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Insuring Needs
By Joseph Wilner, Kansas
TJ was not a typical 15 year old boy. He became extremely aggressive when he felt he was not understood and he had difficulty communicating and interacting with strangers. He rarely left his house and didn't have much contact with the outside world.
I met TJ when I worked as a child and adolescent case manager at the Wyandot Center - a behavioral healthcare center in Kansas. Although weekly visits were a challenge - TJ rarely spoke more than a single word- there was something extraordinary about him and I wanted to know what was going on beneath his silence.
TJ is diagnosed with Autism Spectrum Disorder, and has been marked as different ever since he was a very young child. Despite severe behavioral issues, TJ transitioned into public school, and he had difficultly interacting with the other students who did not understand him. Though for all of his social ineptitude, TJ's interest in electronics and the computer seemed to unlock a covert creativity and imagination. This helped him create social connections he never expected. He began to open up and speak more.
Others began to see beneath the manifestations of his challenged condition a creative and caring person for whom early intervention and care would have helped him develop his potential. Indeed, had treatment been possible at an early age or close to the age of diagnosis many of his developmental difficulties could have been minimized.
"It was apparent that beneath the manifestations of his challenged condition there lay a creative and caring person for whom early intervention and care would have better enabled him to develop his potential." -Joseph Wilner
Unfortunately, funding for early behavioral treatments is still an area of needed advocacy, and the costs of care and indirect costs exacted on society have not been addressed. TJ's family, like so many others, could not afford these services and were left to deal with his aberrant behavior themselves.
Although TJ has benefited from an array of support systems and advocacy professionals it is unlikely he will be able to function independently as an adult and will likely require professional aid for the rest of his life.
"Since the early 1990's, the rate of autism has increased exponentially around the world with figures as high as 60 per 10,000" reports the Autism Research Institute. The Center for Disease Control supports these findings stating that one in every 150 American births exhibit some form of autism. This should send a clear message of urgency that society at large needs to address how autism changes lives and help those affected by this disorder.
Currently private insurance has not kept stride with these statistics and coverage for certain remedial services is often denied. A Harvard University study estimated that families spend up to $43,000 annually for care and treatment for a child with Autism Spectrum Disorder. This financial burden prevents many families from seeking treatment. While currently there is no cure for autism, there is substantial agreement that early and intensive interventions for children with autism can have very positive results. Research has shown that these improvements can come from a treatment model based on Applied Behavioral Analysis (ABA), which provides intensive individualized curriculum interventions for up to 35 hours per week at some institutions.
It seems imprudent to neglect the long-term productive and transforming outcome these services can provide. Yet some insurance companies argue that since a cure for autism does not exist, these services are too expensive to cover. Some also contend that the cost of private insurance will rise along with the increased number of claims. Though in examining the long-term costs and benefits of appropriate early intervention there is probable long-term cost saving effectiveness. Early and productive treatment from ABA can yield long-term cost savings in the end by minimizing costs incurred from life-long needed services to treat adults with autism.
With early initiatives in treatment, many children will become successful contributors to society and live more satisfying life-styles. And as an increasing number of individuals diagnosed with autism live independent, or in some cases, semi-independent lives they will no longer need to rely on professional intervention services for assistance. With limited resources currently available for the treatment of autism, it seems logical that insurance companies assist in shouldering some of the financial burden to transform lives and better society.
