Comments on: Insurance Coverage for ABA: On Treatment and Teaching

By: What’s Medically Necessary?

What’s Medically Necessary? — Mon, 07 Jul 2008 16:57:56 +0000

[...] treatments for autistic children—-has been a regular topic; a number of states have passed legislation (or not passed legislation) requiring that private insurance companies provide for treatment. A [...]

By: The Burden and the Goal

The Burden and the Goal — Sat, 21 Jun 2008 01:57:06 +0000

[...] editor, Dr. Nancy Snyderman, during a recent Today show segment on Missouri families seeking insurance coverage for autism treatments: “The burden right now is on the parents and I think most Americans would [...]

By: Kristina Chew, PhD

Kristina Chew, PhD — Thu, 10 Apr 2008 04:36:31 +0000

In Oklahoma, a House committee refuses a hearing for Nick's Law, which would provide for insurance coverage for diagnosing and treating autism.

By: Florida’s “Window of Opportunity Act”

Florida’s “Window of Opportunity Act” — Mon, 31 Mar 2008 19:01:42 +0000

[...] students who have autism spectrum disorder.” (And here’s some recent discussions about legislation that passed in Arizona providing for insurance coverage for ABA; about a bill in Wisconsin that did not pass; and about a [...]

By: Regan

Regan — Thu, 27 Mar 2008 22:18:18 +0000

Alyric,
I don’t believe in appeal to authority either.

The Baer, Wolf and Risley was just to highlight what is posited to be the dimensions considered in order to say that research and application is applied behavior analytic. To say that defined as example in 1968 as that currently demonstrated might be inaccurate…believe it or not, behavior analysts seem to beat each other up quite a bit over what their science is describing and whether bias or cheerleading is being exercised.

On a single person basis I have found some of the teaching procedures useful in making curriculum accessible to my daughter, and the data analysis helps to keep me honest about whether I am seeing what is she is telling me through her response or what I wish to see.

By: alyric

alyric — Thu, 27 Mar 2008 14:05:42 +0000

Regan

Thanks for the article from Baer and Risley. It’s certainly the cornerstone of ABA and the opening line sums up the empirical basis succinctly.

“The analysis of individual behavior is a
problem in scientific demonstration, reasonably well understood (Skinner, 1953, Sec. 1),comprehensively described (Sidman, 1960),and quite thoroughly practised (Journal of the Experimental Analysis of Behavior, 1957
-).”

Seriously, I couldn’t describe the vacuousness of ABA quite so well as this short paragraph. Note the ’scientific demonstration, reasonably well understood” – yes in rats and pigeons and there have been other explanations for Skinner’s experimental results, which didn’t rely on operant conditioning.

“comprehensively described by Sidman”, which i haven’t read but since when is description support for this approach? I have read Sidman’s seminal article on equivalence relations and that was a pretty good example of the breed.

“Quite thoroughly practiced” like description isn’t persuasive that this approach has merit. Phrenology in its day had many enthusiastic practitioners.

By: DeafPulse.com - the one-stop pulse for all Deaf-related news and blogs.

DeafPulse.com - the one-stop pulse for all Deaf-related news and blogs. — Thu, 27 Mar 2008 07:49:49 +0000

[...] Minister Gordon Brown’s grilling by senior MPs on the Commons liaison committee. (54 clicks) Insurance Coverage for ABA: On Treatment and TeachingLast Friday, Arizona Governor Janet Napolitano … Deaf woman auditions on French version of American IdolNouvelle Star is the French version of [...]

By: KimJ

KimJ — Wed, 26 Mar 2008 01:09:55 +0000

Jannalou, I’ve seen PBS in various environments in different states done by different people and the results always appeared the same for my son. One thing they had in common was using standard tools that had been used with other autistic students that weren’t like my son.
You’re right about integrated play therapy and with some background and dedication, anyone can do it with their kids/students. I think it can be easily done with a yard duty during recess even. But as soon as you say, “directed play” or “supervised recess” the school staff freaks out and says, “but we don’t have the money!!”

By: Regan

Regan — Wed, 26 Mar 2008 00:14:52 +0000

I guess if you argue that autism is a function of dysteachia then it completely falls into the realm of education (although I wouldn’t hold my breath waiting for good behavioral training for all direct staff or a $50K/student budget (our district was in a tizzy because they might have to allocate $11K/student and having gone through district training, I have a pretty good idea of the limited idea of what ABA is). If IDEA was funded properly and the money spent wisely, I wonder how much stress would be off this situation?
If you argue that it is mental health, then where does it fall in the big picture of mental health parity? Are mental health disorders just “dysteachia”? Is the solution to go back to school?
If you argue that it is genetic or essentially medical then the comparison might be made to providing OT, PT or other related services for those with traumatic brain injury, other organic syndromes or those who have need of rehabilitative and in some cases habilitative services.
Off the top of my head things that might fall into the medical realm as part of a treatment team are complicated eating and sleep disorders, as Patrick noted, complications of toilet training, motor function, speech therapy (or maybe more aptly the communicative portion), functionally assessing SIB or aggression or positing change in medication or other, etc.
I’m not really arguing, or even thinking that I have a handle on this…it’s complicated and further complicated by the considerable sums of real or hypothesized $$$ involved. I think that in considering the triage that some math might be involved in how much is spent dancing around this (retainers for educational tort funds), appointment of multiple blue ribbon panels that report the same findings, Federal Special Ed funds returned to the federal govt (and sometimes $$ is actually sent back because it is not spent), other services delivered in a comparable policy (see the CAHI report) compared to that delivered in direct services to children, youth and adults. Sometimes it all reminds me of a gigantic shell game.

By: Jannalou

Jannalou — Tue, 25 Mar 2008 22:37:30 +0000

Patrick,
To my understanding, the ABA-as-medically-necessary-intervention folks are saying that since autism has to be diagnosed by a medical doctor, and ABA is “necessary” for an autistic person to become a “functioning/contributing member of society”, it must naturally be medically necessary. I think there is also something to do with ABA programs being psychological in nature, which makes them mental health-oriented.

However, I agree with you: by and large, ABA programs are NOT medical in nature. Most ABA programs have a large educational (read: academic) component, which certainly makes them the providence of the educational system, not the health care system.