All About Autism

The US Department of Health and Human Services released its final rules regarding the 10 essential health benefits every state must include in their new Affordable Healthcare Act (AHA). Most disappointing is that the AHA fails to require states to include coverage for behavioral health treatment including Applied Behavioral Analysis (ABA). What does this mean for children and families living with autism? Consider this…

• 1 in 88 children and 1 in 54 boys are diagnosed with autism every year
• Autism is the fastest-growing developmental disability in the U.S.
• Autism costs a family $60,000 a year on average
• Applied Behavior Analysis (ABA) is the only treatment of autism that’s substantiated by research.

Congress wrote ABA into law; however, this requirement has disappeared in the new HHS regulations. Without this coverage, the financial burden falls on the parents and families – many of whom don’t have the financial resources to assume this cost. Does that seem right to you?

A child not receiving ABA therapy needs more expensive services throughout his entire lifespan, ultimately requiring long term financial support from the government.

• The cost of autism over the lifespan is $3.2 million per person
• Cost of lifelong care can be reduced by 2/3 with early diagnosis and intervention

Children with autism who are diagnosed at an early age have the best outcomes. The American Academy of Pediatrics now suggests that autism screening be a component of a well baby check at 18 months. An early diagnosis allows for intensive interventions, ABA being at the top of the list.

ABA is the use of techniques and principles to bring about meaningful and positive change in behavior. These techniques can be used in structured situations, such as in a classroom lesson, as well as in everyday situations, such as during family dinnertime or at the neighborhood playground. Some ABA therapy sessions involve one-on-one interaction between the behavior analyst and the child.

Coverage varies state by state. Some states require no autism coverage; others allow coverage in an AHA plan only. Others offer coverage in state regulated health plans but not AHA. Finally, some states require coverage in both state and AHA plans. But should geography determine whether a person with autism gets the services he or she needs?

I believe autism insurance coverage should be in all health plans in all 50 states. Do you?

AJ and Mary at the Christmas Ball

School friends are so fabulous, aren’t they? They hold a place in our hearts like no other. At one time or another, we’ve all wondered about what’s happened to our school friends. Sometimes it’s out of pure curiosity and other times it’s the desire to rekindle a friendship. Sometimes the wondering leads to wonderful surprise reunions.  When Adrien (AJ) Pinto and Mary Downey arrived at the 2012 Christmas Ball, they had no idea that the other was attending the event.  Both were planning on a fun evening, but what the night had in store was more than just dancing and laughing.  It was a reunion of happy hearts, sixteen years in the making. Continue reading →