Healthcare

Healthcare

The United States has a fragmented healthcare system made of many private health care facilities that are largely owned by the private sector. Primary care doctors are usually the first point of entry when there are any health concerns before referrals to any other appropriate health establishment if necessary.  There are thousands of insurance companies that cover private health insurance and up until fairly recently, it has been very hard to get health insurance to cover autism because it is risky and treatment is very expensive.  This has recently changed due to new legislation but availability can depend on whether a particular State has enacted autism insurance legislation or coverage for government-funded health programs such as Medicaid.

The causes of autism are not readily known or available.  The U.S. Center for Disease Control and Prevention (CDC) reports that autism and related disorders are more common than previously thought.  There is an increase in those being diagnosed and  3-4  times as many boys than girls are affected. On average one in 110 children born in the U.S. have autism. One in 70 boys and one in 315 girls are affected. It is thought by professionals that the increase is due to a wider definition of the spectrum.

It is essential to get an expert diagnosis in order to access the different services and treatments that may be available as it is beneficial to begin an early intervention program.   An evaluation and assessment of the child may be done by a multidisciplinary team of professionals.  Doctors who specialize in autism will observe the child, ask parents questions about the child’s development and behavior and do a variety of tests such as intelligence tests to evaluate the child’s strengths and weaknesses.

The following are some examples of the types of people and places listed by the National Institute of Mental Health (NIMH) of whom to go to that will make a referral to, or provide diagnostic and treatment services (NIMH):

Family doctors

Mental health specialists such as psychiatrists, psychologists, and counselors

Community mental health centers

Health maintenance organizations

Hospital psychiatry departments and outpatients clinics

State hospital outpatient clinics

Local medical and/or psychiatric societies

Once diagnosed, the quest to find affordable health insurance coverage to cover autism can begin. Around half of the states currently have enacted autism insurance legislation which makes healthcare insurance coverage more available, though it can be expensive. Recent laws have increased coverage for government-funded health programs such as Medicaid for those on low incomes and disability is covered if it comes within the disability guidelines, so more families now qualify for assistance. 

There are all kinds of treatments and interventions available and a treatment plan can be devised and tailored towards the individual child.  Different teams of specialists can evaluate such things as speech, communication, and motor skills.  The main ways of treating the child can be through:

Behaviour Therapies and other types of therapies

Applied Behavior Analysis (ABA) can be used to shape and modify behavior.  Occupational Therapy is available to work on fine and gross motor skills, for example, and there are other therapies such as Speech Therapy.

Individualized Education Plan (IEP) for school-age children

Parents are encouraged to be involved with teachers in setting targets or goals to be reached within the particular school year and describe any special support required in meeting them. 

Medication

Currently, there are no medications available to treat autism, but there are supplements that can treat and manage some of the symptoms.  Ritalin, for example, can be used to treat impulsivity and overactivity and there are other drugs that can be used to treat behaviors such as aggressive behaviors or repetitive behaviors.

Though healthcare is fragmented in the United States, there is a wide range of therapies and interventions available for children with an Autism Spectrum Disorder.  Accessing these can depend on the child having an expert diagnosis of autism and on what health insurance coverage the child has.

References:

CDC. Cdc.gov: How Many Children Have Autism?  Retrieved 29 March 2011, from

https://www.cdc.gov/ncbddd/kids/autism.html

NIMH.  Nimh,nih.gov: How To Find Help

https://www.nimh.nih.gov/health/find-help

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Being an RBT for me was extremely fun because where were you going to find a place where you can be completely silly without having to worry what people thought about you? This was the only job that made me feel like I could make a dramatic difference while being myself.

I also liked to be surrounded by people that had the same goals of wanting to help kids and the teamwork made the job much easier and more enjoyable.

Change and progress was the ultimate goal for our kiddos. The early intervention program was seriously only a miracle because I saw changes in the kiddos that from day one, you wouldn’t even recognize who they were.

Changes from being able to utter 3-4 words where they can only make a syllable from when they started, the behavior decreases in which kiddo that used to engage in 30-40 0 self-harm to only half, learning how to wait during games, table work where they use to swipe and drop to the floor if they had to.

My favorite was when the parents would tell us what amazing progress they were making at home. I used to tear up and felt for these parents so much because it was already difficult for them and now, they can trust and rely on ABA and the therapists knowing their goal was ours.

By Emma Rogers, BA, RBT

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