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Insurance premiums (monthly payments) would increase slightly for everyone if insurance companies pay for autism-related services and therapy.
The authors calculated how many people have been getting autism-related therapy, and how much those therapies cost. Then they figured out how much it would cost private insurance companies to pay for it. They estimated that the monthly payments for all of the people insured by private companies would go up about 0.2-2%.
In order to provide a medical home for children with autism, doctors will likely have to spend time developing and working with teams of community-based specialists.
This article describes how insurance can be billed to pay for the many services that are often required for children with autism. The authors start by stating that every parent who takes their infant and young child to visit the doctor should ask about child development. If there seems to be a problem, then a screening test can be given and these can be charged to insurance. The time needed to score and explain the test to parents can also be billed to insurance. The article goes on to describe how codes can be used to bill insurance for care of children with autism.
Many states are seeking to follow the lead of Pennsylvania and Louisiana and expand private health insurance coverage for autism services.
This article discusses who should pay for autism treatments. Under the U.S. Individuals with Disabilities Education Act (IDEA), early intervention and special education programs must provide services to children with autism. This will be a large cost if health insurance has to pay the bill for services offered in public schools. The concern is that the cost of health insurance will go up so much that small businesses will no longer be able to afford health insurance. The hope is that more and more children will be able to shed the autism diagnosis by age 8.
Neurofeedback may be a good treatment for people with autism, but care must be taken to find a licensed therapist.
This review article describes how neurofeedback can be used to train brainwaves. There are three types of brainwaves: beta (alert state of mind), alpha (relaxed), and delta (asleep). People with autism tend to have a lot of slow waves (alpha and delta) in their brain. The author notes that while there is research to support the use of neurofeedback for autism, not all insurance companies will pay for neurofeedback. Parents and patients can find therapists who do neurofeedback by going to the Web site for the Biofeedback Certification Institute of America (www.bcia.org).
The Providence Neurodevelopment Center opened a satellite clinic in Newberg, Oregon to serve children with autism. The center provides a place where children can receive sensory integration in areas called "Bear's Den," "Bird's Nest" and "Jungle Gym." Clinic therapists provide speech therapy, occupational therapy, nutritional education, and free child screenings. The facility is able to serve children without insurance because the community comes together to support the clinic with fund raisers.
Reins from Above, in North Carolina, provides therapeutic horseback riding for children with autism and other people with developmental and physical disabilities. As with many other alternative treatments, insurance doesn't pay costs for children to ride, but there are groups that will help with money or sponsor a child. Stacey Ryder, the founder, utilizes volunteers to help the children with core strength, muscle strength, balance, and social skills. When one young volunteer, Corrie Walters who wants to be a vet someday was asked about volunteering, she said, ""I like just seeing how big of a difference it makes in the students," she said when asked what she loves most about volunteering."
It is difficult enough when families move from Army base to Army base, not to mention overseas deployments for one or both parents, but when a child with autism is involved, the hardships are increased. The military provides some coverage for applied behavior analysis (ABA), speech therapy, and occupational therapy, but active duty parents still struggle. Many times one parent will stay in a city that provides excellent intervention for their child, while the other parent moves. The Department of Defense is working in several areas: Army Community Service, Officer and Civilian Women's Clubs, and Tricare (the active duty insurance company); in addition, respite care services can be found.
Illinois children with autism can now receive insurance benefits up to $36,000/year and unlimited number of therapy visits until age 21. Insurance companies are required to cover "autism diagnosis, occupational therapy, physical and speech therapy, psychiatric and psychological services and applied behavioral therapies." This bill will provide for people who are not covered by large group insurance policies, and will require all insurance companies to provide diagnostics and interventions for communication and social skills issues.
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Just around the bend...
Jul 26, 2009 by AnonymousSummer is half over and as with people nationwide concerns regarding bugdet cuts to services, inavailability of services that are supportive of our children on the spectrum and the dangers in the community that became more apparent as they get older abound. While I am sure parents overall have concerns about their children being at risk in their community this fear is exacerbated greatly when your child is often oblivious to these dangers because of social skill and comprehension deficits. In the past few weeks I have run into two friends whose teenage sons, once a part of a special needs support group which has fallen prey to the budgetary axe, both found themselves under arrest. I could debate the circumstances but suffice it to say that this is every mothers nightmare. So what do we do when the mainstream only hear about early intervention. It is as if by some misfortune parents who have not solved this exhaustive puzzle of advocating and searching for appropriate services and therapies simply no longer exist once their child falls out of that window the public eye envisions of a child on the spectrum. Beautiful doe eyed 2, 3, 4 and 5 year olds. What happens when they become 12, 13,16, 19? when insurance companies want to deem their progress insufficient and therefore not medicallly necessary? When schools have decided thier capabilities long before they max out at age 22? When they have too often become prey for others willing to exploit their disability? I lose sleep over the thought that my son will one day find himself in a compromising situation because of his inabiility to discern dangers around him, or people who would use him, hurt him.... So that is my thought for the week. How do you as educators, clinicians and parents affect change in the lives of our preteens and teens and adults with ASD so that mothers like me will not live this nightmare?
Glass half empty or half full?...
Jun 21, 2009 by AnonymousThere are times in your life when uncertainty can make you doubt yourself. Times when it is hard to tell whether your glass is half empty or half full. Perhaps you ran into someone, an old classmate, whose career path has taken them places you only dream about. Perhaps you ran into an old friend who shared with you some accomplishment their child has achieved, or some possession that you cannot possibly realistically hope to own. There are many times in our lives when someone else’s good fortune will make us question ourselves. I guess that in itself is just human nature and I am human…ok, wait…didn’t I promise to get off this soapbox last week? Yes, we know I am human. Yes, we have already covered the I felt guilt and then vowed to make a difference declaration. And yes, yes..yes we already touched on the I am fortunate to have a child as beautiful, healthy and special as Joshua even though it involves a lot of work, time and energy. Gotcha. So since I don’t have a lot of time to expound on my virtues as a tireless dedicated ASD mom and I am sure you’re bored by now let’s just get to it. Straight, no chaser.
Last week was a crappy week. Maybe it had something to do with the nonstop rain, my over zealous self-medicating with the demon caffeine or maybe it was because I had looked at my once bouncy cheeked little boy and saw a young man standing nearly eye to eye with me and felt the beginnings of a panic attack coming on. Realization was not only hitting home, it was kicking my ass. Not only was my son facing the oncoming challenges of puberty, making friends, girls… (Ok, putting paper bag over mouth and nose and breathing deeply and slowly) but now my shield was gone as well. The reason why I could not go out with friends, join a specific social outing or go back to school to complete my degree. This realization came with the speed and impact of a skillfully placed combination of a prize fight. One minute I was feeling down about my life, next I was talking to another parent on Facebook (do not sit there and act as if I am the only Facebook addict out there) whom I had not seen since our sons were in kindergarten together. While I will not talk about her son’s condition here, needless to say after inquiring about him I felt like I had no right to complain though she admonished my saying so and said in her own kind hearted and generous way that as parents we have the right to complain and should not feel bad about it, nor should I pity her. I get tired of the things I struggle with; school, insurance issues, his difficulty with making friends. And then I am faced with the sobering fact that while I may have had to fight for services in school and through my insurance company there are those who cannot get an IEP, or who have no insurance or availability of services.
So, in short you may ask have I been humbled this week…maybe not the best word. Just a week when I saw my glass as half full as opposed to half empty and for once appreciated the glass more than the contents.
Repetition...Here I go again!!!
Jun 7, 2009 by AnonymousThis week was much like many others in the respect that I was going through a period of feeling totally overwhelmed with life in general and my emotional pendulum was yet again swinging from one extreme to the other, a phenomenon my family have long since chalked up to mom having “one of her days.” Nothing extremely out of the ordinary actually. I had been asked to submit again further documentation to my insurance company to substantiate the need for my son’s ongoing speech therapy. I had requested and received home work material for the expressed purpose of practicing hard won skills so as to ward off the ever present monster in the closet; regression. I had intended yet again to organize files, stow away winter clothes, check the fit of summer clothes, etc., etc. And then it hit me. As I checked emails, twitter accounts, my space pages and face book…it hit. This emotion that was at once akin to emotional vertigo and short of a panic attack. The overwhelming enormity of all that goes with caring for a child with ASD. It was a feeling that I could not quite place the night before as I watched my son struggle to perform math problems that we had been working on all year and still seemed to just escape his grasp. It was the feeling of clawing your way up a mudslide. It was the feeling of being stuck in one place while the world seemed to move around you. The repetition of it all in an effort to gain some minuscule ground and trying to find contentment in that. When that realization came, with it came the self-loathing. How could I possible feel tired of it, resentful, angry…and if I did, what must he feel?
In reading submissions from others on line and parents that I have personally connected with, I have come to one conclusion; the drive to protect, nurture, and see that our children flourish is all consuming. I have met some truly awe inspiring parents with children on the spectrum and have found evidenced in them immeasurable strength. But almost universally I have found that the same strength that drives us alternatively burns us out. We are called upon to wear so many hats that we find ourselves filled to overflowing. I have sought alternative ways to deal with this sense of feeling overwhelmed…therapy, exercise, prayer and mostly that works. I have learned to reprioritize my life. No longer is it most important that my house be spotless. There are days when I feel it would pass inspection by the Board of Health…barely. No longer are my finances handled with the precision of a calculator wielding accountant…thank goodness for online payments! The laundry may not be done to Martha Stewart’s standards…(ok, did that pile in the corner just move by itself…it’s small, I think I can take it!). Point is I am doing the best I can. Today. And maybe tonight in the solace of my beloved shower I will cry, long, shoulder wracking, hiccup inducing, eye swelling cries that will leave my eyes red and puffy as only my favorite shampoo can. I will toss and turn and watch another episode of Law & Order with one eye on the clock, and then sleep the sleep of a parent whose mind will not be still. Tomorrow is a new day, a new fight, a new challenge. A bus pulls into my driveway and his voice sing-songs on its way out through the closing door…”bye mom, love you” as it has every school day this year. I smile and realize repetition ain’t that bad.
Spring Break #2
May 1, 2009 by AnonymousSpring Break #2 is here! Unfortunately, Thomas' school is one of those that has been closed due to a "probable case" of this swine flu. Perhaps I'm a slacker mom, perhaps I'm being far too blaise, but I think that this whole thing is a lot of hooey that conveniently coincides with the network ratings time, generally referred to as "May Sweeps."
As a result of all of this Swine Flu stuff, Thomas' school is closed until May 11 - a terrific thing indeed for an autistic child who has a difficult time adjusting to schedule changes - and especially unscheduled schedule changes. We're going to try to do a lot of reading next week and some math in the new Everyday Mathematics book Mrs. H. sent home last week.
As for Hayley, she's lucky she was even let into Preschool this morning, being the sister of a boy who attends an infected school. They had to have the director of the preschool call their insurance agent to see if she could attend. Luckily, they gave her the all-clear, but I feel like we're about to be quarantined with a big blood-red cross painted on our front door. However, instead of lamb's blood, they'll have to use the small can of Ralph Lauren "Hunting Coat Red" we have in the garage. A modern spin on a medieval plague classic.
Again, I think it's a load of hooey.
Last Wednesday, Jonathan took the kids to see Thomas' Sea Life exhibit at school. The kids mostly played in the classroom centers, but Jonathan (I was working) got a chance to talk to Mrs. H. who again expressed her desire to "take Thomas home," because she is so attached to him. She has no idea what she's talking about since Jonathan and I have positively decided that Thomas is a different kid at school - a more focused and less energetic kid. She also said that Thomas is reading at level C, which means absolutely nothing to the lay-person, but she explained to me on Thursday that it's a first-grade level. We think that's great, but why won't Thomas read at home for us?! It's like an exercise in futility trying to get him to sound out words. He'll make the letter sounds but then he won't put them together to make a whole word. Mrs. H. says that it's okay; he'll get it and she's just thrilled with his ability to read so far. That should be good enough for us, but I keep trying to find opportunities for him to read. I've tried saying, "You have to learn to read before we go to Walt Disney World 'cause we'll need your help reading the signs!" I don't think he buys it. Honestly, I don't either.
Thomas will be attending Hayley's dance recital with us this year and he will hopefully be well-behaved. My parents are going, Jonathan's mom is going and the three of us, so Hayley will have quite a little audience watching her dance to "I Feel Pretty." She does a lot better than she did last year. I was talking to one of the other moms from Hayley's dance class who's daughter was in Hayley's class last year too and we both agreed that we and our husbands laughed ourselves silly watching the little girls' recital - they were just so interested in the people and the lights and the costumes that any interest in dancing was not a priority at all. It was adorable.
Thomas has expressed an interest in participating in a dance class next year. Jonathan and I are both fine with it, but we wonder if that will open Thomas up to a bunch of teasing. Of course, it will roll right off of Thomas' back as he is nearly immune to that kind of thing, if he has even experienced it yet. Maybe we'll sign him up and perhaps notify the staff of the special circumstances, adding a stipulation that if Thomas can't do it or is too disruptive, he can get out of the class and we can get at least most of our money back. I have to admit that I think it's kind of cool that he would even want to do a dance class. Another Billy Elliot, maybe? Mommy can dream.