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. When this article was first written, CDC's estimate, from its 2006 surveillance data, was about 1 in 110 children. CDC's newest estimate, from 2022 data, is about 1 in 31 eight-year-olds in the 16 U.S. communities its ADDM Network tracks. Those communities don't necessarily represent every U.S. child. 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. Every state now has a law requiring some private insurers to cover autism services, though which plans they apply to varies. 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

No medicine treats autism itself, but prescription medicines can help with some symptoms. Two (risperidone and aripiprazole) are FDA-approved for irritability in autistic children, and ADHD medicines such as methylphenidate (Ritalin) 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

cdc.gov/ncbddd/features/counting-autism.html

NIMH. Nimh,nih.gov: How To Find Help

nimh.nih.gov/health/topics/getting-help-locate-services/index.shtml

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