According to statistics from the Centers for Disease Control and Prevention, one in 68 children falls somewhere on the autism spectrum.
The fastest-growing developmental disorder in the United States, autism spectrum disorder (ASD) is almost five times more common in boys (1 in 42) than girls (1 in 189). Additionally, the CDC estimates it costs at least $17,000 more per year to care for a child with autism, including extra expenditures for healthcare, education and ASD-related therapy.
While there is still no cure for ASD, research has shown early intervention can have a significant impact on a child’s development and ability to more fully interact with peers at school. It’s at this intersection of education and healthcare where Educational Services of America (ESA) offers resources to help these children thrive.
Headquartered in Nashville, Tenn., the company currently provides services in 27 states. “We serve about 17,000 kids a day, and they have a very wide variety of disabilities,” explained ESA President and CEO Mark Claypool, who founded the company in 1999. “We work primarily with public school systems,” he said, noting the company partners with about 250 different systems. He added ESA also works directly with some state governments and insurance carriers.
“We had been working with older kids through school systems for a long time, but we wanted to identify a strong provider in the early intervention space,” Claypool explained. “Autism is a very dynamic disability, and the sooner you can intervene, the greater the impact on the child’s life.”
With EAP, he noted, “We acquired this really strong regional brand and put tremendous resources behind them.” Today, EAP reaches four times the number of children and continues to expand with additional clinics coming online at a rapid pace. Currently, there are clinics and/or in-home services being provided in 11 states including Arkansas, Florida, Georgia, Kentucky, South Carolina and Tennessee in the Southeast.
“We’re growing very rapidly,” Claypool said. “In fact, we’re in the process of opening 15 new autism clinics in the next year.”
Applied Behavior
At the heart of the program is the use of Applied Behavioral Analysis (ABA). “We know the evidence supports ABA as the most effective treatment, by far,” said Claypool. “It enhances positive behaviors and diminishes negative behaviors.”
According to the Center for Autism and Related Disorders, the effectiveness of this evidence-based therapy has been well documented over the past 40 years. ABA utilizes the principles of learning theory to craft interventions designed to measurably improve ‘socially significant behaviors,’ which include reading, academics, social skills, communication, and adaptive living skills including self-care, toileting, understanding time and money, and honing work skills.
“The same model of behavioral therapy is applied to all of our children across the board but will vary in its intensity,” Claypool explained of addressing individual needs depending on where a child falls on the spectrum.
Finding a way to help these children is critical considering the number of children diagnosed with ASD. “If we don’t do this, the cost will be staggering. These young people will not be able to transition to adulthood and lead normal adult lives,” Claypool pointed out.
With ABA therapy, however, he said the team has seen some remarkable outcomes. “There is no one type of child with autism. There are IQs all over the board, but many do have high IQs and need to have their potential unlocked,” he continued.
That was certainly true for one South Carolina mom. Told it would be best to find her son a residential program because he would never function on his own, she took matters into her own hands and became the co-founder of the Early Autism Project. Today, that son is working on his master’s degree at the University of South Carolina and speaks eight languages.
While certainly not every child with autism will perform at that level, Claypool said all children deserve the chance to reach their own potential.
The Intersection of Healthcare & Education
Realizing that ability, however, can be more difficult in some states than in others.
Claypool explained Part C of the Individuals with Disabilities Education Act requires public school systems to identify preschool children with special needs. However, he added, “It’s very, very loose how to do that. Frankly, it’s not followed through on very often. That issue really drove parents who had children with autism to find another way to have their children identified, diagnosed and treated.”
Of importance, he continued, is the understanding that special education, as it is constructed, is built on civil rights law. “That’s important because it was built on a minimum set of services defined as ‘free and appropriate.’
“But that’s not enough for parents,” Claypool said. “They want progress, and they want to know their child is going to get the very best treatments.” Therefore, he continued, “More and more, they are looking to healthcare rather than education systems to bridge the gap.”
According to the Autism Health Insurance Project, 39 states plus the District of Columbia have now enacted autism insurance mandates, meaning all fully funded, state-regulated insurance plans must provide the benefits specified by law. While the specifics vary from state-to-state, each of the mandates requires insurers to provide ABA to young children with autism. Self-funded (employer-sponsored) plans, however, are not legally required to offer autism benefits even in states that have mandates.
As of May 2015, Alabama, Idaho, North Dakota, Oklahoma, Tennessee and Wyoming had no autism insurance mandate. Ohio, Hawaii, Mississippi and North Carolina were in process of enacting a mandate, and Utah had passed legislation, but it won’t go into effect until 2016. Additionally, the federal government has recently told all states their Medicaid programs must offer ABA therapy for children under 21, but only a handful of states have put this directive into action at this point.
For More Info & Referrals
For more information on autism and other programming by Educational Services of America, go online to esa-education.com. For more information or to refer a child with autism to EAP, go to earlyautismproject.com.
RELATED LINKS:
Early Autism Project: www.earlyautismproject.com
Autism Health Insurance Project: http://www.autismhealthinsurance.org