Category: Autistic Spectrum Disorders

Autistic Spectrum Disorders includes pervasive developmental disorders: aspergers, autism, pervasive developmental disorders & autism

Autism screening & treatment paid for by insurance in some states. www.freedomOK.net/wordpress

Michigan Class Action Settlement on Autism Treatment Hailed as Landmark Case
The article below discusses a recent class action case in Michigan wherein insurance co has agreed to pay for ABA treatment for autism. Hopefully, other methods such as P.L.A.Y. and FloorTime – softer approaches than ABA — will also be covered. Contact Easter Seals for P.L.A.Y. in Santa Cruz and Monterey Counties. If you are interested in Floor Time — a way to spontaneously interact with children there are a several therapists available in the Santa Cruz and Monterey area.

In my opinion as a psychologist it is crucial that parents be in the driver’s seat and make decisions they think in the best interest of their child. Too often parents defer to others (this therapist, that therapist) and are slow to voice their concerns. There are many treatments for autism and autistic spectrum disorders. Parents need to decide what is best for THEIR child.

Emial cameronjacks@gmail for more information. Dr. Cameron Jackson, licensed psychologist in CA PSY14762

June 23, 2009
In what plaintiffs lawyers are calling a landmark autism case, a Michigan insurance company has agreed to reimburse at least 100 families for costs involving treatments for their autistic children.

The $1 million class action settlement from Blue Cross Blue Shield of Michigan comes amid a legislative wave in which a growing number of a states are passing laws that require insurance companies to pay for autism treatments and screenings. To date, 13 states have such laws, the most recent being Connecticut, Colorado and Nevada. New Jersey is currently considering an autism bill, and Pennsylvania’s law goes into effect July 1.

The June 17 Michigan settlement, meanwhile, has autism advocates hopeful that insurance companies will stop claiming that behavioral therapy for autistic children is experimental, and start paying for it.

“It is a significant victory for the families, obviously, and it marks a trend, hopefully, that insurance companies will start to look at autism treatment differently,” said Areva Martin, an attorney at Los Angeles-based Martin & Martin who is currently handling about 30 autism cases. She believes the labeling of autism treatments as experimental is “absurd.”

“It’s a neurological condition similar to a patient that has a stroke,” Martin said.

In the case, Johns v. Blue Cross Blue Shield of Michigan, filed in the Eastern District of Michigan, the family of an autistic child sued Blue Cross for allegedly failing to acknowledge that a treatment known as applied behavioral analysis is scientifically valid. ABA therapy attempts to change behavior through positive and negative reinforcements.

In the suit, the plaintiffs alleged that Blue Cross’ pattern and practice of characterizing ABA as “experimental” was arbitrary, capricious, illegal and contradicted by many years of scientific validation.

Blue Cross sought dismissal of the case, but a judge permitted it to go forward.

The case settled shortly after plaintiffs counsel obtained a court order requiring Blue Cross to produce documents that validated the effectiveness of ABA. Among the documents obtained was a draft of a 2005 Blue Cross Blue Shield medical policy, which stated: “Applied behavioral analysis (ABA) is currently the most thoroughly researched treatment modality for early intervention approaches to autism spectrum disorders and is the standard of care recommended by the American Academy of Pediatrics, National Academy of Sciences Committee and the Association for Science in Autism Treatment, among others.”

Blue Cross’ documents also stated: “The earlier the disorder is diagnosed, the sooner the child can be helped through treatment interventions.”

“I think we had ’em. Their files were so damming,” said Gerard V. Mantese, of Troy, Mich.’s Mantese & Rossman, one of two lawyers who represented the plaintiffs. “We kept hearing from Blue Cross that this is experimental, we’ve researched it. So when we sent our discovery requests saying, ‘Show us what you have,’ their file looked almost like my file. It had paper after paper supporting ABA therapy.”

Under the settlement, Blue Cross will pay for behavioral therapy rendered to more than 100 children in the past six years. Mantese believes this is the first such lawsuit settlement where an insurance company has agreed to pay for autism treatment.

“We’ve searched across the country for similar cases. This is the first one that we’re aware of,” said Mantese, who is getting calls from numerous attorneys handling similar cases. “I’m getting calls from all across the country. They’re encouraged. They’re pleased with the settlement, and they’re motivated to fight for these families and these children.”

Jeffrey Rumley, vice president and general counsel for Blue Cross Blue Shield of Michigan, issued this statement: “We knew we could resolve this matter to the benefit of the families involved, and are pleased to be able to conclude this matter in a manner that puts the families first who received services from the early intervention program,” Rumley stated.

Separate from the lawsuit, Blue Cross Blue Shield of Michigan announced on May 11 that it will offer its customer groups the ability to purchase coverage for autism treatment programs that provide intensive early intervention. The new benefit option involves coverage for children aged two to five years old who use ABA, although the insurance carrier said that it still considers ABA an investigational and experimental treatment.

The coverage will begin on July 1.

“We saw a need in the community and moved to find a way to address it,” said Thomas Simmer, M.D., Blues Cross Blue Shield of Michigan senior vice president and chief medical officer, when announcing the new coverage last month. “We developed this coverage option as part of our commitment to improving the health and wellness of all Michigan children and families.”

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Aptos psychologist: Take a look at $100 mo subscription for ABA for autism www.freedomOK.net/wordpress

The link below takes you to an About Us page for Rethink Autism which has sample lessons using ABA techniques. There re a handful of free sample lessons. The subscription cost is $100 a month WITHOUT professional assistance. There is an additional monthly charge for professional assistance.

The good news is that you as parent have complete control of how the ABA program is done. You know how much stress your child can tolerate. You can tailor the lessons to fit the needs of your child. Certainly, $100 a month seems very reasonably priced.

One of the complaints I hear regularly about ABA is that outsiders come in to the home. The “work” is done in a separate room and the child is isolated from parent involvement during the session. Frequently some kind of sugar reward is used to motivate the child to do the work. All of those kinds of complaints are addressed with this program. No strangers. No isolation, Use of praise and hugs for a reward.

I looked at the sample for teaching imitation. It is clear and something a parent can do readily. Like telemedicine this program might be quite helpful for certain kinds of families.

In California because of budget issues the Early Start program (ages 0 to 3) may be drastically cut. Use of this kind of a online subscription program might be a helpful adjunct for some regional center clients who receive Early Start services.

written by Dr. Cameron Jackson, Ph.D., J.D. Licensed clinical psychologist cameronjacks@gmail.com

Rethink Autism

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Aptos psychologist: Asperger’s Web Ring has 91 sites. What think of sites? www.freedomOK.net/wordpress

Web Ring exists for all sorts of topics. For autistic spectrum disorders (autism, pervasive developmental disorder, NOS, etc) there are several interesting rings: Autism Family Circle, Special Needs Support Groups and Asperger’s Web Ring.

Anyone who knows of a particularly good site – please post what it is and why you like it.

I am in process of joining the Asperger’s Web Ring which has 91 sites. What that means is you can quickly move from one sit to another and see what you think of all of them.

For more info go Web Ring

There is also a Children’s Health Issues ring that has 50 sites. I plan to join that ring too once I figure out how to do so!

Any sites you particularly like that relate to children — please share the info so it can be posted.

For more information about Web Ring — Google it and put in Autism.

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Aptos psychologist: know the early warning signs of autism. Go to www.freedomOK.net/wordpress or www.firstsigns.org

First Signs launches a National Campaign to Inform Physicians and Parents about Autism and Developmental Disorders.

“First Signs, a national awareness initiative, was recently launched recently in the state of New Jersey to inform the state’s physicians and parents about the early warning signs of autism and developmental disorders. The New Jersey pilot, which was launched in collaboration with UMDNJ-Robert Wood Johnson Medical School and New Jersey Center for Outreach Services to the Autism Community (COSAC), was the first statewide campaign of its kind in the country by the Massachusetts-based First Signs, Inc, launched in collaboration with UMDNJ-Robert Wood Johnson Medical School and New Jersey Center for Outreach Services to the Autism Community (COSAC).

“Since First Signs announced its program launch on April 27, 2001 in Washington D.C. before the Congressional Caucus on Autism, the non-profit organization has been receiving hundreds of requests from pediatricians, parents, and other clinicians throughout the country for information about early identification and treatment. The organization hopes to create a national model for disseminating key information about early warning signs, the need for routine developmental screening, of children from birth to age three, and the options available to parents of children diagnosed with autism spectrum disorders.

In the December 2001 issue of Archives of Pediatrics and Adolescent Medicine, the editorial “Child Development in Pediatrics: Beyond Rhetoric”, by Barry Zuckerman, M.D., Marilyn Augustyn, M.D., and Steven Parker M.D., First Signs is described as a parent-run organization calling for “regular systemic screening by pediatricians with validated instruments, emphasizing the social and emotional aspects of development, to identify autism spectrum disorders.” First Signs is noted as an example of how parents are listening closely to the recent national emphasis on the importance of early childhood development. “Because parent groups have a long and special tradition of improving care for children, it is likely that they, rather than professional organizations, will be more effective in changing practice.”

“First Signs grew out of the personal experience of founder and president, Nancy Wiseman, whose daughter was diagnosed with autism spectrum disorder in 1998. Based on her daughter’s steady improvements through early identification and treatment, Wiseman, a marketing communications professional and parent, knew that she had an important message to share with both physicians and parents—that the earliest possible diagnosis and intervention are the keys to success for all children at risk of developmental disorders.

“The high and growing incidence of autism and related disabilities demands greater awareness and improved early identification,” says Wiseman. “We don’t know how to prevent autism or how to cure it, but one thing we do know is that early and intensive treatment and intervention can profoundly change the quality of life for children at risk and their families. The key is early detection.”

To that end, the First Signs mission is to ensure the best developmental outcome for every child. By educating both parents and physicians, First Signs hopes to promote ongoing discussions regarding the most important and often overlooked aspects of development: social/emotional, communication, and behavior.

Through an integrated mix of print and broadcast press, direct mail, public service announcements, speaking engagements, and at their Web site, the First Signs campaign is focused on a primary target audience of physicians, parents, and family service organizations. The program has three primary components: a screening kit designed for physicians and family practitioners, an informational mailing sent to parents of children under three years of age in participating states, and a comprehensive Web site that provides evidence-based information for parents and professionals.

In August 2001, physicians in participating states received a mailing offering letter from UMDNJ/Robert Wood Johnson Medical School and COSAC with an offer to receive the a free First Signs Screening Kit and to earn CME credit by viewing and completing materials on an enclosed educational video. The screening kit includes an educational video (hosted by Lesley Stahl of “60 Minutes”), a developmental milestones wall chart, validated screening tools for both developmental and autism screening, recommended screening guidelines for physicians, and an Early Intervention referral guide. The 20-minute educational video, entitled “On the Spectrum: Children and Autism,” outlines the diagnostic criteria for autism spectrum disorders, provides guidelines for conducting developmental screening, and describes how to relay developmental concerns to parents. The video is hosted by Lesley Stahl of “60 Minutes” and features actor Anthony Edwards of “ER” and football legend Doug Flutie. “On the Spectrum” draws upon clinical expertise, with interviews of some of the top experts in the field.

One of the initiative’s major goals is to encourage more pediatricians to refer young children to early intervention programs. In keeping with the recent AAP Policy Statement on the Pediatrician’s Role in the Diagnosis and Management of Children with Autistic Spectrum Disorders, First Signs recommends that a physician or nurse practitioner perform a routine developmental screening at every well visit for any type of atypical development. The First Signs Screening Guidelines leads physicians through the referral process for those children in need.

Parents of children under age three will receive an informational mailing three weeks after the physician mailing goes out to create awareness around the hallmark milestones during each stage of development. A checklist of developmental milestones is included in this mailing, which helps to serve as discussion points between parents and physicians at the next well visit. To minimize language and cultural barriers in parent populations, First Signs will test informational mailings to Head Start programs and day care centers in selected areas to see if family service workers can influence parents to have their children screened.

The First Signs Web site provides physicians and parents with essential developmental information, an explanation of the screening process, a systematic guide that walks them through each stage of the process, listings of available local and national resources, and links to research, books, articles, and programs nationwide. Physicians and parents can become better informed about the different educational, biomedical, and alternative treatments for autism spectrum disorders.

First Signs has been endorsed by the American Academy of Pediatricians/New Jersey Chapter, Medical Society of New Jersey, and the New Jersey Pediatric Society. First Signs is funded by a number of foundations and government agencies, including Cure Autism Now, the Doug Flutie Jr. Foundation for Autism, the Mellanby Autism Foundation, the New Jersey Governor’s Council on Autism at UMDNJ, and Parents of Autistic Children (POAC) of Ocean County.

Originally published in Developmental and Behavioral News, published by the AAP, Section on Developmental and Behavioral Pediatrics.

References
Zuckerman, B., Augustyn, M., Parker S., (2001). Child development in pediatrics: Beyond rhetoric. Arch Pediatr Adolesc Med, 155, 1294-1295. [50]

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Related Links
First Signs
Group that advocates early detection of autism, with information about screening tools and treatment information.
http://www.firstsigns.org accessed 12/5/2008
Autism Society of America Home Page
Parent information on Autism and support and advocacy information. A good source of credible information about diagnosis and management autism.

for more info to to: More info

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Aptos psychologist: Dog therapy does wonders. No overflowing refrigerator! Dogs can reduce blood pressure. Help socialize children. www.freedomOK.net/wordpress

I recently saw a post on Twitter about a family raising $13, 000 to buy a particular kind of therapy dog. They believe that a therapy dog, trained by a particular organization, will enhance the life of their child who has autism.

Yes, dogs provide wonderful therapy for people includng children who have an autistic spectrum disorder. But $13 K is a steep price to pay.

Are there other ways to get a dog which can increase the social and communication skills of your child? Yes!

There are rescue organizations for many kinds of breeds. In the economic downturn, more pets are dropped off at the local pound. Most communities have good resources for training dogs.

One decent rescue dog or pound dog plus lots of appropriate training can probably produce a dog that meet your child’s needs.

One organization that does provide therapy dogs is: 4 Paws Dog

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Aptos psychologist: In England, 50% of persons with autism fall through cracks…www.freedomOK.net/wordpress

English doctors
English doctors
Do you want nationalized health care? Look at what socialized medicine provides persons in merry old England: NO services for roughly 1/2 of all persons suffering from autism. See what following article says:

“Eight out of 10 doctors need more training to spot the signs of autism, according to a new report.

The study, from the National Audit Office (NAO), also found that around half of the estimated 400,000 adults in England with autism may be falling through the gaps due to a lack of services.

This is because they do not have a learning disability and services are mostly set up for people with illness, physical or learning disabilities, and mental health problems.

A poll of 1,000 GPs for the report found 80% thought they needed additional guidance and training to identify and manage those with autism more effectively. Many did not know where to refer people with autism due to a lack of specific services.

The study said: “In our survey of GPs, 64% told us that they referred adults with suspected high-functioning autism to adult mental health services, and 19% to learning disability services.

“(A total of) 12% were not sure where they should refer such patients, and only 10% reported that they would refer them to a specialised autism diagnostic service.”

The NAO found that most NHS organisations and local authorities do not know how many people with autism live in their area, something it said should change. It also called for specialist support services.

The study – called Supporting People with Autism through Adulthood – said: “Providing specialised support could improve outcomes for this group of people and their carers, and potentially enhance value for money, as the costs of establishing such support could be outweighed over time by overall savings.”

Tim Burr, spokesman for the NAO, added: “Greater awareness of the numbers of people with autism, as well as better understanding of autism amongst those providing health, social care, benefits, education and employment services, would lead to improved quality of life for those on the autistic spectrum.”Mark Lever, chief executive of the National Autistic Society (NAS), said: “Neither the Government, people with autism nor the taxpayer are getting value for money from existing autism services and support, leaving those affected by the condition feeling isolated, ignored and often at breaking point. This is simply unacceptable.”

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Aptos, CA:Easter Seals shows parents how to PLAY & ENGAGE their autistic child.www.freedomOK.net/wordpress

From Aptos psychologist Dr. Jackson 831 688-6002

Easter Seals offers P.L.A.Y., a method that is softer and more gentle than Applied Behavior Analysis (ABA). Parents need to educate themselves about the different techniques available for assisting children with Autistic Spectrum Disorders. Parents need to be in the driver’s seat as to what kind of therapy they think will be best for their child.

There are “squishy” softer methods such as P.L.A.Y. and FloorTime. And there are “prickly”, harsher methods in my opinon such as Applied Behavior Analyisis (ABA). Different methods for different severities and kinds of autistic symptoms. Each child is unique. Parents who have educated themselves will make the best decisions.

Call EASTER SEALS in Aptos for informantion about how to PLAYFULLY engage with children with social and communication delays. Go: Easter Seals

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Aptos psychologist: screen your child for social & communication delays by 12 months.

Does your child smile and laugh when looking at you?
When your child plays with toys does he/she look at you to see if you are watching?
When you are not paying attention, does your child try to get your attention?
Does your child point to objects?
Does your child nod head to indicate yes?
About how many different words does your child use meaningfully that you recognize?

The above questions are from the the CBS Intant-Toddler Checklist. Visit www.brookspublishing.com for more information.

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Aptos psychologist: Parent-led home programs for children with autism are available & work www.freedomOK.net/wordpress

Through Early Start the regional centers serve many children with social and communication delays. Children do not need a diagnosis of autism or autistic spectrum disorder to receive early start services from 0-3.

In Santa Cruz County, a variety of venders provide services under the auspices of the local regional center. A wide variety of programs are available from P.L.A.Y. – which as its name denotes helps parents to have fun while interacting and teaching age appropriate social and communication activities to their children – to strict ABA type programs such as ABRITE wherein, I have been told, the parent is not permitted in the room during therapy sessions.

Personally, for various reasons I support programs such as P.L.A.Y offerred locally through Easter Seals in Santa Cruz (http://central.easterseals.com). I also support Floortime approaches. One local therapist with Floortime using a DIR approach is licensed MFT Lisa de Faria, located in Scotts Valley. Through her you can obtain other names of competent therapists using the DIR and Floortime model.

It is possible, though not frequently done, for parents receiving Early Start regional center services to create their own particular mix of social skills training, speech and occupational therapy. When people come out to assess, that is the best time for the parent to state that they want to be in charge of the mix of services offerred.

Below is an article by Jill Echer. From her blog: Autism Tomorrows www.autismtomorrows.blogspot.com

What the Psychologist Should Have Said by Jill Echer from her blog: autismtomorrows.blogspot.com

“If psychologists told the truth when delivering an autism diagnosis, this is what they would say.

“Thank you, Mr. and Mrs. Jones, for bringing little Joey in to see me. It was an honor and privilege to spend time with such a sensitive and special child. I know you are concerned about Joey’s social development, and I can understand that; as you know, when we see distortions in social development, we usually give it a label, an autism spectrum disorder. But just because we have a label, that doesn’t mean we understand the problem any more than you do.

I see the same things you saw before you made the appointment, for example, Joey is not pointing to objects and then referencing you, as normal toddlers do many dozens of times each day. He’s not responding to his name or turning his head when you say, “Look at this!.” He does not share and show, or draw attention to himself. He has a few words to label objects but it not engaging in any little conversations or respond to questions. He’s not interested in other children, lacks eye contact, and does not pretend play with toys. I am not any more observant than you, I just have the ability to put these omissions in stark relief by administering some diagnostic tests.

We have no idea why Joey is developing so differently than other kids his age. New theories seem to be developing every day, and just about everyone agrees that autism is a neurobiological disturbance caused by a mix of genetic and environmental factors. Some theories relate to neural under connectivity, neural overgrowth, lack of synaptic pruning, failure of certain neural pathways to develop, weakness of the mirror neuron system, neuroinflammation, mitochondrial dysfunction, even hormonal influence on the developing brain. But in the end, we just don’t know.

I know what you’re thinking: why would a psychologist like me have any business diagnosing and treating a mysterious neurological disorder? That’s a good question. In reality, the field of psychology is completely irrelevant to autism. And worse, and I’m very sorry about this, my profession has a history of doing more harm than good to people with autism, and their families. For decades, from the 50s through the 70s, we routinely blamed the children’s mothers for causing the social withdrawal resulting in autism. Then from the 80s to today most of us have portrayed autism as a behavioral disorder addressable at least in part through behavior modification based on discredited work by someone who knew nothing about autism, named BF Skinner. His legacy is a form of systematic rewards and punishments used originally on dogs and pigeons. Psychologists who follow the behavioral model don’t believe in addressing the core deficits of autism, just shaping external behaviors. My profession has done a poor job of developing or understanding effective therapies; in fact we do very little hands-on work with your kids. Most of our observations come from ivory tower research papers; we remain naive and a bit mystified about how to implement meaningful therapy.

You asked about prognosis. There are few good longitudinal studies examining long-term outcome, but from my experience I see that children with these early developmental patterns have some level of social and sensory difficulty that persists throughout life, although there is evidence that some children do in fact recover. Some individuals move along the spectrum and become quite functional; others are wired in such a way that they always have profound problems relating to our world.

That said, we psychologists have done a terrible disservice by presuming your kids are mentally retarded, when in fact so many people with autism, though nonverbal and remote, have proven to have active and engaged intellects. We know this because many of them have learned to type or point to communicate amazing and complex thoughts. I myself have met several of these kids and believe that a great many people with autism could do the same if given appropriate help and guidance. I am sorry that my profession has perpetuated so many myths about people with autism. Autism for the most part is a disorder of the sensory-social system and not of the intellect.

You asked about next steps. We psychologists usually follow a cookie-cutter approach that recommends a total of 25 hours per week of intervention, including about 10-18 hours per week of ABA and about 7-15 hours of other therapies, including speech therapy, occupational therapy, and play group.

But let me tell you the truth. By running a parent-led home program, you are free to emphasize the critical deficits in autism, namely development of social interest and relatedness. You will have complete control over quality and training of the therapists and the ability to videotape sessions to provide constructive feedback to the therapists. It is not as hard and daunting as it sounds. For one example of an excellent home program, see autismtreatmentcenter.org.

The real issue here is not parent competence, but availability of support and funding, even though 40 hour per week parent-led programs cost one-quarter as much as 20 hour per week therapist-led ABA programs. But because agencies, school districts and insurance do pay for some portion of an ABA program, cost efficiency is a moot point for some families, and I understand that.

You asked about Joey’s repetitive behaviors, like flapping his hands, and sifting sand, and spinning wheels. Well, I know we psychologists have labeled these type of repetitive behaviors as aberrant and maladaptive, and again, I am sorry about that. We have no idea why Joey does these things, but of course these activities have meaning and value to him; it how he is taking care of himself and exerting some control over his confusing world.

We have sought to extinguish these type of activities through behavior modification, but that almost never works. Please look at Joey’s repetitious behaviors as an opportunity to join him in his world, to get to know him better. It’s a wonderful starting point for strengthening your relationship and earning his trust. Do not judge him, after all he is doing the very best he can given his most unusual neural wiring. Your total acceptance will be the best starting point down the road.

For more articles by Jill Escher, go Jill Echer Autism Tomorrows

the above was written by Jill Escher
“I’m a former attorney, a stay at home mom of three, and an active community volunteer. For those who care about resume type information, I grew up in Los Angeles, have a BA from Stanford University (1987), and a Masters and a J.D. from the University of California, Berkeley (both 1996). We live in San Jose and Santa Cruz, California. The goal of this blog is to help parents of children with autism think critically, and in a more informed way, about their children’s treatment options. Please reach me at jill.escher@gmail.com.
View my complete profile

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Aptos psychologist: support Autism Treatment & Acceleration Act 2009 by Durbin & Mendendez www.freedomOK.net/wordpress

Check out and support senate bill introduced by Senators Durbin (D-Il) Casey (D-PA ), and Menendez (D-NJ): the Autism Treatment and Acceleration Act 2009 (ATAA) http://www.autism-society.org/site/news2?page=NewsArticle&id=13301. ATAA would create many services for adults with autism- vocational, employment, housing and transportation to name a few. This is something for all of us to support.

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