Autism and Dealing with the US Medical Insurance Indsutry

The United States has a fragmented healthcare system made of many private health care facilities that are largely owned by the private sphere. Primary care doctors are usually the first point of entry when there are any health concerns before referrals to any other fitting health establishment if necessary. There are thousands of insurance companies that extend private health policy and up until fairly recently it has been very difficult to get health insurance to cover autism because it is risky and handling is very expensive. This has recently changed due to new legislation but availability can depend on whether a specific State has enacted autism insurance legislation or coverage for government funded wellness programs such as Medicaid.

The causes of autism are not readily known or available. The U.S. Center for Disease Control and Prevention (CDC) describe that autism and related disorders are more ordinary than previously thought. There is an increase in those being diagnosed and 3-4 times as many boys than girls are affected. On average one in 110 children born in the U.S. experience autism. One in 70 boys and one in 315 girls are affected. It is thought by professionals that the increase is due to a wider definition from the spectrum.

It is all-important to get an skilful diagnosis in order to access the several services and treatments that may be available as it is helpful to begin an early intervention curriculum. An evaluation and assessment of the youngster may be done by a multidisciplinary team of professionals. Doctors who specializes in autism will watch the child, ask parents questions about the child’s development and behavior and do a variety of tests such as intelligence tests to measure the child’s strengths and weaknesses.

The following are some examples of the types of people and places listed by the National Institute of Mental Health (NIMH) of whom to go to that will make a referral to, or render diagnostic and treatment services (NIMH):

Family doctors

Mental health specialists such as psychiatrists, psychologists and counselors

Community mental health centers

Health maintenance organizations

Hospital psychiatry departments and outpatients clinics

State hospital outpatient clinics

Local medical and/or psychiatric societies

Once diagnosed, the quest to find affordable health insurance coverage to cover autism can begin. Around half of states currently have enacted autism insurance legislation which makes healthcare insurance coverage for more available, though it can be expensive. Recent laws have increased coverage for government funded health programs such as Medicaid for those on low incomes and disability is covered if it comes within the disability guidelines, so more families now qualify for assistance.

There are all kinds of treatments and interventions available and a treatment plan can be devised and tailored towards the individual child. Different teams of specialists can evaluate such things as speech, communication and motor skills. The main ways of treating the child can be through:

Behaviour Therapies and other types of therapies

Applied Behavior Analysis (ABA) can be used to shape and modify behavior. Occupational Therapy is available to work on fine and gross motor skills, for example, and there are other therapies such as Speech Therapy.

Individualized Education Plan (IEP) for school age children

Parents are encouraged to be involved with teachers in setting targets or goals to be reached inside the particular school year and describes any special support necessary in meeting them.

Medication

Presently, there are no medications available to treat autism, but there are supplements that can handle and manage some of the symptoms. Ritalin, for example, can be used to treat impulsivity and overactivity and there are other drugs that can be used to treat behaviors such as aggressive behaviors or repetitive behaviors.

Though healthcare is fragmented in the United States, there is a wide ambit of therapies and interventions available for children with an Autism Spectrum Disorder. Accessing these can depend on the youngster having an skilful diagnosis on autism and on what health insurance coverage the child has.

Autism Spectrum Disorder Diets

Gluten and Casein, when in relation to autism have received lots of research and attention of late. Many doctors and parents have reported marked improvements in their child’s behaviour upon removing these elements from their diets. It should also be noted that in general most people have reported a reduction in the amount of diarrhoea and constipation during the dieting phase. So it begs the question, what exactly is Gluten and Casein and what effect, if any, can they possibly have on ASD sufferers.

Gluten proteins are found in a variety of wheat and grains, including  most of the standard types like, oats, rye, barley, durum, kamut and foods made from those grains. They are also commonly found in a range of sauces, vinegars, artificial coloring and hydrolyzed vegetables. Casein is found commonly in dairy products and foods containing milk and is included in the majority of cheeses, butter, yogurt, and whey.

The gluten/casein free diet has not received widespread endorsement from the medical fraternity mainly due to the lack of empirical evidence and research. As we all know, doctors commonly get hung up on wanting to see the states before they are prepared to accept the results of a single patients response. There have been a few studies conducted on GFCF diets with mixed results. Some studies have shown widespread behavioural improvements whilst others have shown a lack of response. There is mounting interest in the gastro-intestinal aspects of autism with major studies currently being undertaken by the University of California. So it will be interesting to see what evidence comes of this over the next few years. One thing is for certain though, we are only just scratching the surface of our knowledge on autism and its many aspects so, personally, i’m not willing to discount anything quite yet.

The theory that is doing the rounds at the moment is that people suffering from autism can not digest Gluten and Casein based products properly and these left over compounds end up forming peptides which can act in unknown ways in the body. It has been reported by some sufferers that there is sometimes a feeling similar to the use of opiates and that this is related to the build up of these peptides. Obviously, any form of peptide like this is likely to cause behavioural and neurological disfunctions and can also interfere with the immune system which is also common in mild autism sufferers. The veracity of this theory is currently being debated but it is a fact that researchers in both the US and Europe have found these peptides in the urine of autistic people.

Changing your child’s diet in an attempt to lesson their asd symptoms is something that should not be taken lightly and I highly caution anyone considering this route to consult with their doctor. Doctors can often run gluten and casein sensitivity tests to determine, if in fact, your child has these peptides in their system. Once a base line has been established, then a diet can be implemented to aid the specific issues.  But let me tell you, removing bread from your child’s diet will be a battle and definitely takes some pre-planning.

As a parent, you need to sit down and work out what is available and what you can get them to eat. Foods that can be eaten on a gluten-free, casein-free diet include rice, quinoa, amaranth, potato, buckwheat flour, corn, fruits, oil, vegetables, beans, tapioca, meat, poultry, fish, shellfish, teff, nuts, eggs, and sorghum, among others. There is also a number of brands that are now openly promoting GFCF snacks and food and these can go a long way to making the diet more palatable to your child.  Having said that, be aware of hidden gluten and casein in food because not all manufacturers do the right thing and label their products correctly.

Often the easiest thing to remove initially is milk. Soy milk can be a likely substitute and is often switched without any notice. The removal of milk is also an easy first step before getting to the hard stuff, gluten, which it is recommended be removed after the first month. I would also suggest that you take the step of keeping a detailed food diary and also add additional information on your child’s behaviour day to day. You may discover a correlation between acting out and consumption of certain foods.

Research into the connection between autism and gluten/casein is continuing and at this stage the jury is still out. My results suggest that there is a small connection and that food can be an exacerbating factor…at least in my child’c case. So in any case, your mileage may vary but it is still worth investigating.

Stay Well

John