Comprehensive care: MidMichigan Health brings pediatric treatment under one roof

Often times, children with autism and autism spectrum disorders (ASD) have a difficult time integrating into a classroom setting and beyond, struggling with many aspects of life beyond the classroom.

A few years ago, a new partnership formed between the Midland County Educational Services Agency (ESA), Community Mental Health for Central Michigan and MidMichigan Health to address and create a holistic and comprehensive solution to give children with ASD, or any other rehabilitative need, the strongest trajectory towards adulthood, with the ability to work and live a good life.  

The intent was to create a collaborative environment for treating children of all ages throughout the continuum of care through a set of multi-disciplinary components working together. With the help from all three organizations, The Pediatric Center for Rehabilitation and Behavioral Health was born. Under this model, the facility acts as a single touch point for parents as well, relieving parents of having to often step in as their child’s defacto case manager between facilities, providers and treatment protocols.

“As part of that process, we studied a collaborative program available through the University of Missouri called the Thompson Center for Autism and Neurodevelopmental Disorders, where children with autism come and receive therapy, comprehensive work ups, and child-specific training is provided for schools and other classroom settings,” says Katherine Dollard, Director of Behavioral Health Services with MidMichigan Health. “Some of the team went out to see the Thompson Center in person and that helped us finalize plans to model a program of our own off what the University of Missouri has created.”

This type of treatment is specifically helpful when integrating the Applied Behavior Analysis component with a child’s home and educational environments.

The team of organizations started the initial program at Midland ESA’s Sugnet School campus in Midland, but quickly outgrew the facility and moved to Longview Elementary School.

“After the initial move, we found we outgrew the facility at Longview as well,” says Dollard. “And then we were able to renovate and move into the facility that has now become the new Pediatric Center for Rehabilitation and Behavioral Health. The facility is occupied by MidMichigan Health and Community Mental Health for Central Michigan with support from Midland County ESA.

The Pediatric Center for Rehabilitation and Behavioral Health model aims to equip children and young adults ranging in ages from birth to 17, with the functional tools that allow them to adapt, learn, grow and thrive.

With that comes a range of services that can be tailored specifically to each child’s needs. The Center is equipped with the resources to treat children with autism and all other neuro-behavioral disorders. The Center also provides specialty rehabilitation programs for children with neuromuscular, cardiopulmonary, integumentary, and musculoskeletal deficits and injuries for children of all ages. The Center is a leader in rehabilitation and is dedicated to empowering the whole family so they can optimize each child's quality of life. They see children with all diagnoses; from cerebral palsy to pediatric athletes, the Center’s rehabilitation team is experienced and works hard to provide outstanding care with the best patient outcomes. The Pediatric Center for Rehabilitation and Behavioral Health brings occupational therapy, physical therapy, speech language therapy and Applied Behavior Analysis (ABA) under one roof.

The Center has a range of services that can be tailored specifically to each child’s needs.

“When it comes to treating children with autism and beyond, having all of these disciplines available in the same facility and often working together is state-of-the-art care,” says Dollard. “We also work with the child’s school and make sure that our programs and their programs match or at least complementary, so we aren’t working against one another for the child’s development.”

“That helps in the cases where we can connect our treatment plan with issues their teacher may be having at school or a parent at home, because when you are trying to change a behavior, it helps if the child is getting one consistent message,” says Dollard. “This comprehensive treatment plan helps everyone get on the same page with each family and working as a team for the best care of the child.”

This type of treatment is specifically helpful when integrating the Applied Behavior Analysis component with a child’s home and educational environments.

“ABA works on both positive and negative behavior change, with issues like aggression for example and addressing the cause of negative behaviors, while also reinforcing and supporting things we want to see increased like socialization, communication, toilet training and more,” says Dollard. “The program really looks at a child’s strengths so we can build on those capabilities and behaviors, and in instances where children are atypical in their neurodevelopment, we target treatment to help build positive skills they will need going forward.”

“Because we’re working with children, these programs all feel like different forms of play,” explains Dollard. “So, our Board-Certified Behavior Analyst and Behavioral Technicians design specific programs around the different types of skills and behaviors that children need based on the identified goals and the age of the child.”

A microphone and audio equipment utilized with the Center's speech therapy team.

Thus, the care provided at the Center is truly individualized and targeted for learning skills in treatment that will transfer to behavior and function at home, school and beyond.

“Our philosophy is that we can do so much of this through fun, engaging activities that feel like school and play with lots of positive attention,” says Dollard. “Sometimes these types of services get a reputation that they are based on discipline and rigidity, and we make sure this is a very positive experience for the child and the family.”

“We’ve seen children make some tremendous strides in a short amount of time,” says Dollard. “Instances where children initially didn’t want to come to treatment and were aggressive while they were here, who now say they don’t want to go home and want to stay and play with their best friends. For us, it brings tears to our eyes sometimes to see the amount of growth and change in these children through this treatment.”

These strides often transfer to behaviors at home or school, especially if they are reinforced in a comprehensive manner notes Dollard.

 “For example, if the child is working on developing their eye contact or writing skills, we will regularly have parents and teachers tell us that these are behaviors they are seeing increase shortly after they start working with us. It’s truly remarkable to see,” says Dollard.

A therapist at MidMichigan's Pediatric Center for Rehabilitation and Behavioral Health.

The Center opened in January 2020 with both new and existing patients, and continued to treat patients with enhanced safety protocols in infection prevention due to the COVID-19 pandemic. ABA services resumed in June 2020 and got back to a great second start

Treatment ranges from child to child depending on their specific needs. Some children may come as little as five hours per week, other may come as much as 30 hours per week, based on the child’s individual needs.

With the needs of our immunocompromised and otherwise vulnerable patients and families, the Center also leverages MidMichigan Health’s robust telemedicine capabilities, and patients can be seen virtually for their care.  During the COVID-19 pause, telehealth was available for children and parent training also took place. Telehealth will be an ongoing option for rehabilitation services in all disciplines.  

The facility works with both commercial insurance providers and Medicaid. For physical therapy, occupational therapy, and speech therapy services all insurances are welcome and we do have a self-pay option as well. Most children covered by Medicaid being seen for ABA services are treated in the Center by Community Mental Health for Central Michigan (CMHCM).  MidMichigan Health also contracts with CMHCM to see some children with Medicaid as their secondary insurance.  Some insurance providers require that the child first receive an evaluation at an Approved Autism Evaluation Center (AAEC), while others allow for a direct referral without first going to an AAEC.    

“Because we’re working with children, these programs all feel like different forms of play,” explains Dollard.

The Center is working on eliminating some of those barriers, and is in the process of getting approval to become an approved Autism Evaluation Center. Approval is expected later this year, but until then, potential patients are encouraged to call the Center and have someone walk through any insurance questions with them.

“With the move to this comprehensive model and into our new Center, we have truly really broadened our capabilities, gained new space to work with a larger age range, and most importantly, gives us the space to grow,” says Jena Colon, manager of Rehabilitation Services at MidMichigan Health. “We now have the ability to leverage huge indoor and outdoor spaces, we’ve added additional therapists and expect to add more once we receive the final authorization as an approved Autism Evaluation Center.

That approval will add to the Center’s breadth and depth of experience.

“The true strength in our programs lie in our great patient outcomes and the years of experience of our therapists,” says Colon. “Our therapists have an average of over 20 years of experience in pediatric rehabilitation across all diagnoses and it is truly a wealth of knowledge and experience to draw from. Experience plays a huge role when it comes to working with children, as we will often be with them through every age and stage of life.”

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Read more articles by Courtney Soule.

Courtney is a longtime Midland resident and enjoys telling the story of the community's evolution. She ran Catalyst Midland as the publication's managing editor from October 2017 through September 2020. Her favorite topics are interesting people, change makers, outdoor recreation and design. Aside from Catalyst, her published work can be found various places including Elephant Journal, Thought Catalog and a number of other websites, papers, menus and the occasional one-liner.