Taylor is looking intently at the matching game in front of her. The 3 1/2-year-old is the picture of concentration, so much so that she is beating the pants off the adults playing with her. During the game, she asks to take a nap, and her mother gently redirects her to continue with the game until it is done, which will be very shortly. At naptime, Taylor goes to bed and stays there by herself until she falls asleep.

Sounds like a pretty typical afternoon in the life of a preschooler, but until just five months ago, says her mother Heather, this scene would have been unimaginable. “Taylor would melt down anytime she had to stop something. If she was working on a puzzle and it was time for dinner, if she didn’t want to stop, it was a 30- or 45-minute tantrum,” says Heather. Naptime was equally chaotic. “Taylor had broken all of the locks and doors. She was hurting herself trying to climb out the window,” she says. “It could take up to two hours for her to calm down enough to take a nap.”

Last December, Heather and her husband, Tom, finally had a name for what Taylor was experiencing: Autism Spectrum Disorder, which also explained Taylor’s language delay, issues with sensory overload and her hyperactivity. The school system recommended that the couple look into federally-funded Behavioral Treatment Services (BTS) provided by Lutheran Family Services (LFS), and since January, Taylor has been receiving 15 hours of services a week.

Funded by Medicaid, BTS uses the diagnostic tools of Applied Behavior Analysis to create a plan for better functional behavior, communication, and self-regulation – in short the skills that help children better cope with a complex world.

To help Taylor transition from activities, the BTS team came up with visual strategies that provided her both structure and a way of understanding her daily routines.

“There is still a hiccup now and then, but now I know why Taylor is acting the way she does, and this assistance has given me tools I can keep in my back pocket to use at any time,” says Heather. “Taylor will have to adjust to life, because life isn’t going to adjust to her,” Heather says. “That’s the real world and that is the world I want for Taylor.”

Data sources

• U.S. Census Bureau, “American FactFinder,” 2007 American Community Survey (accessed May 2011). Data came from the following tables: Statewide poverty percentages, GCT1701, Ratio of income to poverty level, C17002
• U.S. Census Bureau, “American FactFinder,” 2009 American Community Survey (accessed May 2011). Data came from the following tables: Statewide poverty percentages, GCT1701, Ratio of income to poverty level, C17002
• Half in Ten analysis of Table 1, 2007 State Expenditure Report, National Association of State Budget Officers.
• Half in Ten analysis of Table 1, 2009 State Expenditure Report, National Association of State Budget Officers.
• U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement, 2007 through 2008.
• U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement, 2009 through 2010.