So, several days ago, I said that step 1 is to find a behavior analyst. Let’s talk about what else you need to do.

Step 2: All hands on deck. Now, you’ve found a behavior analyst, you’re researching ABA and Verbal Behavior. You know this is what you’re child needs – here’s the big question – How do we pay for it? It’s time to solicit some help. Assemble the following:

A prescription for ABA from your doctor

A summary of relevant research about ABA’s effects

A copy of your assessment, behavior program, or other program materials from you ABA provider

Your insurance contact information

Here are some details:

Letter and Prescription from you Doctor – a primary care physician or a specialist who diagnosed your child are great people to help. You should have a prescription for behavior analysis services. Ask for specifics, like recommended number of hours per week. We’ve had kids with something like ’40+ hours per week of intensive Applied Behavior Analysis at an Early Intervention Clinic until at least the 5th birthday’
Having this documented as your physician’s recommendation is very helpful. Your ABA provider can submit this with their assessment and recommendation to your insurance company, state agencies, etc.

Now that your physician has done their part, your behavior analyst needs to do the same. A BRIEF summary of successful published research, the agencies personal results, and clarification of the services to be provided can be helpful in allowing the potential funding source to understand what is being requested. Remember, there are a whole lot of people out there who still don’t know about ABA. They want to be sure that if money is going to a treatment, it’s legitimate and warranted. Your documents should provide clear, concise information about ABA, its expected outcomes, and why it is absolutely necessary that your child receive it and receive it now. Documents should always be professional and polite, but firm.

Assessment: Your behavior analyst should have conducted an assessment, and should have a recommendation for service as well as program goals. If you’ve already been receiving service, then a progress summary is also very helpful.

Now it’s time to call your insurance company, probably with your behavior provider, and all the ammo you’d like to try.

You may get pre-authorization for service, or you may leave the call empty-handed. Don’t give up! Try sending a claim for service received, it just may get paid. Try fundraising to off-set your out of pocket costs.

Family, friends, and even strangers may be sympathetic to your struggle. Don’t let me be a pessimist, sometimes, a family has great insurance, or a pre-established program for funding, or a school system that is willing to cover their ABA expenses, or a full-scholarship. We have half a dozen clients right now who we NEVER have to say a word about money to. However, we have far more clients who funding is the overriding topic of our every interaction. If you can afford to pay out-of-pocket for service, that’s great! There is no better investment. If you can’t, though, it’s time to get creative. We have a couple moms (and dads) who are true superstars with this, and their efforts are commendable, impressive, and downright amazing. They do bake sales, movie nights, picnics, and a whole host of other undertakings to raise funds for their child’s therapy.

The overall lesson to take from Step 2 is: You’re going to be busy if funding therapy is your goal. Sit down with your behavior analyst and call your insurance company to try to get pre-authorization for service. If you are unable to get a pre-authorization, ask your behavior analyst to submit the claim as an out of network provider. They may get rejected, but you may get reimbursed by your insurer, as some of our clients have. It never hurts to try.

Hi, all. So, for several days I’ve been stringing you along about providing info for newly diagnosed families. Tonight, I finally deliver.

When you receive a diagnosis of autism, your head spins. There are so many questions and not enough clear answers. Often, physicians tell you ‘ he has autism’ but not where to go or what to do about it.

Here is a guide for families with a new diagnosis. Please pass this information on to those who may need it.

Tonight is just Part 1, or rather step 1, in a long process. Over the next several days, I’ll outline WHO can help you, how they can help, what to (try to) do with your insurance, potential funding sources, documentation you will need, and whatever else I can think of that might be useful. Keep reading.

Step 1: Seek out a behavior analyst – do your homework. Intensive early intervention via applied behavior analysis is your child’s best shot at recovery / maximizing his or her potential. The younger the child starts therapy, the better the outcomes tend to be. Do your homework by finding a quality provider – one that is certified in behavior analysis (you can find certified professional at the Behavior Analysis Certification Board’s website at www.bacb.com) and by checking out the program thoroughly. Not all providers are created alike. You want a program that knows a lot about verbal behavior training. You want a program where several professionals collaborate about your child, their progress, and how to best meet program goals. You want a program that has documented mainstream success stories.

Here’s a link to our ‘So What’s Next?’ Guide to help out until the next post . . . http://www.floridaautismcenter.net/EI-Site/default.htm

Apologies to Marcie, who left a wonderful comment that went unseen until tonight. I replied to your comment in the comments section, and hope you find the info helpful.

Hi, all. I know I promised newly diagnosed info and haven’t delivered. I will shortly, I promise. It’s been a crazy few days – we now have 14 school kids signed up between the 2 locations. 1 spot left in Daytona. We’re feeling fortunate today.

However, we’re also feeling down. Our families are dedicated, wonderful people who are working their fingers to the bone for their children. It breaks my heart to see so many people who are struggling to get the therapy they need. Insurance is denying claims, grants and scholarships are being cut, and there is quite simply no way some parents can pay for everything their child needs out of pocket. One of our amazing moms is really going out of her way to help fund her daughter’s therapy, and has given me permission to pass this info along. There is a fundraiser going on for her daughter with a dress designed in her daughter’s honor. Proceeds from the sale of the dress go towards Gentry’s therapy. Please go to the following website and buy this beautiful dress for a beautiful little girl in your life, knowing that you are helping another beautiful little girl have a successful future. http://grannybsclothesline.blogspot.com/

After talking with this mother today, we decided there is more we can do to help as well. Jessica is planning a community garage sale to help raise scholarship dollars for our private pay families. It will be in late August and she will provide us with details soon. You can bring us your materials drive items and now we’ll take ANYTHING. Whatever we can’t use in the center, we’ll put in our garage sale. We are also seeking caring, compassionate volunteers who love children (background screening will be required) to train to work with some of our kids. Please contact us if you’d be able to come in for 5 hours per week and work with our kids under our supervision.

Thanks to all of you who support us and our kids.

Sorry the blog’s been down for a few days. We were switching web hosting services and it got a little nuts. I couldn’t post anything and we ended up switching up the blog a bit. I’m searching for the new perfect theme. I’m going to be posting tonight about good info for families with newly diagnosed kids. Stay tuned . . .

I’m so thrilled about the upcoming school year. Currently, we have 3 kids registered for Daytona and 9 for Sanford. Three of the Sanford kids are interested in moving to the Orlando program, so that means we need 3 more for Orlando to make it a go for January. I’d really like to get one or two more for Daytona for August. Especially with our low tuition, it seems to me we should easily be able to find a couple more kids who aren’t in love with their public school experience. Right now, everything seems like a whirlwind. There’s a lot going on for me both personally, with 2 young kids, and professionally. I’m so happy with the way the school year is coming together and with our current EI kids. I have 3 kids that I think would be perfect for the autism preschool that we’ve been trying so valliantly to get off the ground, too. I’m going to be calling the 3′s parents tomorrow and hoping that they are all still interested. It’s 2 2-year-olds and a 3 year old. This would be our first experiment with having kids this young in groups, and I want to know if small group instruction can be as effective as our awesome one-on-one program. If it is, we can help a lot more kids as 3 kids with a teacher cuts down dramatically on cost. I’ve never talked about the Autism Preschool concept on here, and I’ve never read anything about any other program trying such an idea. If any of you have, please let me know. If any of you have a child that is younger than kindergarten and needs a low-ratio program, let me know that, too. I can’t wait to get this off the ground! We’ve been listing it as a service for a few months, but this is the first time that I think we’ve got a feasible group of kids who are the same in age and ability level as well as in their timing in contacting us. Yeah! For those of you who want info on this program, I’m posting it below

What? ABA Preschool; 3 – 5 children per class with 1 – 2 teachers

Who? Children ages 18 months to 6 years

When? Half-day (9AM to 12PM or 12:30PM to 3:30PM) and full-day (9AM to 3:30PM)

 Cost? $275 per week for half-days; $575 per week for full-days.

Requirements? A screening will be necessary. See us for other details.

How do I sign up? Call, e-mail, or stop by to schedule an individual appointment.

Anyways, sorry the blogging is kind of ‘advertisy’ tonight – send me questions and topics so that I can talk about your issues, instead!

Have a great night!

Martha will be back tomorrow – yeah!

Readers, I have a favor to ask – please go to our site and fill out surveys and, more importantly, reviews. I’d really love to get a few reviews that we could post to the site. You can link into the page from the main page or go to it at www.FloridaAutismCenter.net/survey.html

If you are a happy current or past client or if you’ve visited us and found us to be helpful, we’d love to hear about it. THANKS! So, today I want to do a little mini behavior lesson. We have a new client who hits frequently. The intensity isn’t too bad, but it’s near constant and on anything he can get his hands on, literally. A previous behavior provider did a functional assessment and found the behavior to be multiply controlled. For those of you that aren’t behavior analysts, that means that he does the behavior for more than one reason; maybe he does it sometimes to get attention, but other times he does it to get out of doing work, for example. For him, the behavior seems to have a component of ‘self-stimulation,’ meaning that we can’t find a really good reason that he doing it other than maybe that it ‘feels good’ or is somehow ‘self-rewarding.’ Self-stimulation is kind of the behavior analyst cop-out for ‘can’t really figure out exactly why’ this behavior is occurring. The previous behavior provider put in a simple blocking procedure, but this seems ineffective as he engages in the behavior frequently, sometimes less than 10 seconds between incidents. At this rate, it seems most of the provider’s time would be spent holding the child’s arms down. We are considering using a DRO procedure, or differential reinforcement of other behaviors plan. What this means is that we will set a timer for an achievable interval, maybe 10 seconds for this child, that he can go WITHOUT hitting. Then, whenever 10 seconds go by that he DOESN’T hit, well give him a reinforcer (a little treat of some kind that has the goal of increasing his ‘time not hitting’). Gradually, we will increase the interval that he needs to go without hitting in order to get the treat. This is just a starting point for procedure. What we’d ultimately like is that there is a much bigger DRO program in place and he’s getting all kinds of praise, etc. for all the good work he’s doing and forgets all about the hitting! I’ll give you an update on this new one in a few weeks. I think I’d like to start giving some info about new kids (we’ve had 3 this week) – their behaviors, issues, etc. – and then give progress updates after a month or so. Maybe this will be the first child I use to begin to tell little mini success stories after a month or two of treatment. This will be REALLY easy to do when school starts and we have LOTS of new kids in the building!

So, I’m reading other blogs tonight because I plan to constantly look for ways to make this blog better. I just found the most amazing blog and I want you all to take a look at it. The topic today is whether ABA is medical or educational. There’s also an interesting little tidbit about IRS publication 502, which apparently states  that ABA therapy for autism is a tax deduction. (I never knew this, I’m going to look up the publication tonight.) Anyways, check out this really great blog, which is tonight my hero.

http://autism.about.com/b/2009/07/07/applied-behavior-analysis-educational-or-medical.htm

Before I’m done for the night, I want to say THANK YOU to my wonderful husband. He’s working away on our data system every day and I know it’s going to be amazing.

Did you know that you can go online and file a complaint against your insurance company with the State of Florida? You can, go to www.myfloridacfo.com It’s pretty easy to navigate, but let me know if you have questions. Someone will follow up with you within 30 days. This is a great, easy way to let someone know if your plan is supposed to be covering service under the new mandate, but is refusing. If you have Blue Cross Blue Shield, several families from our center have already been active in alerting the state about BCBS’ non-payment issues. Call Greg Mauldin directly to tell him your concerns

The other day I posted about Daytona and was remiss to mention the aid – just like our Sanford program, there will be an aid during a large portion of the instructional time. The aid brings the ratio to 3 kids to 2 teachers. Sorry about the oversight!