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Senators Want ABA Therapy Deemed ‘Essential’


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Members of the U.S. Senate are pressuring the Obama administration to do more to require health insurers across the country to cover autism treatment.

In a letter sent last week to the nation’s top health official, a group of democratic senators said that President Barack Obama’s signature health care reform law stands to leave those with autism in the cold unless more is done to ensure that applied behavior analysis, or ABA, therapy is covered.

Under the Affordable Care Act, Congress specified 10 types of health care services that insurers must include in all plans offered to individuals and small groups starting in 2014. One of those benefits is “mental health and substance use disorder services, including behavioral health treatment,” which many autism advocates hoped would be interpreted to include behavioral treatment for those with the developmental disorder.

However, federal regulators largely left it to the states to determine whether or not autism treatment would fall into the required category. And that has some members of Congress disappointed.

“All people affected by autism should have access to needed treatment. That will not occur under the guidance issued by the Department of Health and Human Services,” wrote Sen. Kirsten Gillibrand, D-N.Y., Sen. Barbara Boxer, D-Calif., Sen. Al Franken, D-Minn., and Sen. Sherrod Brown, D-Ohio, in their letter to U.S. Secretary of Health and Human Services Kathleen Sebelius.

“If the guidance is not changed, children and adults with autism will not be better off when Affordable Insurance Exchanges launch in 2014 than they are today,” the letter said.

The senators are calling on Sebelius to specify that ABA therapy must be part of each state’s behavioral health treatment requirement when the federal guidance on essential benefits is finalized.

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Comments (20 Responses)

  1. Rebecca Doll says:

    Please don’t forget about Federal coverage for Federal Employees!!

    OPM (Office of Personnel Management) allowed ABA to be covered in 2013 …. but that means there are limited options or no options in many states as it was up to the insurer to offer the coverage. Only 23 states have coverage in 2013. There are no options in Northern California and in Southern California we would have to switch from a PPO to HMO to get coverage.

    Will ABA therapy ever be required for Federal Employees?

  2. KA101 says:

    Hmm. I never knowingly received ABA, but having passed the bar & all that I’d think I did OK. I do know that we auties, when we’ve discussed it, certainly seem to show a correlation between “received ABA” and “has quite a few symptoms of PTSD”.

    So, not precisely an *essential* service if you ask me. I’d be inclined to support Skillstreaming and positive behavior support, but not getting people to touch-nose on demand.

    (Our bodies are ours, not yours, and demanding compliance of itself only leaves us open to abuse & exploitation. And at the risk of Flippantly Offending the Parents–who always seem to be NT, and thus were not in danger of ABA themselves–I’m pretty confident that participating in field-sobriety tests, while certainly important, isn’t precisely an ADL.)

  3. abaclarification says:

    You may want to look up the definition of ABA to see that ABA is beyond the scope of Discrete Trial Training which you described below and includes PBS as well as several other methods. ABA is a field not an approach and is representative of a number of evidence-based practices.

  4. DU says:

    KA 101: Perhaps the form of ABA you’re familiar with is of the old brand; the tabletop kind. The ABA therapy my son has received is all about positive reinforcement for improving social skills and pro-social behavior. It’s part of a fun, uplifting environment – not robotic skills acquisition. The therapist makes all the difference in the world, but I don’t think your experience of ABA is among the mainstream practice of the therapy today.

  5. John Best says:

    ABA is 100% useless for autism. It might help some people with Asperger’s. The only thing that should be essential for autism is chelation with Alpha Lipoic Acid. That is the only treatment that can cure autism.

  6. Carol Krawczyk says:

    While ABA benefits many autistic people, it is not a one-size-fits-all treatment for all autistic people. ABA, I have heard from many other parents, is good for many autistic children, but is not for everyone. There are other therapies that have been shown to aid individuals who are not goal-oriented or who have different needs. Many autistics benefit from forms of sensory integration therapy, FloorTIme, TEACHH and other programs. Providing choices are more important than requiring one choice alone. Michelle Dawson, a brilliant adult who was told that she was required to take ABA therapy in Canada when she was diagnosed with ASD, fought this requirement and won.

  7. YOYOYO says:

    It is my opinion asa the parent fo a son with both DS and ASD, that the most important thing that the government can do is unlock the restrictions on HOW money can be used by families for the benefit of their family member. For example – ABA may not work but not be the answer for every family – possibly Greenspans method or another behavior training works better. Why MANDATE which therapies work, but instead include a panoply from which to choose. Doesn’t cost the government any more money (and I pay taxes so it is MY money as well. )

  8. Carmen Allen says:

    First, all children attending public schools can get ABA therapy a/k/a Positive Behavior Supports (PBS) paid for by the school system. It was codifiied in IDEA 97. The Amendment offered to the ACA by Democratic Senator Bob Menendez was for Autism treatment. This is just another attempt to codify it and make it the only specific named therapy for ALL students on the spectrum. Each child, autistic or not, is an individual, there is no one size fits all and we need to stop trying to codify one therapy over all others. Autistic children and their parents deserve to have choice of the therapies used with them. It is a Civil Right to choose therapies to be used on each individual. Im just sayin…

  9. Dadvocate says:

    As I testified in front of HHS, it was clearly stated by the authors (on the record) that the Congressional intent in the Affordable Care Act was that behavioral health treatments, including ABA, should be an essential health benefit under the ACA. That is not debatable. My fear is that fiscally challenged states will try to limit or water down the coverage for this proven therapy that many, but not all, with autism require to help them develop skills and lead safer lives.

    KA101, I find (and I’m sure othes will too) your comment not only presumptuous in assuming tha mantle of leadership for a diverse group (“we auties”?) but also laughable, were it not so sad, that your personal achievement of a JD qualifies you to opine on whether behavior therapy is appropriate for people like my son, who requires intensive supports 24/7 for his safety and well being and who (although he expresses a strong desire to learn skills and tries very hard on that front) will be unable to satisfy the minimum requirements to earn a high school diploma. It’s a diverse community. ABA has helped many and can help many more. We should all respect one another’s choices, including ABA, whether we agree with them or not.

  10. John Best says:

    Autism is caused by mercury. Behavioral junk does absolutely nothing to address the brain damage caused by mercury. Parents of autistic kids need to know the truth about mercury so they can cure their kids. Forget all of this behavioral idiocy and address the problem.

  11. KA101 says:

    It’s good to hear people defending ABA as an umbrella concept. The experiences I’ve heard my fellows reference as “ABA” would indeed fall under the “Discrete Trial Training” term…
    …but when someone’s holding one’s sensory-sensitive hands in tacky glue, one tends not to pay attention to the clinical name of the approach.

    (Yes, one of my colleagues on the spectrum experienced that. I’m not sure whether her therapist restrained her hands in a painful texture while she had the broken wrist, or if the texture was simply more painful. She wrote pretty clearly about it; google “Just Stimming” and “Quiet Hands”.)

    I’d respectfully suggest to the ABA community that their Discrete Trial Training is giving the entire field a bad name, as the term “ABA” in our discussions is pretty synonymous with “abuse” or “torture”. Clarify the name all you want, but you’ve got a serious image problem at best.

    As for how I might possibly be able to speak for people who aren’t me, just because I’m a lawyer*? Simple. The ability to speak on behalf of others is part of the job. I’ve talked with my people both in-person and electronically, rather often, and I think I have some idea through what we’ve gone.

    Part of that involves our shared experience that speaking only for ourselves allows NT providers to compartmentalize and minimize our voices as not really seeing the big picture. (Bev of Square 8 did an excellent cartoon on that several years ago.)

    Part of that involves knowing that those of us who personally suffered the abuse (and, typically, have the PTSD) may not have the spoons to show up here and type about it themselves. It’s not easy for us to write about abuse on personal blogs, let alone shared netspace such as here.

    And part of that involves knowing that if we all remain silent, parents can continue to claim that everything they do was for our own good, up to and including those parents that kill us.

    *Earning a JD degree & being a lawyer are two different things.

    Thank you for your time.

  12. Evidencebased Momma says:

    DU You said it perfectly! ABA IS “all about positive reinforcement for improving social skills and pro-social behavior. It’s part of a fun, uplifting environment – not robotic skills acquisition. The therapist makes all the difference in the world” —ABA is not just one specific treatment and abaclarification said it perfectly too; “ABA is a field not an approach and is representative of a number of evidence-based practices”
    KEY PHRASE: evidence-based! ABA is an approach that takes time–it’s not a “let’s schedule 6 appointments and my child should be cured”—my child continues to receive it during the school day and we infuse it at home. She is 14 now, included in science and history classes and does a pretty darned good job considering she was a non verbal, tantrumming, toddler! And we should all respect the opinions and beliefs of others and not try to force their “mercury causes autism” belief in our faces (Mr. Best—are you still running for President? If so maybe you should focus your time more on getting votes than trolling the Internet & social media sites looking to force your beliefs on everyone! You won’t get votes that way!)

  13. Beth Dridi says:

    ABA saved the quality of my sons and families life. First, of all it was in no way abusive. Actually, my son was abusive. His behaviors included constant screaming, biting, hitting, head butting, kicking, pushing, etc. He received intensive 1 on 1 training through early intervention which took place in my home. Never, at any time did any type of abuse take place. The end result was progress. The therapists were fun, caring, and TRAINED SPECIFIC to AUTISM. Whatever took place in the past is just not the case, ABA has evolved so has my son as a result. Insurance should cover the necessary proven therapies specific to Autism. This is a neurological / developmental disorder labeled DISABLED. Why is this population of disabled, denied medical treatments and supports?

  14. Erika H says:

    John, I am thrilled you have found the cure for your child’s autism. I am thrilled there are people with autism who have passed the bar and folks like Temple Grandin. There are also people with autism who showed signs at birth without exposure to mercury, and who will not be heading to law school any time soon, likey children. They would very much benefit from this therapy mandate.

  15. Erika H says:

    Sorry, that was supposed to say, like MY children. They have both received ABA therapy, and my five-year-old, especially, is showing dramatic improvement. My nine year old has more severe sensory issues, and needs a lot of sensory input as part of his therapy program to see improvements.

  16. Carolyn says:

    Whenever politics gets involved in education or medicine, people suffer. Clearly, given the comments on this page, this is a divisive issue within the autism community. No one “treatment” should be “required” for anyone, much less the diverse community of children and adults with autism.

  17. John Best says:

    Hiding behind pseudonym of “Evidencebased Momma”, Yes, I’m the only candidate for president who will tell the truth about autism. I’m also the only one who will tell the truth about bankers and how they rob all of us. Calling me a “troll” doesn’t give credibility to your false statements about autism. We can cure lots of these victims of mercury poisoning. Vote for honesty!

  18. Glen S says:

    DU and Dadvocate: Thank you for taking a certain poster to task. He/she loves to act as if the world should follow his/her lead; and gets quite upset when others don’t. Thank you very much for demonstrating that he/she is quite in the minority.

  19. KA101 says:

    Thanks for that insight, Glen S. It’s been a long time.

  20. heidi says:

    this is great news!!

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