Comments on: “Costs,” Insurance, “Treatment,” ABA

By: Insurance, ABA, and Older Children

Insurance, ABA, and Older Children — Sun, 19 Oct 2008 20:10:50 +0000

[...] same questions remain: Are educational treatments like ABA better provided by public schools or private insurers, [...]

By: Marla

Marla — Tue, 14 Oct 2008 00:59:36 +0000

Since M just began the center that bases most everything on ABA, as I understand it reading this reminds me that I need to stay very involved. I don’t like the idea of forced eye contact and even some forced communication. I know the people are very kind and loving and seem to have her best interest at heart…but, do they know her like I do? No. Today we were told she began crying because she refused playing along with a telephone game. A way they are trying to get her interested in remembering short bits of info and passing it on. I am concerned that they will push her too far and have the opposite affect.

Needless to say when I read the posts you link to here I begin to panic. Sigh.

By: Another Laura

Another Laura — Mon, 13 Oct 2008 14:46:17 +0000

My concern is that the mandate will be construed by the parents of newly dx’ed as government endorsement, or as Jen put it, “the” treatment. In MA, two of the specialty providers in the zero to three program offer both ABA and floortime. In my view, this is the progressive and better model for specialty providers. If I were to draft the legislation, I would cover both therapies, in the alternative (to keep it cost-neutral), to promote the progressive specialty provider model.

By: Kristina Chew, PhD

Kristina Chew, PhD — Mon, 13 Oct 2008 11:42:06 +0000

That’s really interesting to hear about, Jen–ABA has been very helpful for Charlie, but not from every provider. One behavior consultant (hired by a school district) set up some programs that led to an increase in the very behavior he was supposed to be addressing (head-banging……). A speech therapist who had an ABA background was one of the most helpful therapists/teachers that Charlie ever had and I’ve found that ABA has been the most helpful for Charlie when therapists have been very open-minded and included an emphasis on teaching communication and understanding sensory needs. ABA is pretty widely used in schools in New Jersey and I think there is a lot of variety. Some schools and school districts use more of a verbal behavior approach.

By: Jen

Jen — Mon, 13 Oct 2008 10:28:45 +0000

I have very mixed feelings on ABA- it was helpful to one of my children, and very destructive to another (although there were some other factors at work there as well).

One of the things that concerns me with the growing governmental and insurance acceptance of ABA as “the” therapy is that I am afraid that other therapies and services will be cut in order to provide it alone. By far the 3 best things that we’ve ever done with my children are OT for sensory needs, speech, and behaviour therapy (which in our case was basically a therapist helping me to understand behaviours, and then helping to come up with practical strategies to make them more manageable).

Now that we have ABA (or as they call it in Ontario, IBI- Intensive Behavioural Intervention) in the schools, not only are school boards and individual teachers and aides having a lot of trouble implementing it (in my experience), but the other services are dropping off- we’ve had shortages of speech therapists and OTs in schools for at least as long as 10 years (the length of time that my kids have been attending schools), and I find that very sad.

I don’t know what the answer is- I know that some families find ABA very helpful, but I also find it frustrating that both schools and insurance companies seem to be going the “ABA or nothing” route.

By: Kristina Chew, PhD

Kristina Chew, PhD — Mon, 13 Oct 2008 02:39:15 +0000

thanks and thanks for your comment on the framing of autism—–at least a little behaviorism runs is present in a lot of teaching (what are letter grades to students?).

By: Barbara

Barbara — Sun, 12 Oct 2008 23:43:20 +0000

The precedent is set for specifically qualifying a medical treatment for insurance coverage. The decisions as to which would be funded appear spurious only to those who have no insights into the mesh of business, medicine and culture. Early-on, contraceptives were not covered, but later, Viagra was widely subsidized by insurance. An insurer may completely exclude coverage for a whole class of medication or any single surgical technique, any single diagnosis.

So, for the record, “ABA” helps some families. All should have access to it, therefore.

Giving an educational technique a monetary moniker equal to a pharmaceutical seems bizarre. Generic ABA, or behavior modification is an endemic interpersonal behavior in our society. Many people interact on a level of exchange in every interpersonal interaction – ‘though not obviously with the exchange of tangible food (reward).

Excellent post. Hope I’m not to late to leave a comment on the framing of autism. Thanks for both your post and the links.