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Treating Patients With Autism? Here’s Some News They Might Want to Know

Op-Med is a collection of original articles contributed by Doximity members.

Every 1 in 40 children between the ages of 3-17 is diagnosed with autism, and the prevalence only continues to increase. Thankfully, so does research, policy, and funding.

New Research In Time It Takes to Diagnose

In the research realm, there was a recent breakthrough in decreasing the time it takes to evaluate a child with autism. A study reported in Science Direct in May 2019 suggests a potentially new way to diagnose autism using fMRI (functional magnetic resonance imaging), which may decrease the time it takes to diagnose autism drastically, from hours with a specialist to 30 seconds. The diagnosis is made by identifying significant differences between images of typically-developing children and those with autism. This information may give hope to some families who have children with autism and for those who continue to advocate for further research in autism.

Continued research in this area may help cut down the time it takes for families to participate in an evaluation for autism and receive necessary therapy. Because of the rising prevalence of autism, there is a shortage and increase demand for BCBAs (Board-Certified Behavioral Analysts) to provide ABA (Applied Behavior Analysis) therapy. Both the shortage of BCBAs and prevalence of autism have contributed to the increased wait time for families needing an autism evaluation and therapy. In some places, it can take a year to be evaluated, with each evaluation taking about 2–4 hours. As pediatricians are usually one of the first professionals parents seek advice from, it may be reasonable to provide this information to parents early so they may be able to plan accordingly.

Change in Insurance Policy for Autism Services

Parents of children with autism, like every other American, worry about insurance. There is always the question related to insurance coverage of who will pay for the services. According to the CDC, behavioral interventions for children with autism can cost between $40,000- $60,000 a year. Currently, 46 states have implemented regulation that requires insurance to cover autism services.

A recent win has been reported in Florida for families needing ABA therapy. The AHCA (Agency for Health Care Administration) has decided to postpone their Medicaid funding cuts, allowing clinicians to continue to provide ABA Therapy to their Medicaid clients while implementing other ways to track Medicaid fraud such as GPS tracking and increased collaboration with BCBAs. Because of previous Medicaid fraud cases, the AHCA (Agency for Health Care Administration) had proposed to cut Medicaid funding for ABA Therapy, up to 51 percent cuts in reimbursement rates, which would force many ABA Therapy practices to no longer accept clients with Medicaid due to low reimbursement rates, leaving many families without therapy. Because therapy is so integral to patients with autism, it’s important to share any information with families about forward movement on the policy side of health care to educate them in areas they may not understand.

With new research on decreasing the time it takes to get an autism diagnosis and positive actions in the continual fight to gain appropriate funding for autism resources, pediatricians can equip and educate families with positive information for them to continue to advocate for their own children as well as their community.

Image by Lightspring / Shutterstock

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