While there’s currently no cure for autism spectrum disorders, experts agree that intensive behavioral therapies, like applied behavioral therapy (ABA), can make a huge difference. Research shows it needs to be intensive to be effective, to the tune of 20 hours a week. But in Massachusetts, insurance companies often don’t cover ABA and families must pay out of pocket for expensive therapies.
Now, the new autism insurance bill, signed by Governor Deval Patrick today, hopes to remedy that. “I really see this as a civil rights issue,” says Carolyn Bridgemohan, MD, of Children’s Hospital Boston’s Developmental Medicine Center. “This bill validates the rights of people with special needs to have fair and equal access to the health care that they need.”
How many people do you know with autism? If you don’t work in a school or the medical field, you mightn’t be closely acquainted with the developmental disorder, as most people with autism are under the age of 22. But according to the Centers for Disease Control and Prevention (CDC), autism now affects approximately 1 percent of kids in the United States. In Massachusetts, it’s estimated that 700 kids will be born with autism this year.
The legislation mandates that insurers cover evidence-based treatments of autism spectrum disorders that are prescribed by a licensed physician or psychologist. Testing for diagnosis (which is crucial as early diagnosis has been shown to result in better outcomes), behavioral therapies, occupational therapy, physical therapy and speech therapy would all be covered, starting in January 2011.
Without this kind of coverage, says Bridgemohan, individuals with autism may not achieve their full potential. That’s detrimental to the individual, their family and also to society. “As a community, we’ll have to provide supports later on in life for these individuals that wouldn’t be necessary if better services were available earlier,” she says. “An element of this is financial, but really this is a matter of social justice.”
For families with autism, who are already navigating school systems and their child’s complex medical needs, battles with insurance companies over coverage is taxing, says Bridgemohan. “Many times, a child may not be functioning well, they may have terrible sleep patterns, aggressive behavior or feeding problems that impact the whole family,” she says. Treatments that typically haven’t been covered can help both the child–and families–quality of life. “Therapies like applied behavioral therapy can be incredibly helpful in teaching children attention skills, social skills, appropriate behaviors and how to interact with other people,” she says. “These treatments are critical for many individuals with autism but they require a highly specialized therapist. Not everyone has had equal access until now.”
The bill signing was held at Fenway Park in Boston. Legislators, families, doctors and autism advocates rallied together and cheered as Governor Deval Patrick signed the bill into law.