Autism: Important Information You Need To Know

What is Autism Spectrum Disorder?

Autism spectrum disorder (ASD) is a developmental disability that causes people to behave, communicate, interact, and learn in ways that are different from other people. ASD is caused by differences in the brain, potentially due to a genetic condition. Other causes are unknown. Scientists believe multiple causes of ASD act together to change the most common ways people develop. There are no physically distinguishing attributes. The abilities of people with ASD can vary significantly. People with ASD may have advanced conversation skills or be nonverbal. Some people with ASD need a lot of help in their daily lives. Others can live with little to no support.

When does ASD develop?

ASD begins before the age of 3 years old and can last throughout a person’s life. Symptoms may improve over time. Some children show ASD symptoms within the first 12 months of life. Others may not show until 24 months or later. Some children with ASD gain new skills and meet developmental milestones until around 18-24 months of age then, they stop gaining new skills or lose the ones they have.

Children with ASD may develop difficulties developing and maintaining friendships, communicating with peers and adults, or understanding what behaviors are expired in school or on the job. Children with ASD often develop anxiety, depression, or attention-deficit/hyperactivity disorder.

Signs and symptoms

People with ASD often have problems with social communication and interaction and restricted or repetitive behaviors or interests. People with ASD may also have different ways of learning, moving, or paying attention.

Examples of social communication and social interaction characteristics related to ASD include:

Avoiding eye contact
Not responding to name by 9 months
Lacking facial expressions by 9 months of age
Does not like interactive games like pat-a-cake by 12 months of age

Does not share interests with others by 15 months of age (for example, shows you an object that they like)
Does not point to showing others things they find interesting by 18 months of age
Does not notice when others are hurt or upset by 24 months of age
Does not notice other children and join them in play by 36 months of age
Does not pretend to be something else, like a teacher or superhero, during play by 48 months of age
Does not sing, dance, or act for you by 60 months of age

Examples of restricted or repetitive behaviors include:

Lines up toys or other objects and gets upset when the order is changed
Repeats words or phrases over and over (called echolalia)
Plays with toys the same way every time
Is focused on parts of objects (for example, wheels)
Gets upset by minor changes
Has obsessive interests
Must follow certain routines
Flaps hands, rocks body, or spins self in circles
Has unusual reactions to the way things sound, smell, taste, look, or feel

Other signs and symptoms include:

Delayed language skills
Delayed movement skills
Delayed cognitive or learning skills
Hyperactive, impulsive, and/or inattentive behavior
Epilepsy or seizure disorder
Unusual eating and sleeping habits
Gastrointestinal issues (for example, constipation)
Unusual mood or emotional reactions
Anxiety, stress, or excessive worry
Lack of fear or more fear than expected

Risk Factors

There is not one sole cause of ASD. Many factors have been identified that make a child more likely to have ASD, including environmental, biological, and genetic factors.

The following may put children at greater risk of developing ASD:

Having a sibling with ASD
Having a certain genetic or chromosomal condition, such as fragile X syndrome or tuberous sclerosis.
Experiencing complications at birth
Being born to older parents.

ASD has been observed in all racial, ethnic, and socioeconomic groups. It is 4 times more likely in boys than girls.

Diagnosis

There is no medical test, like a blood test, to diagnose the disorder. Doctors must look at the child’s behavior and development to make a diagnosis. ASD can sometimes be detected at 18 months of age or younger. By 2, a diagnosis by an experienced professional can be considered reliable. Many children do not receive a final diagnosis until they are much older. Some people are not diagnosed until they are adolescents or adults.

Treatment

Current treatments for ASD seek to reduce symptoms that interfere with daily functioning and quality of life. ASD affects each person differently. Each person with ASD has unique strengths and challenges and different treatment needs. Treatment plans usually involve multiple professions and are catered to the individual.

ASD treatment can be given in education, health, community, or home settings, or a combination of settings. Support can continue into adulthood to aid in continuing education, completing job training, finding employment, securing housing, and securing transportation.

There are several categories of treatment available:

Behavioral
Developmental
Educational
Social-Relational
Pharmacological
Psychological
Complementary and Alternative

Is Applied Behavioral Analysis (ABA) covered by insurance?

Behavioral approaches have the most evidence for treating symptoms of ASD. A notable behavioral treatment for people with ASD is called Applied Behavior Analysis (ABA). ABA encourages desired behaviors and discourages undesired behaviors to improve a variety of skills. Most insurance plans will cover autism therapy, including ABA therapy and autism evaluations. Coverage varies based on your location and plan.

How much does ABA therapy cost without insurance?

ABA therapy costs 62k to 250k a year without insurance coverage. ABA therapy ranges from 5k to over 20k a month without insurance coverage. ABA weekly therapy costs start around 1k and can go up to 5k without insurance coverage. ABA coverage can vary from state to state and plan to plan.

Insurance companies that cover ABA therapy include:

Medicaid
Aetna
Cigna
UnitedHealthcare
BlueCross BlueShield
Kaiser Permanente
Anthem

Self-funded vs. fully funded ABA therapy insurance plans

There are two types of insurance plans in the United States: self-funded plans and fully insured plans.

Self-funded plans must comply with federal laws, but not the state versions. Your employer makes the final decision about what will and won’t be covered by insurance.
Fully insured plans must provide benefits per state laws, and your insurance company will determine what is and is not covered.