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.
References
What is Covered? The Insurance Landscape for Autism Services (forbes.com)
What is Autism Spectrum Disorder? | CDC
Treatment and Intervention Services for Autism Spectrum Disorder | NCBDDD | CDC
Signs and Symptoms of Autism Spectrum Disorders | CDC
