Therapies for Autism and How to Pay for Them

Updated on July 10, 2009
B.D. asks from The Colony, TX
7 answers

We are in the process of getting an official diagnosis for my son. We know he's on the autism/PDD spectrum and most likely on the milder side. We have mostly focused on his speech delay and have been working with an ECI speech therapist since last August. We have come a long way in that area.

Fortunately, we go to a pediatrician who is up on biomedical treatments and had us down that path before we suspected autism. She said his head banging was not normal and did some biomedical testing she says are related to behavioral and developmental issues. The tests showed he has severe abnormalities in how his body is functioning, leaky gut, high yeast, high mercury levels, etc. So, we are treating him with custom vitamins and other supplements.

We did not suspect autism/PDD for quite some time because he is very social and affectionate, which in my stereotype eliminated that possibility. He has come a long way with speech. At 18 months, he didn't say yes/no nor did we have a way to communicate wants. He screamed a lot and head-banging and self injury have been an ongoing problem (until antifungal treatments and removal of milk in his diet). Now, he names MANY objects and we have basic communication of wants and needs. He cannot communicate or understand abstract ideas, listen to a story, or understand emotions. He also has sensory issues with some textures and is very sensitive to many sounds. Spontaneous screaming is a daily occurance.

We are now trying to figure out what therapy paths to take. He has been receiving speech therapy through ECI for the last 9 months. We have assessments set up for a neuro/psycho evaluation (to get the "official" diagnosis), speech, occupational therapy, and physical therapy through Our Children's House at Baylor in the coming weeks. I went that path originally because they are the treatments I had exposure or knowledge of before doing more and more research. After doing more reading, I wanted to know more about ABA therapy. We have an assessment set up at Behavioral Innovations next week as well. Both of those are in network for our insurance, but on the surface of what I've been reading so far, our coverage will barely scratch the surface. We are in Lewisville ISD and I have met with them already about their programs available once he turns 3. Until then, our only option that I am aware of through the state is to continue ECI, which I think isn't nearly enough treatment hours and I've been waiting for 2 months for an OT evaluation. That is what led us to try to do more on our own.

What therapy treatments have been successful for you? How on earth did you pay for them? Have you done any training on ABA to peform it yourself in addition to private therapies? I've seen some sites referencing new legislation requiring insurance companies to provide treatments for autism, but I don't fully understand it yet.

On a similar note, any recommendations on keeping life sane for siblings? My 6 yo is starting to realize there is a difference and we're starting conversations with her about all we're trying to do for her brother. She's been hit with a double-whammy with his diagnosis coming at the same time as a new baby arriving in our home.

Any tips on making this decision would be greatly appreciated. Thanks in advance!

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So What Happened?

Thank you all for your thoughtful responses! Initially, insurance told me that 60 therapy visits/year were covered. With 3-4 visits a week, we would have run out quickly. They acutally cover 60 visits per therapy (speech, occupational and physical). That's a huge difference!!! Another change I have learned is that Texas passed a law last year that requires insurance companies to cover autism treatments, including ABA therapy. Their coverage isn't enough, but it is a help. I am also continuing to work with ECI and we are in the LISD system to transition my son to their progam when he turns three.

All of your tips and advice have been incredible helpful. Thank you!!!

More Answers

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C.W.

answers from Dallas on

ECI is great, we have used them 2 times with our own Son and a foster child with Sensory Issues. I would continue with ECI cause they have a sliding scale and work with your insurance and we were told the first 6 months are free and then they are still billing insurance.

I work for Easter Seals and Easter Seals does have therapists, so check with them. They do a lot of research and work with the State to get grant money for Autism Treatment. Call Easter Seals and get on the list and more information on their program. They can give you support groups and there are disability type support groups. The ARC may be helpful to you as well. We've been foster parents for 6 years now. Our first foster child had something similiar to Muscular Dystrophy, he couldn't speak well, pointed at everything when we got him. He was on Medicaid and we got him therapy (he was 5 years old). He made a remarkable progress in the year we had him. We took him to the Child Study Center in Fort Worth. They are excellent. I would highly recommend going there for an evaluation and see what they recommend for him. They have Developmental Pediatricians who can address behavior, food/diet issues, medical issues, delays, they can do testing,etc.... We've taken 2 children there, 1 foster child and our own. I wouldn't go anywhere else. They are the best, they did wonders on our first foster child! We did a lot of home therapy and did all the exercises they asked us to do with him. He made huge improvement in one year. Our child has Sensory Issues, Developmental Delay, Motor delays in fine motor skills, communication and visual perception. Our Dev. Pediatrician recommended play therapy/behavioral therapy for us as parents to help with behavior issues and learning proper behavior management skills to help our child with. Our Dev. Pediatrician recommend getting a speech evaluation and we did that with Therapy 2000. Our Dev. Pediatrician recommended getting Occupational Therapy as well. She gave us literature on temper tantrums and explored medicine issues, if we wanted to go that route. They are very thorough and do research in children's behavior and medicine with Down's Syndrome and other medical conditions. It does take awhile to get in, cause they are excellent! It took us 5-6 months to get an evaluation. It took a couple of months to get an appointment for the evaluation. You have an application with lots of paperwork to fill out and your paperwork is reviewed to see if they can accept you as a patient. You can be placed on a waiting list and sometimes you do get moved up sooner.

We've used these therapy agencies with the foster kids and our own child:
Therapy 2000- they come to your home, might be great for you with your kids! They are based out of Dallas. Therapy for us was $12.50 a session. We had occupational therapy for 2 months and the therapist hurt her back. She wasn't able to continue doing therapy, so she told us she couldn't come anymore. They didn't have another therapist in our area. They released us from therapy and we had to find a new therapist.

Sante Pediatrics- this is where our child goes now. They are located off 8th street. We started in April and so far everything is going well. She does take in home patients and sees patients in the office as well as the home. She has recommended a Spio Suit. I would highly recommend you check into this. We are getting one for our child. We've seen a DVD and literature on it that tells stories about Autistic, Sensory Challenged Kids/Adults, Cerebral Palsy kids,etc... being greatly helped by the Spio suit. I can give you more information on it, if you would like to know more.
Our child has gotten fitted for it and we are waiting for it to arrive.

Child Study Center Therapists- they are basically Cook's Children's Hospital therapist. Child Study Center contracts out with Cook's to do their therapy. They were awesome therapists- they have speech, occupational,and physical therapy there. They worked well together and gave us home exercises and really challenged our foster child. At the child study center they have a private school and if they require therapy, they can go to therapy without having to leave the building. It is an expensive school, I checked into it.

There is one place near 820 close to NRH, I believe. I called them and they didn't take our insurance. They are in the phone book. There is also therapy places listed in Fort Worth Child magazine.

I would honestly use ECI until your child is 3 and then after your child turns 3, then get a private therapist or go thru your school system. ECI has a Nutritionist that can help you, Behavioral Therapist that can recommend behavior issues, Speech Therapists, Occupational Therapists and Physical therapists. Honestly, it is the cheapest route and the most easiest right now for you. I would continue with them, unless you really don't feel your child is making much progress. You can always ask to speak to Supervisor and request for new therapists to come out. All our ECI people were great and gave us tons of information with our foster child. You might want to continue ECI and add Easter Seals and a support group for Autistic Parents.

Try going to Our Special Children in Fort Worth at the ARC meetings. They have trainings once a month. I got a lot of help from their trainings, literature, fun activities for the kids/family. They had a training on how to deal with a child with a disability that had siblings. I didn't take it, however I know they have information on it. They were able to hook me up with another parent who had a child with the same disability as our foster child. I thought that was so cool, cause it was not as common to have the disability that our foster child had. They are located inside the Child Study Center, you can get on newsletter list and join and be a member. There are numerous trainings and conferences to go to.

There is a disability conference/vendors there with products that I went to when I was in Pre-Paid Legal. I can't think of who to contact about that. I would have to search my emails and paperwork for that. If you want more info, I can look for that later. The ARC would probably advertise for that also.

I've worked with 2 individuals that have Autism and PDD. One was a child and one was an adult. The adult, I helped him with his job. I was his Job Coach at a grocery store. I work part time for Easter Seals helping people with disabilities in their work place.

If you want to contact me, let me know and I'll give you my personal email or phone number, if you would like to talk.
I'll keep you in my prayers.

As far as payment issues go, with the foster child, it was all covered under medicaid or our foster agency.

As far as our own child. We have United Healthcare and they are awesome. They pay for quite a bit, we have the PPO insurance plan. The Child Study center evaluation wasa one time $50 or $60 fee out of our own pocket/co-pay. However, they waited until insurance paid first to see what we would owe. The insurance paid for the testing and all the other expenses. I thought that was good since I know evaluations from Child Psychologists and other can be expensive. No, they aren't Psychiatrists or Psychologists, however they have special training in the developmental area. Psychologists are great too for evaluations, if you have a lot of behavior issues/mental/phyiscal issues as well. Warning, Child Psychologist will have you fill out a huge a 4-5 page parent evaluation form. They are bubble in type questions and they are repetitive and it is draining or at least it was for us and all the foster kids we had.

Therapy with Therapy 2000 (in home therapy was more expensive). It cost us $12.50 a session. She came 2 times a week. Insurance paid the rest for the evaluation and therapy sessions.

Sante Pediatrics- we pay $5.50 per session for Occupational Therapy. Insurance pays the rest. The evaluation was $7.50

We've had to get help with our financial expenses. We are on one income and our co-pays for the play therapy and our therapy sessions with the Play Therapists are $20 a piece. She doesn't take credit cards, only check or cash. My Mom is helping with extra money each month for that. My husband does have a flex account, credit card to put our medical expenses on that is tax free. You may want to check into this with your Husband's employer. You may not be able to change it until next year. We have to decide an amount that is taken out of his pay check at the beginning of the year that will be tax free. It is a use or lose type program. We never lost any money, we've always used it.

Your child may qualify for SSI if he gets the Autistic Diagnosis. Our child is three and he has Sensory Integration Disorder,Developmentally Delayed in fine motor skills and in visual perception and oral motor skills, he drools a lot. He is weak in his strength in his mouth. I haven't checked into disability or SSI. You may want to check into this with Social Security Department. I know our first foster child did get SSI checks each month. That would help you all out tremendously! Definitely get a sitter and go apply and start the process.

Check online for Autistic or PDD support groups for parents. This would be helpful for you to connect with other parents who have the same issues as you. Our Son is very sensitive to sound, smell and touch. I'm looking for a Sensory Integration Disorder support group. The ARC may be able to connect you with the right people also.

The Child Study Center has you write more and fill out their questionnaires more in your own words, however they aren't as lengthly as Psychiatrists and Psychologists use.

One of our foster kids had Sante Therapy come to our home. They were good also. I never had any problems with scheduling them or any issues.

If you need any numbers for the Therapy places, let me know and I can get them for you.

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L.M.

answers from Dallas on

....We just had our son diagnosed about 9 months ago with PDD/NOS and he is on the milder side of the autism spectrum. We are going to be putting him in the school system as he just turned 3 in June. Since it is thru the school we do not have to pay for it. My suggestion is to apply for SSI (thru social security) for him if you want more therapies other than ECI. Maybe you could quailfy. Other than that then it is up to your insurance I guess to pay for other therapies.
-L. Mosely

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M.R.

answers from Dallas on

I am a single mother a son that just turned 4 last month and he is also on the Autism Spectrum along with Sensory Integration Disorder with Speech and Motor Skills delays. He was diagnosed in Feb 2008. He had been going to speech therapy since about 18 months, he had numerous of ear infections which caused him to have some hearing loss but he is now going to a speech therapist that specializes in Autism and he has done wonderful. It has been a strain financially for me. He goes to PPCD in Carrollton which he gets some Speech and Occupational Therapy there but also gets OT at Easter Seals. I am also looking at other resources and avenues for assistance and what other treatments he can get. He is on the waiting list for the Autism Treatment Program through Easter Seals. Early intervention is the key:-)

Please do not hesistate to contact me so I can give you as much info as I have.
____@____.com
M.

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K.H.

answers from Dallas on

i dont know your financial situation but i would talk to social security about s.s.i. even if you don't qualify financially they may be able to get you on a medicaid program that would supplement your insurance & pay for private therapy. it doesn't hurt to try

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S.M.

answers from Dallas on

Not sure where you live but you might try contacting TWU or UNT. I know one of them offers therapy and the universities usually offer sliding scale. Good Luck!

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D.T.

answers from Dallas on

Hi B.
We also have a son w/Autism. He was diagnosed at about 2 1/2. We are in Flower Mound. First thing to do Keep all of his Paper Work in a special folder for easy reference. Stick with ECI they are helpful and will ensure he gets registered for the LISD PPCD (Program Preschool Program for Children w/ Disabilities). Just before Jaxon turned 3 ECI let go the LISD school district began their analysis and assessment to ensure he qualified for the program. Jaxon began a PPCD program @ Flower Mound Elem that specializes in communication. It's called PPCD/Com. His teachers there are outstanding!!!! Not all PPCD programs are equal. Jaxon also receives OT, Speech, and some PT. He is responding well. He also was scheduled for ESY (Extended School Year also known as summer school) We took Jaxon to the Child Study Center in Fort Worth for a second opinion. Dr. Nancy Hitzfelder concured with the original diagnosis. We also had his hearing checked with Easter Seals and are also on their waiting list. There are Medicade Waiver programs available that are not based on Salary. SSI is based on salary. We did do some ABA and private speech and this was all out of pocket &verry expensive. I have recently seen a communication from President Obama that Autism was on his list of things to address. You may find some references in the childrens section of the Lewisville Library to help w/ your older one. One last thing there is a great Developmental Pediatrician specializing in Autism and other disabilities in Lewisville. His name is Dr. Rios he is located on Main street and is taking insurance. Please feel free to contact me If I can be of any help.

A little about me a SAHM with 3 wonderful blessings age 12,10,&3. Married to a wonderful husband of 14 yrs

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T.T.

answers from Dallas on

Our daughter has PDD/NOS (High Functioning Autism) as well. She also has Sensory Intergration Dysfunction, Motor Tics and Static Encephalopathy.

We started with ECI when she was 19 months for Speech but didnt work well for our daughter. She needed more intense Therapy in a closed in environment so we started private therapy with Therapedia in Keller...which worked wonders. She only had 5 words at 21 Months and was learning a word a week. She now has prob 50 - 100 words now. Still speech delayed but working on it step by step.

She also had OT with ECI and Phystical Therapy and OT with Therapedia as well. Insurance does not pay for Speech but does cover OT and PT. She just graduated PT so YEA!!!

She attends a MDO that accepts children with Autism since her current MDO did not want to take her next year or wanted to hold her back. They were a great school just not prepared for a Special Needs child. Thankfully we were able to find a school that would take her Thanks to ECI. No other school would accept her!!!!

She will also start public preschool 5 days a week for 3 hours. She will be in a Special Ed class PPCD program which will help on speech and other skills that she will need to help develop her social and motor skills.

No advice on the sibling issue. We have chosen not to have any more children because we have an autisic child. Didnt want to take a risk of another child with special needs. I think our DD would like a sibling but the amt of care she needs is too much.

Our main issue is when she has her major fits that last for 2 hours or more. Her vistibular problems and no sense of danger is another concern. We ALWAYS have to keep an constant eye on her - you can NEVER take your eyes off her!!! People dont understand they see a "normal" looking 3 year old but are unware of what it is like to raise an autistic child. They see an child that doesnt listen maybe spoild but dont understand that she has Autism. It is VERY frustrating!!!

We cant take her to the Circus, keep her away from water, public places she has to be in a stroller or cart at all times!

She is a handfull at times but i wouldnt changer her for the world!

if you would like to talk sometime i am here.

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