The small subgroup of families that even have ABA services included in their health insurance plans are now finding out that the only ABA services authorized require 100% implementation by licensed clinicians. Now as a licensed clinical psychologist myself, I know that it is unrealistic for me to be present for every hour of a child's intervention. Not only is it cost-prohibitive for a licensed provider to be present for every hour of ABA intervention, it isn't evidence-based practice! The data on intensive ABA programs has historically relied on the undergraduate student implementers of the intervention, not licensed professionals.
Autism and Insurance: a Push for Coverage
For those parents, unlike Henderson, whose children need more therapy and treatment than the school or state provides, insurance is the next step -- but it too is often little help. Many insurance plans exclude autism treatment or refuse to cover behavioral therapy because they say it is an educational, rather than a medical, treatment.
Recently, however, the insurance situation has been changing. In the past three years, the advocacy group Autism Speaks has coordinated a push to get states to pass laws mandating that insurance companies cover autism treatment.
"Our community had gone for far too long at the mercy of insurance companies who used autism as the basis of denial for meaningful, necessary, evidence-based interventions," says Peter Bell, executive vice president for programs and services at Autism Speaks.
The organization's push is working: In 2006, only Indiana had such a law in place. Today, 25 states do.
"Children are receiving treatments, making tremendous progress and are often able to transition into a school environment with less support," Bell says. "This is an investment in the future."
In Massachusetts, Debe Needham Chamberlain has seen that change firsthand. She and her husband, both special education teachers, paid out-of-pocket for their son T.J.'s $150-per-session occupational therapy for three years and worked extra jobs to make the money. The bill mandating autism coverage was signed into law in last summer, and just recently, for the first time, T.J. was able to see the occupational therapist with only a co-pay.
"This is such a godsend," Needham Chamberlain says. T.J. was lucky to be able to attend school in the district where his mother teaches, which offers ABA therapy in school, but the district they live in does not. "People mortgage their houses so that their children could get services," she says. Now, with the new law, they are moving T.J. back to his home school district, and insurance will cover out-of-school ABA therapy.
"The cumulative impact of thousands of mandates across the country has been to raise the cost of coverage -- in some cases beyond what small employers can afford," she says.
And, she says, many of the therapies mandated in some of the new state laws are educational rather than medical -- and so should be provided by school districts.
But Bell, of Autism Speaks, disagrees.
"Autism is a diagnosis you receive from a medical professional," he says. "School and teachers do not give an autism diagnosis."
More ...
At a time when autism diagnoses are soaring nationwide, many parents and professionals insist that ABA therapy is the best way to help these children live normal lives.
Eric Larsson, a Minneapolis psychologist and leading advocate, says ABA is more than just a treatment - it's a way to rescue children "from the ravages of autism." He tells parents that nearly half of children can recover if they start ABA soon enough.
"They're coming to us because they want to cure their child," he said. "Just like you or I would do if we had cancer."
But other autism experts say the benefits of ABA treatment have been blown out of proportion. They say there is scarce evidence that it's really better than less costly alternatives.
"A lot of claims out there are inflated," said Barbara Luskin, a psychologist with the Autism Society of Minnesota. "Autism is a difference in the way your brain is. You're not going to cure it."
This year, for the third year in a row, the Minnesota Legislature is debating whether to require the state's health insurance plans to cover ABA treatment for autism, a speech and behavior disorder that is said to affect 1 in 110 children nationally.
More than 20 states have adopted such mandates since 2007, says Lorri Unumb of Autism Speaks, a national advocacy group.
Ultimately, she hopes it will become the law of the land as part of national health reform.
MONTREAL, April 5 /CNW Telbec/ - Early Intensive Behavioural Intervention (EIBI), the most highly recommended, comprehensively researched and universally recognized treatment for autism, continues to be questioned, underfunded and ultimately threatened - but only in Quebec.
At least four compilations of multiple studies in the last three years confirm that EIBI is a well-established, evidence-based practice. Elsewhere in North America, it has been the standard autism therapy for years.
"The language issue is keeping Quebec behind the rest of North America on EIBI," said Dr. Katherine Moxness, director of Professional Services, West Montreal Readaptation Centre (WMRC).
"Because there is no French-language data on EIBI from a Quebec-based population yet, we are constantly forced to defend this proven therapy and the costs associated with it," said Dr. Moxness.
Nevertheless, rumours that EIBI is ineffective or even harmful have been circulating in Quebec for just as long, promoted chiefly by one autism specialist and a small group of self-identified experts who strongly question the evidence or who profit from offering therapies that are not supported by the scientific community.
In January, Montreal's La Presse newspaper published a series of articles on EIBI. Based on isolated cases, unfounded statements and even misrepresentation of sources, those articles attacked EIBI's effectiveness and cited challenges and irregularities in applying EIBI as an argument for abandoning it altogether.
A resulting press release and editorial letter by a dozen Quebec-based autism experts, including Dr. Moxness, systematically refuted the points made in the articles but received no media coverage.
"Allowing these rumours to circulate unchecked could lead to parents denying their children access to the most effective treatment and justify a government policy that does not prioritize EIBI," said Martine Beaurivage, WMRC director of Child and Family Services.
THE FACTS:
About West Montreal Readaptation Centre
West Montreal Readaptation Centre (WMRC) was one of the first rehabilitation centres in Quebec to develop an EIBI program and has treated some 700 children since 2004. It follows a rigorous clinical curriculum with measurable results and oversees EIBI services to over 100 children with autism annually.
Katherine Moxness, Ph.D., is a departmental director and psychologist who has worked with hundreds of people with autism for over 15 years and was instrumental in lobbying for Law 21 to allow psychologists to diagnose autism. Both Dr. Moxness and Martine Beaurivage have seen dramatic improvements as a result of EIBI. Also a psychologist, Ms. Beaurivage directs WMRC's Department of Child and Family Services and is a member of several autism expert committees.
Center for Autism and Related Disorders' Research Study Finds Chewing Gum an Effective Treatment for Children with AutismRumination involves regurgitation of previously ingested food, re-chewing the food, and re-swallowing it. The study examined a child with autism who displayed chronic rumination for approximately one year, resulting in the decay and subsequent removal of several teeth. After several treatments failed, including thickened liquids and starch satiation, the child was taught to chew gum. His rumination decreased significantly when gum was made available.
[FULL ARTICLE]
Take your child for a complete medical exam. Some behavioral problems associated with autism, like temper tantrums, can sometimes be reduced if physical problems common in children with autism, such as gastrointestinal issues and allergies, are alleviated.
Put your child on a gluten-free, casein-free diet, which means no barley, rye, oats, wheat, or dairy. Many families of children with autism have had good results – but only if the diet is followed to the letter, no exceptions.
Get your child started on speech therapy as soon as possible. If your child is nonverbal, try PECS, which stands for Picture Exchange Communication System. This technique, which uses picture cards, may encourage them to speak.
Get your child sensory-integration therapy, which has been proven effective in helping children with autism become less sensitive to light, sound, and touch.
Hire an occupational therapist to help them with skills they’ll need for an independent life. Depending on the child, this can be anything from physical coordination to anger management.
Use applied behavioral analysis, or ABA, the only intervention approved by the Surgeon General’s Office. ABA is a one-on-one approach to teaching children how to react appropriately to everyday social situations with the help of rewards. Parents can either hire an ABA-trained therapist or learn the technique themselves.
Try other therapies. Most children with autism benefit from a combination of treatments.
Consider verbal behavior intervention, which is designed to develop language skills through motivation and reinforcement.
Test the TEACCH approach, which customizes an education program to the child’s strengths and weaknesses. Because children with autism tend to be visual learners, the program is structured around visual clues.
Consider becoming trained in Relationship Development Intervention, or RDI, which suggests everyday things parents can do at home to help their child adapt to changes and be more open to interacting with others.
Enroll your child in school when they turn three. The Individuals with Disabilities Education Act requires that states provide special education services to children with disabilities, beginning at this age.
Stay up-to-date on autism research; new therapies are being tested and developed all the time.
The new program, a master’s degree in Applied Behavior Analysis and Autism, is offered fully online.
Read the entire draft of President-Elect Obama's federal mandate for autism insurance coverage
What Is Discrete-Trial ABA?What If My Child Doesn't Enjoy Rewards?ABA vs. Developmental Approach?What Is 'Floor-Time Therapy'?What Is The Denver Model?What Is The TEAACH Model?
