Legislation would cover autism therapy - Army News | News from Afghanistan & Iraq - Army Times

Legislation would cover autism therapy

WASHINGTON — Julian Irby was initially told his autistic son would never speak. But intensive therapy has taught 17-year-old David not just to speak but to handle basic chores like taking out the trash and putting away the dishes.

“He can at least put together basic sentences to ask for things,” said Julian Irby, a professional engineer in Pensacola, Fla. “The only reason that he’s been able to learn to do those things is because we’ve had therapists and workers work with him one-on-one.”

Irby retired about five years ago as a commander in the Navy’s civil engineer corps, before the Pentagon’s Tricare health program began covering expensive autism therapy for dependents of active-duty military personnel. He relied on Medicaid for the “applied behavior analysis” that David needed.

Tricare still doesn’t cover autism therapy for the children of military retirees, and Irby says that needs to change. Republican Rep. Jeff Miller of Florida agrees.

“It’s a huge inequity,” Miller said. “It doesn’t cost a lot of money.”

Miller’s Military Family Autism Equality Act would provide autistic children of retired military families with the same health benefits as autistic children of families of active-duty service members.

“Tricare has been doing a really nice job with their active military,” said Fran Warkomski, executive director of the Scott Center for Autism Treatment at the Florida Institute of Technology in Melbourne. “It would be great if they expanded to the retirees.”

The military began covering dependents of active-duty personnel under Tricare as part of a pilot program in March 2008. By Oct. 14 that year, Congress had approved legislation to boost the cap on Tricare coverage for extraordinary physical or mental conditions, including autism.

The coverage provides up to $2,500 per month for training, rehabilitation, special education, institutional care and sometimes transportation. The new provision has helped 850 children so far.

“Many people say I’m paying for my child’s Harvard education on the front end so that they will be able to function in society,” said Susan Byram, executive director of the Autism Society of the Panhandle. “When you do an early intervention with autism, there is so much potential. That’s what parents are always so hopeful about.”

An estimated one of every 150 children has autism, making it more common than pediatric cancer, diabetes and AIDS combined, according to the Centers for Disease Control and Prevention. The condition impairs language development and social relations.

Intensive early treatment

Scientific studies have found that intensive treatment in early childhood can make a big difference. The treatment calls for 35-40 hours a week of working on a task for 3-5 minutes at a time, followed by an equal amount of play time, with 10- to 15-minute breaks each hour. Tasks are broken down into manageable pieces.

But Medicaid’s low reimbursement rates make it tough for families to find providers of the applied behavior analysis designed for autistic children. And private insurance often excludes coverage for autism, according to advocacy groups.

As a result, parents of autistic children often must pay out of pocket for the costly therapy, which many can’t afford. Advocacy groups such as Autism Speaks have pushed for states to require insurance coverage to pay for applied behavior analysis. So far, only South Carolina, Texas and Indiana have approved legislation, according to a February 2009 report by the group.

“Autistic children have so much potential to change and to learn if they receive this early teaching,” Byram said. “If we are able to help them very young with these therapies, then they may be able to give back to the community rather than need government support.