Autism is a complex neurobiological disorder that severely impairs the ability of an individual to process and integrate ordinary information from their environment. This disorder severely affects the way autistic individuals relate to others socially and their ability to communicate and learn. It affects all five senses, impairs their sensory integration and impacts every aspect of their life and their connection with the world around them. Although it is considered a life span disorder of varying severity, autism is treatable. Early diagnosis and intense early intervention are vital to future development and progress of children with autism. Autism is a disorder that knows no cultural, racial, ethnic, or socioeconomic boundaries.

The impact of autism on a typical family is financially and emotionally devastating. Currently, health insurance in the State of Florida does not extend coverage to treat autism. There is no fairness or equity offered by health care plans for children with autism. They are without the health insurance coverage that is readily available to other individuals with similar neurological and physical impairments. Coverage is not offered in the same manner or under the same terms and conditions to individuals with autism. From the onset of this disorder, and as a result of this discrimination, most children with autism are not given an opportunity to acquire necessary treatment or sufficient therapeutic intervention. Consequently, without opportunities for treatment, the inability to communicate causes a culmination of frustration and increased aberrant behavior in many autistic individuals. This often results in increased severity and the necessity for prolonged or life long therapeutic treatment, and diminishes the chance to become an indistinguishable member of society. In extreme cases, untreated individuals with autism may become a danger to family members and to society in general. This is a tragedy that not only has exorbitant economic implications for the immediate and extended families of individuals with autism, but also for all of the taxpayers of Florida.

The NIH has made it clear that autism is a pressing public health problem that merits the best efforts of public and private agencies in research, treatment and services.

Parents report four major obstacles with respect to insurance coverage for children with autism:

1. Many services are covered by Medicaid and thus accessible only to those who will be forced into bankruptcy, become a divorced caregiver without assets, or become indigent and unproductive citizens.

2. Reasonable and appropriate coverage for Physical or Occupational Therapy is not available, with the occasional exception, limited to 60 days or 60 visits whichever comes first.

3. Although it is required for emergence of speech, Speech Therapy is denied completely. Insurance carriers justify this disclaim asserting that the child has not yet acquired speech, therefore it is unnecessary.

4. Proven Intense Early Intervention (IEI) in applied behavioral analysis is not considered a medical intervention by insurance companies, even though it coincides with the identical concept of neurological adaptability through brain plasticity. Implementation of similar treatments allows patients afflicted with other neurological traumas the ability to train different areas of the brain to respond. This is a practice similar to other medically based therapies.

Effective Medical and Therapeutic Treatments

Speech Therapy                  Physical Therapy

Effective treatments for autism do exist and treatment is based upon individual cases and effective response. Many children with autism meet the typical developmental milestones through the age of 18 months and are not diagnosed until the age of 2. Some children with autism are verbal and require only part time speech therapy which includes treatment for articulation and functional problems, and many do not require physical therapy.

Intense Early Intervention (IEI), a.k.a. applied behavioral analysis or Lovass treatment has been proven effective in treating young children with autism and is considered to be medically necessary by a significant number of pediatric neurologists and psychiatrists around the world. In a landmark study done by Lovass in 1987, 47% of children who began this treatment before the age of four lost the diagnosis. This form of treatment directs portions of the brain how to learn. It provides similar results as do many medications or surgical procedures in other afflictions.

In the words of Dr. Jane Garland M.D., F.R.C.P., Associate Professor, Department of Psychiatry at the University of British Columbia:

"…After reviewing the literature and observing this program in action, it is my opinion that it is unacceptable to withhold funding for intensive early intervention with a program which clearly works, when we do not have any other effective treatment for Autistic Disorder. This is the same as funding treatment with medications, surgery or rehabilitation services for any other medical disorder….At present the only families receiving this treatment are those with the financial resources to do so, which is clearly unfair and does not provide equal access for all children."

Dr. Garland concludes that, "...effective early intervention could make the difference between a life of dependency and a developmentally capable child."

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