Health Care

Keep Autism Earliest Intervention Onus with Schools

| by Val

What about requiring insurers to cover autism-related screenings, diagnoses and treatments? How will this affect the autism affected child's chances at attending school and participating in life amongst typical peers?

Screenings usually are covered when deemed appropriate by a doctor...and screenings result in diagnoses so they are one in the same. Treatments cover a wide spectrum, just as autism does. What are the medically approved Autism Treatments available? Emphasis on medically approved...

One might want to refer to this article when considering Autism Treatments that will supposedly be covered by insurance - through current mandates that are going on state by state. Fact is, according to the aboved linked article by Jean Mercer, Ph.D., complimentary and alternative treatments (CAM) are not considered medically approved. Basically, if there is not significant data to support the method, it does not become medically approved. CAMs are generally methods that have anecdotal findings that need to be pursued.

With regard to medically approved treatments for autism - points to the fact that there is not much out there as far as conventional treatments for autism and that is addressed in walkamilewithautism post Ain't Got No Conventional Treatments For Autism.

The status for the autism community is that of parents doing their best and determining efficacy based on how their own child is responding to any particular treatment or intervention. The reason parents do this is because their alternative would be to do nothing - if they were to wait for medically approved treatments for autism intervention.

School systems have worked upon an Individual Education Plan (IEP) that incorporates teaching and/or reaching an autism affected child - by both recording the methods to be utilized for instruction, and then also recording the progress a child realizes from the IEP plan that is in place. The schools deem what will be effective and sometimes parent advocates help in identifying other more effective methods, based on anecdotal findings that are deferred to in the IEP process or through the courts.  The IEP process has many times been a contentious one based on the fact that there are no medically (or educationally) approved methods for addressing the instructional needs of the autism affected child. If there were a singular method that had been empirically identified as efficacious, there would not be reason for all the methods currently available for intervening upon autism.

Complimentary and Alternative Medicine (CAM) is often defined as interventions for which there is insufficient systematic evidence supporting efficacy or ruling out potential harmfulness. Additionally, ...many CAM treatments remain in the CAM category because of lack of plausibility as well as lack of evidence. (Mercer)

There has been a lot of research and study into the CAM(s) utilized for children within the autism spectrum (intense earliest intervention has been at top of the list lately). But, has the point been reached where the interventions that parents use for their autism affected children are considered mainstream - in the medical sense? I guess not, but...

So far the laws of similarity and sympathy seem to be at play as far as moving our community into a mindset that insurance mandates are going to do what has yet to be proven by hard data. Every determination and legislative justification for mandating insurance coverage of intensive earliest intervention thus far is based on the chance that earliest intervention will normalize the majority of children - and also based on the anecdotal reports from some parents who have normalized their young child; ones that are still very young and not quite finished with their very unique walk with autism. Again the mandates are there because of the chance that there might be improvement, and not because of already existing evidence supporting efficacy and reduction in lifelong needs or costs.

The community is full of parents with very young autism affected children who have thought their child was normalized (or better) due to a particular intervention, but then a worsening occurs. I am one of those parent's, but let us look at another. A case in point is the story of one mom who thought her child was better due to intervention against P.A.N.D.A.S. The mother was ready to write her book and then realized they weren't quite done with the journey yet. (See Fighting Autism And Winning) I see promise in the mom's fortitude and will be following her family's story. But, I also see wisdom in her thought to pull back and wait out the conclusion for a while.

Autism Speaks actually had involvement in a recent study that pointed to the fact that involvement in intense earliest intervention did not cause the majority of autism affected children involved in that type of programming to lose their autism, but it did help somewhat with communication skills. (See according-to-jaapa-denver-early-start.html ) In actuality the majority of the autism affected children will probably continue to need significant supports after intensive earliest intervention.

My own daughter had much success in the earliest intervention (in scribd no cost Hello, Dr Wells), but still had a severe worsening at ten years of age that taught everyone in my neck of the woods some huge lessons - especially me.

I have seen school districts and some specialty schools already aptly apply the CAM of intense early intervention for autism affected children, and the results already disprove what is being recently proposed to the overall community - a state at a time. Essentially, the argument for the mandates that is being applied and strongly emphasized to families of young children with autism, is that earliest intervention is going to normalize the majority of autism spectrum individuals, thus saving later costs. The data that is out there does not support the proposed conclusions that are being given to families of youngest autism affected children, and the law makers with regard to intensive earliest intervention. In essence they are being led slightly astray, for reasons unknown to me.

At least when my family embarked on our journey of earliest intervention, we understood the odds and only decided to keep on trying in hopes that it would help. We didn't have the disingenuous propaganda floating about us as families with younger autism spectrum children do now. What is more disheartening to me is that the experts have deferred to the ambiguities as fact, when they are not. What ever happened to being blinded by science and looking at the hard data? If we don't continue to do that we embark on wayward paths, and therefore neglect to take the right ones.

In Life Is Like A Box Of Atypicality And IQ what is pointed out is the fact that those within the autism spectrum vary greatly in both their affect and intelligence level. The IQ that the autism affected child is born with has much to do with determining the outcome, not the rote IQ (teaching the test, so to speak) that might be developed in the earliest intervention scenario. Rote or contextual, behavioral or naturalistic, teaching can only do so much if the child's true intelligence ability cannot entertain or discern all the information in the timing that we would all like...before they are ready.

It is right to try whatever might be efficacious for the good of each child, but it is demagoguery to create falsehood in order to meet an objective that will not even do what many are saying it will do.  The intense programs are good and right because they give us a way to interact with our kids, but they have not done what is proposed by many. They have not normalized the majority of the affected children to the point worries mate. And it is not because everyone has been doing it wrong all this time.

Why would anyone think that the insurance companies and doctors are going to find a way to make earliest intervention work in a way that it never has? Many highly educated individuals have already embarked on the journey with the autism spectrum involvement in earliest intervention.

I have no idea how on earth an autism treatment is going to be mandated as far as earliest intervention - and then when it is mandated I have no idea how much it will actually resemble anything that will be efficacious for the very unique and individual needs of each affected child. I do perceive that the parents will have very little control about how it will feel and look - especially when our health care goes governmental. Indeed schools are a wing of the government, but at least when the schools have had the onus of earliest intervention, parents have a say via the IEP process. In the future, all bets are probably off as far as the parents having a say - thanks to mandated insurance coverage and the path it will take autism interventions upon.

As a side note, I see little reason for the schools to provide their very best in earliest intervention via the IEP process, when the states are going to mandate the same process to be covered by insurance.

Earliest intervention had a better chance of being handled in a efficacious way via the school systems. Earliest intervention will be neutered by the system that doctors and insurance will take it through, and the public schools have a reason to tell parents the school systems no longer have to provide the very best for earliest intervention. In locations where public schools have already done well, they have been the place where our autism spectrum kids find belonging; even instilling grace and acceptance via interactions with typical classmates. In essence, mandated earliest intervention paid for by insurance is going to create a step backwards and put our autism affected kids back - in the back room and out of view.