Autism-World

Q: Our son with autism has been receiving “medical” ST, paid for by Medicaid and carried out at our Children’s Hospital and School by an SLP through their outreach program. We started around February of this year and he has been going weekly since then. They said since he is eating and using his communication device then the medical therapy will no longer be necessary. Never mind that he is still extremely resistant and very inconsistent in his eating, or that he is very limited in his ability to use his communication device functionally ??I guess he has met their standards? Or is it just too hard for them to come up with a reason to justify the expense to Medicaid any further? The public school therapists had no clue how to work effectively with him. He gets two more sessions with his current SLP and then they want to see how he does on his own. I guess I won’t have to worry about inconsistent approaches between ST and OT anymore, but it just doesn’t make sense to me how they make these decisions.

Answer:

You know, if a child has unstable juvenile diabetes a comprehensive medical intervention plan would be immediately put into effect. But once that same child has been stablized and was doing better, not one single clinician would dream of declaring him or her ‘cured’ or to state that medical care will “no longer be necessary.” Never.

Instead, what would happen is that while the more invasive and intensive treatment plan would be modified and moderated, it would never be simply discontinued. To do so would be unethical, irresponsible, and without medical credibility. But this is EXACTLY what so many of these same clinicans, and the schools do with children with autism and other developmental disabilities.

Another very clearly stated error they are making is that speech/augmented communication and meal time support (as but a couple of examples), are to be considered a ‘medical’ therapy since autism and other developmental disabilities are not ‘diseases.’ They are, instead, developmental disabilities.

While a DD status doesn’t technically go away, children with DD can certainly be taught how to compensate for and manage their unique needs towards enhanced independence and overall success. So just as the treatment for diabetes is not typically declared DONE and the child with autism and family left to figure out what to do next on their own??ven less so should services for children with developmental disabilities.

This could be viewed as blatant discrimination against children with autism and developmental disabilities and has been in fact, a point I have made a few times over the years with private medical insurers (with some successes, I might add). And whether they think they are doing ‘medical therapy’ or educational/adaptive goals, that Speech group absolutely must have identified clear and focused goals and measurable objectives when they began services (treatment to them!). Perhaps they need to be asked to provide detailed documentation of those goals and the degree to which??nd how??ach has been met.

While I could be mistaken for some reason, Medicaid should not be a major problem here and is typically quite accessible under these circumstances. One very good possibility is that your group there simply does not know HOW to work with your son.You know, every autistic kid is different.

Once you and they do some review of the goals and outcomes they claim they were working towards, you might then be better able to advise these haven’t at all been met??nd even for any for which progress has been documented, they should hardly be considered completed. Ask them their basis to “see how he does on his own?” That is, why do they know that your son will be able to sustain and, most importantly, extend on whatever progress they think is present?

Since this service falls back to the school districts’s responsibility, let them know that you will want correct services for your child based on an appropriate SLP evaluation.

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This entry was posted on Tuesday, November 20th, 2007 at 7:34 pm and is filed under Ask and answer.