P.R. Laws tit. 24, § 3564
Interventions with the population of persons with autism spectrum disorders shall be made by providers certified through the Registry of Healthcare Professionals and/or Healthcare Professionals, and shall integrate the following strategies:
(a) Behavior.— Functional behavioral assessment (FBA) is a scientific procedure conducted when the behavior of a person affects his/her optimum function within the everyday environment. The FBA enables the development of an individualized intervention plan that takes into account the person within the environment where this type of challenging behavior is manifested.
(b) Sensory processing.— Any sensory processing assessment shall be conducted by an occupational therapist knowledgeable in sensory processing and movement disorders. In the case of oral motor disorders that affect feeding and speech processes, the assessment shall be conducted by a physical or occupational therapist licensed and trained to conduct said assessment. Such assessment shall include recommendations based on the outcome of the evaluation process in this area, in light of the findings for the purpose of developing treatment that addresses the deficiencies in the individual’s abilities to process sensory and movement information.
(c) Communication.— Licensed speech-language pathologist with knowledge or training in autism spectrum disorder shall conduct the assessment of communication functions, as well as strengths and areas of need. Effective alternatives shall be provided for the development of verbal and nonverbal communication skills.
(d) Social skills.— The goal of making an intervention for the development of social skills is focused on enabling the person to understand and act according to their social setting, ensuring their participation in inclusive environments. The objectives of the intervention are: to initiate a social behavior, minimize the stereotyped behavior, encourage perseverance, and use of an array of flexible and varied responses and the management of new and established skills, among others. These formal evaluations of social development of persons with autism spectrum disorders shall be made for the purpose of identifying the areas of need. Said evaluation shall be made by a licensed clinical psychologist or social worker with knowledge in autism spectrum disorders. The intervention for the development of social skills shall be implemented by a clinical psychologist or social worker licensed and trained to work with persons with autism spectrum disorders.
(e) Academic and preparatory area.— Academic skills include the development of reading, writing, and mathematics curriculum skills, in accordance with the standards established by the Department of Education. The preparatory skills include basic concepts that serve as the basis for the development of academic skills.
The education of persons with autism spectrum disorders entails not only academic learning but also the promotion of skills and knowledge that enable the development of personal independence and responsibility.
Persons diagnosed with autism spectrum disorders shall be referred to a preparatory preschool academic evaluation to determine their functioning level.
(1) Preschool-aged minors.— These minors shall be evaluated taking into account the learning requirements. The developed skills profiled coupled with the needs and strengths, in accordance with the evaluation conducted by the expert, shall determine the proper academic placement, as well as the support services that the minor needs. The emphasis shall be the development of the areas of need as established in the evaluations conducted. An Individualized Educational Plan (IEP), as provided in the Individuals with Disabilities Act (IDEA), Public Law 108-446 of 2004, as amended.
(2) School-aged minors.— These minors shall be evaluated through formal tests that take into account their language impairments, such as nonverbal tests, for the purposes of identifying the areas of need and be able to devise a PEI to work with said areas.
Youths diagnosed with autism spectrum disorders shall be evaluated to identify their functioning level in connection with employment. The purpose of the evaluation is to devise a plan for development and adjustment to independent life, if the case so warrants. In more severe cases, an evaluation shall be conducted to determine the need or assistance required by the youth or his/her family. After an analysis of the academic functionality of the individual, it is important to develop an independent living program that includes the skills developed at school level, adapted to the needs of said individual and focused on the weakest areas in order to reinforce their abilities.
(f) Medical home-related aspects.— In the case of children and adolescents with autism spectrum disorder, the medical home through the pediatric center and the primary physician of the child and his/her family shall serve as the care coordination center to work with community providers and the agencies to ensure that these persons have access to the services they need and to which they are eligible.
The primary physician or pediatrician shall monitor the development and conduct an assessment to identify children who have developmental delays or disabilities, including autism spectrum disorders. Once the presence of autism indicators or the diagnosis is confirmed, the primary physician and the pediatrician shall make referrals for early intervention or treatment.
This model requires care coordination between systems, namely, health, education, daycare centers, Head Start centers, and medical specialists, as well as community-based organizations that provide families with support to access the necessary services.
History —Sep. 4, 2012, No. 220, § 6.