04/01/2026
April is Autism Acceptance Month — a time when schools hang up posters, social media fills with puzzle pieces and rainbow logos, and organizations release statements about inclusion and belonging. It is also a good time to ask an uncomfortable question: are we actually building the conditions that make belonging possible?
Every day in Maine, behavioral health professionals and ed techs walk into schools, homes, and childcare programs to work alongside autistic children and kids with neurodevelopmental differences — children with enormous capacity, distinct ways of experiencing the world, and support needs that require skill, patience, and genuine understanding. These workers show up, often for little more than minimum wage, with a heart full of good intentions and a training binder that may be weeks old.
And then we act surprised when things go wrong.
I know this from the inside. Before I was an occupational therapist, I was a college kid working as a BHP — learning as I went, doing my best, and figuring out in real time what nobody had formally taught me. I was not careless. I was not indifferent. I was undertrained and under-supported, working with children who deserved more than I was equipped to give them at the time. That experience is part of why I became an OT. And it is exactly why I cannot stay quiet about what I still see happening in this field.
I have spent more than a decade working as a pediatric occupational therapist specializing in autism and neurodevelopmental differences. I have worked alongside BHPs and ed techs who were compassionate, dedicated, and deeply committed to the children in their care. I have also watched those same people — through no fault of their own — use approaches that were outdated, misaligned with the research, or in some cases, actively harmful. Not because they didn’t care. Because nobody taught them anything different.
This is a systems failure. And Maine needs to name it as one.
The gap between what we know and what we train is enormous.
The science on autism and neurodevelopent has shifted significantly over the last two decades. We now understand that many behaviors — meltdowns, refusals, sensory-seeking, shutdowns — are not defiance. They are communication. They are nervous system responses. They are children doing the best they can with the tools they have. Approaches that punish, restrain, or try to extinguish these behaviors don’t just fail to help; they erode trust, increase dysregulation, and in some cases cause lasting harm.
Yet BHPs in Maine can be hired and placed with children after completing a training that may span a few days. Ed techs often receive minimal instruction before being assigned one-on-one with an autistic child or a child with an IEP whose support needs require specialized knowledge. The bar for entry is low. The bar for ongoing education is nearly nonexistent.
This is not a criticism of these workers. It is a structural indictment of a system that underpays, undertrained, and overburdens them — and then leaves children to absorb the consequences.
The stakes are not abstract at all.
When a child in a behavioral crisis is responded to with coercive or punitive strategies, the damage is real. When a child who is communicating through behavior is told that behavior is unacceptable without anyone asking what the behavior is trying to say, that child learns that they are a problem to be managed. That belief — formed in early childhood — does not disappear. It follows them.
Maine has a stated commitment to early intervention, to inclusive classrooms, to supporting neurodivergent children in community settings. That commitment means nothing if the people delivering those supports are not equipped to do so safely and effectively.
I hear the counterargument loud and clear but, I’m making it anyway. I know what people in this field will say: we can’t find enough staff as it is. If we raise the bar, we’ll lose even more people. It’s a real concern and I don’t dismiss it.
But here is what that argument misses: low standards are not protecting the workforce. They are burning it out.
When workers are placed with children they don’t understand, using strategies that don’t work, in environments with no clinical backup — they don’t last. Turnover in direct support roles is staggering precisely because the work feels impossible. Because it is impossible without the right tools. Training, supervision, and support are not obstacles to hiring — they are the conditions that make the job survivable.
And the stakes of getting this right just got significantly higher. As Child Development Services begins to dissolve and public schools prepare to absorb the children, the caseloads, and the costs that CDS has carried — Maine’s schools are going to need more paraprofessional staff than ever before, serving children with more significant and diverse support needs than ever before. They were already stretched. Now they are being asked to do more with less, in a landscape that is actively shifting beneath their feet.
This is the worst possible moment to shrug 🤷🏻♀️ and say “we’ll figure it out.”
We need a plan. Not just for compliance, but for success. That means investing in the people doing this work before they walk into a classroom — and continuing to invest in them after. Ongoing consultation. Access to licensed clinicians. Manageable caseloads. And yes, wages that reflect the skill and emotional weight of what we are asking of them.
The goal is not to make this job harder to get. The goal is to make it possible to do well — and to stay.
Here’s what would actually help:
Maine should establish minimum training standards for BHPs and ed techs that include neurodevelopmentally informed approaches — frameworks like DIR/Floortime, trauma-informed care, sensory processing, and strengths-based assessment. Not as optional professional development, but as baseline requirements tied to real support structures.
These workers should have access to ongoing consultation and supervision from licensed clinicians — occupational therapists, speech-language pathologists, psychologists — who can help them understand the children in their care. The model of placing a paraprofessional alone with a neurodivergent child and calling it a support plan is not good enough.
It never was. This is a choice.
Maine will continue to serve autistic children and neurodivergent kids in schools, childcare programs, and community settings. The question is whether the people working alongside those children will be prepared to truly see them — and whether we will give those workers a reason to stay.
What these workers need is education, support, and patience. What these children need is the same.
Right now, we are offering neither. And we are calling it a system.
That is a choice. And it is one we can make differently.
-----
Written by : Carolann Prescott, BSPY, MSOTR/L, ADHD-RSP, ASDCS
