Paving the way for insurance coverage by Group Health

Declan was one-and-a-half years old when he was diagnosed with Autism. His parents had started noticing a difference with him earlier on when he didn’t seem to behave like other babies his age. He was a content baby, but not as attached to his parents as most socially typical babies were. “Once we got the diagnosis, we were devastated, but it allowed us to move forward to find him the therapy he needed,” his parents said.

When they sought treatment for him, Declan’s parents were shocked and discouraged to find that many insurance providers do not cover therapies and rehab for children with autism. They looked at several different plans and found that some insurers even explicitly excluded autism treatments in their benefit manuals. While they were able to receive an evaluation quickly through a study at the University of Washington, they were randomized to the control arm which recommended..continue reading! >

The village that helped Sean

Susan Murdoch was all too familiar with that feeling of helplessness and fear that comes when one’s child is diagnosed with autism, “The day Sean was diagnosed with autism was the hardest and saddest day of my husband’s and my life.”

The biggest obstacle that Susan and her family faced was not knowing very much about autism and not knowing where to go for help. “We felt completely lost and bewildered.” There were very few resources and support available and they were completely on their own, which Susan says was a very lonely place to be. Luckily, Susan was referred to an incredibly helpful ABA therapist, Dr. Rinamarie Leon-Guerrero. They were also able to enroll Sean into the Experimental Education Unit at the University of Washington. They offered her and her husband a “village” of support resources, understanding, information, and educational opportunities…continue reading! >

Multiple diagnoses challenge David’s family

It was only at nine months of age when Gina began to notice that her son David was beginning to show signs of developmental problems. Having fallen behind in both gross and fine motor skills, David was soon diagnosed with low muscle tone, also known as hypotonia. Concerned for his welfare, his mom soon began taking him to physical and occupational therapy. But David’s challenges did not stop there—at 18 months, David was diagnosed with Apraxia of Speech, a condition characterized by difficulty making the facial movements necessary to form sounds or words. After enrolling David in speech therapy, Gina began to wonder: could Autism be a factor? With this question in mind, David’s mom arranged for a referral to the Children’s Autism Center in Seattle, where he underwent an evaluation in September of 2011. There, David was diagnosed with high-functioning Autism at age 4…continue reading! >

Overcoming obstacles to coverage from Medicaid

When J. A. was first diagnosed with autism at 21 months old, her parents knew there was no time to waste when it came to getting her the proper rehabilitation and therapies. They realized that every moment that she wasn’t receiving treatment was a moment lost and a moment that her development would regress. As their only child they would leave no stone unturned, starting with the Early Steps Study at University of Washington. Much to their disappointment, they were selected as the control group; the specialists only observed her condition, no direct intervention. J.’s doctors had prescribed ABA therapies to her parents, but unfortunately it was not covered under Medicaid and they didn’t have the resources to pay for the dosage privately. While the parents were able to secure five hours of neurodevelopmental therapy a week, they saw little progress. J.’s mother said it was a horrible feeling as parents to not be able to secure the appropriate help their daughter needed…continue reading! >

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