Let's Talk About It: ABA Therapy
Joel Manzer
Marketing Professional & Autism Advocate | Bridging Communities & Driving Change
Being an active part of the autism community for nearly 20 years has taught me one truth: for every study that states one thing, there's another study that states the opposite. I can't tell you how many times over the years people have forwarded me the study that states if you live near an interstate, your children may have a higher risk of being autistic. I mean, c'mon, what?! What's next, breathing causes autism? (yeah, it's become a bit ridiculous at times)
So, I've taken many of these reports and studies with a grain of salt. Knowing causation means nothing to us as our son is already diagnosed...
Anyway... let's get into this week's discussion: ABA Therapy.
TRICARE
Several folks have shared with me this (and other) news reports where Tricare is no longer supporting ABA Therapy: https://abc11.com/amp/tricare-military-insurance-i-team-children-with-autism/10699366/
Now, this seems to address ABA Therapy in schools, but I'm sure it's more like ABA therapy for tier one (level one) autistic individuals. However, let me preface this by stating I'm not a professional ABA therapist, nor do I handle billing in any way. Seeing how the news reports that ABA therapy is no longer being supported by Tricare is really of no surprise to me at all. Tricare is just following what other insurance companies have been doing all along.
So, to those families being impacted by this decision, welcome back to what the rest of the community wrestles with when dealing with autism and insurance. I hate sounding sarcastic, but after 20 years, the GenX side of me is just saying "It is what it is." So, we move forward as best we can. My advice is to keep swimming forward as best you can, and hopefully in time these issues will be sorted out in a way that will prove beneficial for everyone.
Continuing Debate and Another Study
The Tricare decision came after they conducted another study to address its effectiveness. With this latest study, however, the debate continues. Here's one of the links addressing their latest study, if you want to dive into it: https://therapistndc.org/aba-is-not-effective-so-says-the-latest-report-from-the-department-of-defense/
The bottom line with Tricare and this latest study is that they will eventually not fulfill claims. Or, at the very least, have specific requirements that need to be fulfilled before they'd fulfill a claim. That's my assumption based on the news report folks have shared with me. So, if anyone could verify this that'd be greatly appreciated. Also, please cite your sources if you verify- as this helps the discussion.
Even after all this has been said and shared, the debate continues within the autism community at large, with many actually autistic individuals sharing how ABA caused them trauma, while many other actually autistic individuals benefited from it so much they became BCBA's themselves. It appears at this point of the debate, there could be an impasse.
Recently, someone shared this article that I found that was very insightful. At the very least it addressed one truth: ABA Therapy isn't for all autistic individuals.
What does all this debate do in terms of helping those that need to be helped?
Parents Don't Know What To Do
Parents still struggle as to what options there are, and what to do in terms of helping their child.
Let's face it, many parents just wonder what the next steps are for helping their kid and they are told by one group of professionals that ABA is the gold standard and another group of people who state it's the worst thing ever. Who are they to believe?
The reality is that ABA tends to be the only therapy placed in front of them in terms of any options to help their child. So, this discussion has become even more important than just saying "It's great" or "It sucks".
This leads me to share something that was recently posted and discussed in an Autism Support Facebook group, where one parent asks:
领英推荐
Let's just say that the comments were extremely varied. From those who are extremely grateful for it to those who absolutely stated it's the worst thing they did for their child. Many expressed that who you work with in terms of a BCBA and RBT is extremely important, which is also a valid point.
Now, I can't remain silent on this topic any longer, as I have spoken to a broad range of people over the years who address this topic on a regular basis, and as part of being the Editor of MyABA.today (a directory site to help parents connect with therapists) it's important to make sure parents understand how to find a good BCBA and RBT as well as to know their role when considering ABA Therapy. After all, for years, all parents know about ABA therapy is what they've found doing searches on Google. (yeah, we need to stop that for any therapy, the rabit holes are many and very deep and winding)
The folks I've spoken with are both ABA professionals, actually autistic individuals who've been both positively and negatively impacted by ABA therapy, as well as parents who've had their own challenges in finding a therapy/therapist that may help their loved one.
Here's the response I gave to that group question:
Am I off-base? Maybe. But my purpose with this discussion is to keep things in perspective. ABA is a solid form of therapy that has benefited many individuals. However, it needs to be realigned with whom it truly benefits. This means it's a specialized therapy and should be promoted and treated as such.
In regards to Tricare and other insurance companies and their actions regarding ABA therapy: it seems as though they are placing ABA where it needs to be placed in terms of care - as a specialized practice, rather than a kin to a generalized therapy that has become a catch-all for all autistic individuals.
To clarify about finding practices associated with The Council of Autism Service Providers - I was advocating to parents to please find one associated with that organization due to standards of practice that those practices must adhere to. I've
What say you? What are your thoughts about Tricare and Insurance and ABA Therapy?
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Shout Outs!
Sometimes an individual and organization need a bit of a shoutout, as they are making great strides in helping the autism community in some way. Here is this week's highlight:
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Real Estate Sales Professional at Williams Trew Real Estate Services
9 个月Thanks Joel - as we all know, "you meet one kid on the spectrum, you've met one kid on the spectrum"...my son (now 18 - can you believe it!) did ABA therapy for a number of years until be pretty much out-grew it...there are benefits and drawbacks and yeah to many it seems like bribery - but you know what...I'd rather bribe my kid to stay in his bed, take a shower, sit at the table, read a book, follow instructions than have him tear up the house and kick the shit out of the dog, his sister or his parents...life is about trade-offs that's for sure...those who love ABA and those who don't love ABA should simply stay in their lane and figure out what works best for their child, their budget and their family sanity... you know what you should discuss next...dealing with filing for guardianship of an 18-year old on spectrum...navigating the horrors of local MHMR and other governmental agencies that do nothing but waste my time and make my blood pressure spike...and of course dealing with Medicaid, SSI and residential options like ICF and HCS (especially in Texas!) It never ends or slows down does it.... Seth The Fowler 4 Group
Retired
9 个月There is no panacea. There are different methods for different people at different times in their lives. Some work better for some but not others. This is no surprise. If one thing worked for everyone they would get Temple’s squeeze box
People Who are Cared For, Care More! ?? Discover a path in ABA therapy that aligns with your passion.
9 个月Progress happens when we're brave enough to have the difficult conversations. :)
Book Author, Child and Family Clinical Psychologist
9 个月Joel, I think that you make some very good points. The "business of ABA" has been very effective at monetizing already established behavioral interventions, and lobbying insurance companies to recognize ABA and the only "legitimate" intervention for individuals with autism. This has effectively limited the variety of options available for families to access. It has also confused many families struggling to identify what level of support is most appropriate for their circumstance. Additionally, as more and more ABA providers are credentialed, the competition for clients has necessitated these providers to justify their services to an ever expanding range of presenting behaviors. ABA seems to have become a solution in search of a problem. It is the only legitimate (and insurance backed) intervention after all. This is a problem. By minimize the importance of the client's buy-in, their goals, and their readiness for change. I have also observed providers way in over their depth when presenting issues go beyond their level of training. In my mind this "industrialization" of behavioral interventions has taken the humanness out of the supports being provided. Unfortunately the consequence has been quite negative for many.