Would a little healthy hysteria be welcome now as the latest report from the CDC indicates, again, another possible increase in autism in America? The latest CDC survey of parent-reported ASD diagnoses shows an increase from 1 in 86 children aged 6 to 17 reported in 2007 to 1 in 50 in 2011. In this survey, as in any survey of autism spectrum disorder, the rates are significantly higher among boys. In its latest analysis on the numbers on autism, the CDC repeats a weary caveat that the increases are likely due to more accurate reporting and a widening diagnosis of the disorder. This has been a standard response for years; its credibility is growing somewhat weathered as the numbers went (in surveys using different methodology) from 1 in 10,000 in the 1980s to 1 in 166 in 2006 to 1 in 88 children in 2012.
Parents of children with autism probably care a little less about finding better statistical filters than they do about finding practical assistance for their children and getting to the cause of this troubling syndrome. Perhaps most frustrating for parents has been the glacial pace of insurance reform for children on the spectrum. Applied Behavioral Analysis (ABA) therapy has long been accepted from all sides as one of the few credible therapies for children with ASD, yet it has taken acts of state legislatures to force insurance companies to cover ABA treatment. Even when such coverage has been pushed by law, insurance lobbyists find novel means of circumventing the intent and reach of legislative reform.
New York recently joined 30 other states in requiring insurance companies to cover Applied Behavioral Analysis therapy, but the effect of the law was quickly thwarted by lobbyists who pushed through an “emergency amendment” that allows insurance companies to deny coverage if an ABA provider does not also possess an additional license for psychiatry, psychology, social work or similar professions. As NBC local news reports, most ABA providers are not state-licensed counselors. NBC repott that there are 700 board-certified behavior analysts in New York, but perhaps fewer than 50 of them also hold additional state licenses in psychiatry or social work. That would mean only 50 ABA practitioners are covered in New York to treat as many as 20,000 kids with autism. An analysis of New York lobbying disclosures found insurance companies paid nearly $3 million to lobbyists that reported working on the autism bill. Advocacy groups that support families with autistic children spent $264,000.
Intense, early intervention can mean the difference between a full and productive life or a lifetime of struggle, social isolation and costlier interventions in the future for ASD children. Their futures are too precious to be left to an arms race among lobbyists. Autism is a medical problem; it should be treated like one. ABA works; and parents should not be forced into bankruptcy in order to pay for it.
Autism is a neurological disorder and its effects are not subtle. No one would suggest that children born with other genetic disorders or who suffer from other environmentally triggered neurological symptons are not suffering from a "medical problem," why do we treat ASD differently? The answer has more to do with insurance companies' worries over cost than medical syntax. There is nothing fuzzy about the symptons these kids have, despite some of the current rhetoric. Parents with ASD kids are not at the forefront of patholgizing childhood behavior, they are confronting obvious neurological syndromes that will severely hinder if not halt altogether their child's normal development. ABA therapy has been one consistent means of getting ASD kids back on the path to normal social and educational development. Parents should not be choosing between bankruptcy and their child's future in order to treat this medical condition and it is a net loss to society to allow these kids to go untreated when early intervention can be so beneficial.