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Health & Medicine

Parents Call on Lawmakers for Access to Autism Treatment

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One of every 68 children in this country has now been diagnosed with some degree of autism – a disability that makes it difficult for them to communicate and learn.  Virginia requires insurance companies to pay for an intensive treatment called Applied Behavior Analysis until the age of seven, but parents say care should be available for as long as a child needs it, and a bill making its way through the legislature could lift the age limit.

Kate and Gary Fletcher have two little boys with autism. Matthew, who is now 7, made great progress after enrolling in a program of Applied Behavioral Analysis.

“Because of ABA we were able to teach him finally how to use the bathroom on his own.  He has made huge social gains through ABA, just working on greeting people , responding to his name, and it did give him the academic skills he needed to transition to public school this year.”

But the one-on-one training was expensive -- $90 to $150 an hour, and Matthew needed about thirty hours a week. At first the Richmond area couple says their insurance wouldn’t cover it.

“For me it was agonizing, because when you see  thousands of dollars of insurance claims, and we can’t make, because we just don’t make that much in a month.”

“The insurance companies want this responsibility to fall on public schools, and the public schools do not have the means or the staff to deal with students like Matthew honestly.”

They sold Gary’s truck and started thinking of other ways to get the money need for Matthew’s school when, at last, the insurance company agreed to cover ABA.  Matthew started making eye contact, and using words instead of throwing trantrums.

"Instead of him getting frustrated with the lack of communication, if he needed help the two most important words he could learn were Help Please.  So we saw that at home – him actually stopping and instead of getting upset saying Help Please.”

“He was just blossoming.  He was in school.  He was starting to interact with his classmates.  He was more affectionate to us, saying ‘I love you,’ and when we say, ‘I love you,’ he says, ‘Just the way you are,’ because of a line he hears from a Thomas cartoon. It really melts our heart .  It’s in there. He’s just a kid who wants love and express himself to the world, but he doesn’t have the communication skills that other kids do.  It’s been a godsend to our family.”

But now, Matthew has past the age when state law requires insurance coverage, so he’s only getting a few hours a week of ABA. 

“If Matthew had any other medical diagnosis – if he was diabetic, had cerebral palsy and insurance said, ‘We’ll only cover your medications until the age six,’ people would be outraged, but for some reason it seems completely acceptable to say that about children with autism, and it’s not right.”

She and her husband have joined hundreds of parents with autistic children – lobbying Virginia’s legislature to lift the age cap.  Opponents say doing so will increase costs for insurance companies, forcing them to raise rates for everyone, but the Fletchers argues it’s cheaper to provide help for autistic children now than to cover the cost of institutional care later in life. 

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