By Jessica J. Love, Peggy Schaefer Whitby, and Shannon Crozier from the University of Nevada Las Vegas, Center for Autism Spectrum Disorders
Autism is a developmental disorder that has three main characteristics: communication delays, social interaction delays, and restricted/repetitive behaviors or interests (APA, 2000). Children with autism may also have delays in pretend play skills or have little interest in playing with friends (APA, 2000). Onset is prior to age three, although diagnosis can occur at later ages (APA, 2000). Many people have heard that autism is a spectrum disorder; this means that the severity of these traits may be different for each person.
I Think my Child has Autism, What Should I Do?
If you are unsure whether you child is developing normally, you can check common childhood milestones using the Center for Disease Control’s website ( www.cdc.gov/ncbddd/actearly/milestones ). If you suspect a delay, talk with your family doctor first. You can then ask for a referral to a specialist who can screen your child. Specialists are developmental pediatricians, child neurologists, or psychologists/psychiatrists. During the referral process, you can also make an appointment for an evaluation. For ages 0-3, contact Nevada Early Intervention Services for an evaluation. For ages 3 to 21, contact Child Find for Clark County.
What Treatments Work for Autism?
There are many services available for autism treatment. Some are supported by research and some are not. Many treatments are advertised online with testimonials or “quick fix” claims—but they are usually not “evidence-based”. “Evidence-based” means that well-controlled research studies have repeatedly found the treatment to produce a positive change. These treatments are more likely to help. The National Professional Development Center for Autism Spectrum Disorders conducted a large review of studies on autism treatment and identified 24 treatments that are “evidence-based” (NPDC, n.d.). You can go online at www.autismpdc.fpg.unc.edu/content/briefs and click on the name of each treatment to learn about how the treatments are performed and which studies support their effectiveness.
As you are “clicking” through, you may notice that many of these treatments come from principles of Applied Behavior Analysis. Applied Behavior Analysis (ABA) is an approach to learning that is systematic and data driven. It means that treatments are prescribed, made, or changed based upon objective measurements about how the child is responding to the treatment. It has been supported by research to be helpful for both teaching appropriate behaviors and reducing unwanted behaviors. ABA can be used to design interventions that can positively affect all areas of a child’s life, not just academic skills.
Some people employ private companies to deliver Applied Behavior Analysis services in their home or at a clinic. This is often referred to as early intensive behavioral intervention and usually ranges from 20-40 hours per week. The programs are tailored to each child’s needs and family routines. Research has indicated that this type of intervention is very helpful for children with autism (e.g., Lovaas, 1987; Sallows et al., 2005; Cohen et al., 2006). Another treatment that is evidence-based is Pivotal Response Training (PRT). Pivotal Response Training is a method of teaching that focuses on teaching a few core skills during natural routines and using natural rewards. Once the child acquires the core skills, other improvements appear in social, communicative and behavioral skills that were not specifically targeted (e.g., Koegel et al., 1999). This approach involves parents, teachers, interventionists, and sometimes peers in the treatment. It is used across many environments so that the child learns how to use their skills with different people, different materials, or different contexts.
The main thing to remember when choosing a treatment is that every child is different. One treatment may work better for one child versus another. Overall, treatments work the best when they are matched to a child’s individual needs (NPDC, n.d.). Choosing treatments that are based in research will increase the likelihood that your child will have a better outcome.
I Heard that Treatment for Autism can be Expensive. Does Insurance Cover Treatment?
Nevada Assembly Bill (A.B. 162) requires insurance companies to provide up to $36,000 a year for Applied Behavior Analysis (ABA) treatment (Section 1.2.A). The law only applies to insurance plans that are governed by state law. These include small and large group health plans and the State Worker Health Plan (UNLV CASD, 2011). Unfortunately, the law does not apply to private insurance companies. Covered treatments include discrete trial training, early intensive behavioral intervention, intensive intervention programs, pivotal response training and verbal behavior. The provider must be a licensed psychologist, licensed behavior analyst, licensed assistant behavior analyst, or certified autism behavior interventionist. Coverage lasts until age eighteen or twenty-one if the individual is enrolled in high school.
What Other Options are there for Funding Treatment?
Two examples for funding treatment are Nevada Autism Treatment Assistance program (ATAP) and Medicaid. If you are looking to fund in-home behavioral therapy, ATAP can help. The application and info are online: www.dhhs.nv.gov/autism/ATAP_ApplicationForm.pdf, but there is a waiting list. Another option is Medicaid. Medicaid Services for individuals with autism (called a waiver or Katie Beckett option) funds medically necessary services such as speech therapy, occupational therapy, and physical therapy; but Applied Behavior Analysis treatment is not covered. Applications for Medicaid under the Katie Beckett Eligibility Option are made through your local Nevada Division of Welfare and Supportive Services. However, some people are denied Medicaid services because of parent income or resources.
How can the UNLV Center for Autism help me?
The UNLV Center for Autism Spectrum Disorders (UNLV CASD) is a community service, research, and training center for the Southern Nevada. We provide trainings for both parents and professionals, publish an annual directory of autism resources in Southern Nevada, and conduct research on interventions pertaining to autism. Although we do not currently provide treatment for children, we help connect families to the resources they need throughout the valley. Most recently, the UNLV CASD has partnered with the Dave Rice Foundation in an effort to expand resources to local families affected by autism spectrum disorders. The UNLV CASD autism resource guide is available free of charge either online at www.asdcenter.org .