller’s conclusion. Autism diagnoses have increased over recent years. In 2012, the prevalence of ASD was one in 68 children; by 2014, it was one in 59. Yet, at the end of 2016, there were only 800 board-certified developmental-behavioral pediatricians. To put it another way, the demand for autism diagnostic services is 18 times the number of providers. To make matters worse, where a family lives can greatly limit their access to providers, and consequently, their treatment options.

“We knew we needed a more efficient way,” says Mueller.

Telehealth: A More Efficient Way

The practice at Ascend Behavior Partners consists mainly of home-based ABA services. Ascend also provides diagnostic evaluations for children with concerns for autism when diagnostic wait-times are a potential barrier to accessing treatment. That practice is led by a licensed psychologist.

“Our goal was to reduce the time from when a parent has a concern to when they have resolution down to 2 months,” says Mueller.

To help them achieve this ambition, Ascend Behavior Partners turned to NODA, Naturalistic Observation Diagnostic Assessment. NODA expedites the assessment process by enabling families to gather behavioral data at home using mobile technology.


“If our psychologists cannot observe the child, they cannot make a diagnosis. They need those behavioral observations,” says Mueller. “And every family – literally everyone – is on smart phones. There’s no reason that everything that we do with doctors cannot be enabled with smart phones and mobile devices.”

By empowering families, NODA gathers observations more efficiently than in-person visits only. And because the observations are acquired in a child’s everyday settings, they are more representative and accurate.

NODA, families, clinicians, assessment, diagnosis, autism

NODA expedites the assessment process by empowering families and clinicians

“If you bring a 2-year-old child into a doctors office, is the psychologist going to see the same behaviors as at home? That’s not the child’s natural environment. The child might have a bad day on testing or not act the same way,” says Mueller. “NODA helps our team see the child in their natural environment.”

Mueller’s experience has convinced him of the potential of NODA.

“We believe NODA plays such a critical role in behavioral observation; it can be done instead of the ADOS.”

Telehealth and the Status Quo

Mueller sees new technologies addressing real problems in a system often resistant to change.

“Let’s put ourselves in our families’ shoes,” says Mueller. “There are outdated health care systems that don’t jive with our 2019 world. For instance, most referrals are still coming in via fax.”

Then there’s the issue of new technologies being embraced by current compliance structures.

HIPAA compliance is a big concern with new technologies. For small practices, that has to be a really well-considered question,” says Mueller.

And as always, there’s the matter of payment through insurance.

“This is a big barrier to a lot of psychologists. At Ascend Behavior Partners, we view NODA as part of the cost of an assessment. Even though insurance does not pay for N

ODA, we think it would be beneficial for insurance companies to include it as a reimbursable expense in provider contracts.”

But despite the barriers to adopting new technologies, Mueller sees great promise.

Telehealth is in the first inning of the ball game. There are great technologies out there. There’s a lot of tools to create a compliance eco-system that’s leveraged by tech,” observes Mueller. “Artificial Intelligence is going to help significantly. We should absolutely use AI applications with text and video recognition.”

However, Mueller is always careful to see new technology as a means to an end.

“Technologies empower providers to make better, more informed decisions that lead to better patient outcomes,” asserts Mueller. “Technology will not replace providers. Doctors and psychologists will always be important.”

Guiding the Journey

Ultimately, technology empowers the families he serves.

“Families with autism are on a journey. They have to advocate for themselves and stay in the driver seat. It can be exhausting,” says Mueller.

For Mueller, technological solutions can make that journey easier for children with autism and their families.

technological, solutions, NODA, diagnosis, autism, families

Technological solutions can make a family’s journey easier.

“Technology can help guide them. It can facilitate follow-up and provide digestible information on what to do next.  It helps us check in on how families are doing,” says Mueller. “Families can take care of themselves better and ameliorate caregiver fatigue.”

For Ascend Behavior Partners, technologies like NODA will help give families the choices they want and deserve.