MISSOULA, Mont. -- A doctor's office can be an intimidating place for children. A new guide from Montana can help kids of any ability advocate for themselves in medical settings.

"Skills and Strategies for Health Care Decision-Making" can help parents set their children up to navigate the doctor's visit.

Jenn Banna, coordinator of the Montana Family to Family Health Information Center, wanted to develop the guide because she has five kids of her own, one of whom has a rare neurological disorder. She said it can be difficult for families and even medical providers to get children with disabilities involved in medical decisions.

"When individuals can make decisions and participate in their own care, they feel ownership over what's happening, and they feel like they're part of what's happening," Banna contended.

Banna noted when children can answer questions such as how old they are and what their name is, it translates into other parts of their lives. She added other family-led organizations have reached out to say they are excited to use this guide in their states as well.

Sara Graceffo, genetic counselor for Utah Regional Leadership Education in Neurodevelopmental Disabilities, which developed the guide, said users of the resources are navigated by their children's developmental stage rather than age.

There are four stages listed, including choice-maker, question-answerer, decision-participant and decision-maker.

"We broke it down into the different stages," Graceffo explained. "Each stage has a page that has different sections for preparing for the appointment, at the appointment and after the appointment."

Graceffo pointed out the guide also has recommendations such as books and apps that can help with the process.

Banna emphasized part of the reason she wanted to develop this guide is she believes waiting until a child is in their teens to empower them to make decisions in a medical setting is too late.

"I felt like we could add some skills earlier on to prepare families earlier for that transition from being a child to being an adult," Banna concluded.

As the country observes Autism Acceptance Month, Nebraska families raising a child with Autism Spectrum Disorder are among those learning they will be receiving financial assistance.

The Family Support Waiver is based on passage of a 2022 bill and will provide up to $10,000 annually for 850 Nebraska families with a child with a developmental or intellectual disability, and the child will also receive Medicaid coverage.

Leslie Bishop Hartung, president and CEO of the Autism Center of Nebraska, said many Nebraska families raising children with a variety of developmental disabilities struggle to afford their child's care needs.

"It's not a lot of money but it might be just enough for families to bridge those gaps when they really need support, especially over the summer break when there's no school for children," Bishop Hartung pointed out. "And also, specific services that might be a real financial burden."

Families can use the waiver funds for services such as respite care, family caregiver training, home modifications and assistive technologies. Depending on the child's limitations and level of support needed, families can face considerable costs meeting the needs of a child with a developmental or intellectual disability.

Jennifer Clark, deputy director of the Developmental Disability Division for the Nebraska Department of Health and Human Services, said they are notifying around 150 families per month between now and August they will be receiving the Family Support Waiver. The notices are prioritized according to the family's need. Clark says this was determined by their responses to a survey DHHS sent to families with a child on the developmental disabilities waiting list.

Receiving first priority are families in crisis.

"Where the child tends to self-harm or harm others, so whether they're harming their siblings or their family members," Clark outlined. "The second priority is children with disabilities who are at risk for placement in juvenile detention centers or other out-of-home placements."

Clark added families in which the grandparent is the primary caregiver are given third priority, followed by families with more than one child with a disability living at home. Remaining families are prioritized based on the date they applied to the developmental disabilities waiting list.

Jordan Squiers, board president of The Arc of Buffalo County, said they are hopeful the waiver will help fill gaps in services, especially for older youths who do not become eligible for more inclusive services until they turn 21.

"They might be able to get additional help in their home; they might be able to hire somebody to take somebody out into the community more often," Squiers explained. "Kids that age do get the benefit of the schools but obviously we know there's lots of hours in the day outside of that; weekends, summers."

The Family Support Waiver is one of three Home and Community-Based Services Medicaid Waivers available in Nebraska.

April is Autism Acceptance Month and as rates grow, support organizations in South Dakota hope more children on the spectrum get the tools they need to succeed in school.

Researchers with the Annie E Casey Foundation say nearly 9% of South Dakota students receive special education services due to an autism diagnosis, which is four percentage points higher than a decade ago.

Carla Miller, executive director of South Dakota Parent Connection, which works with families of children with disabilities, encouraged parents of children with autism to be proactive with school officials and follow up as needed. For school districts, she stressed clear communication is vital.

"We need to be careful we're not using a lot of jargon that's our related to our field, and really make sure that we ask parents, are they understanding the information we're giving?" Miller urged.

Miller also advised classroom leaders should allow students with autism to participate in as many general class activities as possible while acknowledging their needs. With staffing shortages still a concern, she called on districts to provide more training, especially for general educators.

Miller emphasized special educators cannot foster a welcoming environment on their own and in an era of more awareness, Miller hopes school districts look at students on the spectrum as individuals who bring unique qualities to their class.

"How is autism showing up in the life of that child, and how is it impacting that child?" Miller asked. "Trying to stay away from stereotypical descriptions of autism that can put kids in a box. "

Autism presents a broad range of conditions highlighted by challenges with social skills, repetitive behaviors, and communication. Advocates stressed symptoms can vary widely and the disorder looks different for everyone on the spectrum.


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As siblings in foster care, the fear of being separated is daunting. But thanks to a loving family in Jacksonville, Fla., for two brothers in Ohio, that bond remains unbroken.

Despite Dalton's cerebral palsy and numerous medical challenges, brother Dawson became his devoted caregiver. The two were adopted by Robbin and Steven Brydges through the nonprofit "Wendy's Wonderful Kids," and they've become a beacon for disability awareness.

Now, at 15, Dawson said he's grateful for his parents' support in keeping them together through it all, as he continues to care for his brother.

"He is the most amazing brother a man could ask for," he said. "He has an incredible smile that will just brighten your day instantly. And I'm just blessed to have him in my life, that's all I can say. I'm just blessed."

March is National Disability Awareness Month, and Dawson encouraged anyone considering the adoption process to consider all kids - especially those with challenges who are often overlooked, along with older kids - when it comes to finding their forever home.

Rita Soronen, president and CEO of the Dave Thomas Foundation for Adoption, said children with disabilities or special needs - regardless of race, age, or background - often face prolonged stays in foster care or institutional settings. She underscored the need to establish a support network for families considering adoption, and said the Wendy's Wonderful Kids Program was created to assist families in navigating this journey, no matter a child's unique needs.

"Making those connections of access to networks - access to medical or psychological resources that they will need before that adoption is finalized - is critical," she said, "so that families feel that they will be supported, that they will have access, and that they can successfully raise a child in their home."

According to the Dave Thomas Foundation, its Wendy's Wonderful Kids Program is responsible for more than 14,000 successful adoptions across the United States and Canada.