Getting your Child Started in ABA-Based Therapy Today

What you need to know about finding a provider, dealing with insurance, and making certain that your child has the best opportunity to succeed.

Children with disabilities who receive early intervention services show significant developmental progress a year later, and families report increased confidence in their ability to deal with their child.
(Dept of Education, 2003)

Photo placed in public domain by Centers for Disease Control, Amanda Mills, photographer

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Contents Page 3 . Starting Therapy for the Child with Autism Page 5 . When to Start ABA-Based Therapy Page 8 .. How Much Therapy Will My Child Require? Page 9 . Parent Training Page 10 Cost of ABA Therapy Page 11 Paying for ABA Therapy Page 14 Choosing the Right Provider Page 15 Questions to Ask Providers Page 16 Why Butterfly Effects Page 18 Affording the Best ABA Services on a Budget Page 20 The Word on Insurance Page 21 References

ABA Definitions You Should Know:

ABA Applied Behavior Analysis - The principles of ABA are used to inform teaching methods and treatment plans for children with Autism. They are based almost exclusively on constant encouragement and continuous positive reinforcement. ABA-based therapy is the only approach to Autism therapy that is universally recognized as highly effective. Supported by decades of research, it has been sanctioned as the best approach by the National Institutes of Health, the Centers for Disease Control, the Surgeon General, and the FDA, as well as by many Autism research centers and advocates. The teaching that occurs through ABA-based therapy is best achieved with at least 30 hrs of training a week. BACB, Behavior Analyst Certification Board This nationwide board is widely recognized as the standard keeper for Behavior Analysis. Its certification process is recognized by most states or insurance companies involved with funding ABA services BCBA, Board Certified Behavior Analyst - This is a masters level behavioral consultant position certified by the BACB. It requires the satisfaction of rigorous testing, supervision, and education requirements BCaBA, Board Certified Assistant Behavior Analyst This is a bachelors level position attained through meeting the educational and testing requirements set forth by the BACB. The BCaBA must work under the supervision of a BCBA. ABA Tutor Anyone, trained or not, who delivers ABA services under the supervision of a BCBA, often a BCaBA

The pages that follow are designed to help you shop for ABA services. For more specific information on the therapeutic techniques associated with ABA, visit our service pages at http://butterflyeffects.com

Looking for ABA Services? What questions should you ask? 888-880-9270

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Starting Therapy for the Child with Autism

If you are raising a child with Autism, you need to learn about the benefits of ABA based therapy and... and you need to do it quickly. . . . . Because you have precious little time to waste.

If you are reading this as the parent of a child with Autism, you may already know that your child needs ABA-based therapy. Because if youve talked with experts, you know that ABA-based therapy is the only scientifically proven treatment for children with Autism. You may in fact have done enough research to know that ABA-based therapy is the only therapy deemed effective for the positive treatment of ASD by almost every reputable agency and organization familiar with Autism, including the Centers for Disease Control, the National Institutes of Health, the U.S. Surgeon General, several major insurance companies, and state health agencies.
Above photo placed in the public domain by Centers for Disease Control / Amanda Mills photographer.

Most importantly, if you talk with parents who have already walked the road, you will quickly come to appreciate that ABA-based therapy has changed the lives of their children and families for the better. Those parents can tell you of children who learned how to find their voices, achieve academic success, and connect with society. They may also tell you how ABA-based therapy gave those parents the approach and tools they needed to communicate with the children that seemed lost to them.

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Once you look at the studies and the numbers; you will conclude that your child must have ABA-based therapy: Children with Autism who receive timely and intensive ABA-based therapy demonstrate success rates of 80-90 percent When treated in time, nearly 50 percent of children will begin to demonstrate age appropriate intellectual ability. Of those left untreated, only two percent will realize significant improvement.

Children with disabilities who receive early intervention services show significant developmental progress a year later, and families report increased confidence in their ability to deal with their child. (Dept of Education, 2003)

ABA-based therapy is essential. It is not a luxury or an extravagance.

Fundamentally, it is the difference between a nonverbal child growing up to become a hermit living on government assistance or growing up to become an engaged and communicating adult who goes to work every day and pays his or her way as well as taxes.

If water suddenly cost a dollar a cup, would we start calling water a luxury and do without it?
Photo placed in public domain by Centers for Disease Control, Amanda Mills, photographer

If you believe that happiness and having a sense of worth is essential to being human, if you believe the ability to express and receive love makes the human experience worthwhile, ABA-based therapy is no luxury. IMPORTANT NOTE: You never have to let your child's behavior define who he or she is. The child with Autism is more of a victim of his or her behavior than anyone else. How he or she acts is about deficits in the innate ability to communicate and understand. . . not willfulness. ABA-based therapy will improve communication, giving you a better understanding of your child's unique needs while helping him or her learn to understand and accommodate your expectations. Not sure if it's time to start ABA Therapy? Go to the next page

Looking for ABA Services? What questions should you ask? 888-880-9270

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When Should my Child Start ABA Therapy?

The best answer to that question is yesterday. The second best answer is the day that he or she was diagnosed. The most practical answer and the one you should not ignore is as soon as humanly possible. Ignorance can no longer be an excuse We know that if intensive ABA therapy is applied, it will change a childs life, and the earlier it is begun and the more intensive the effort, the better.

Do not listen to anyone who tells you that you should:

Wait and see. . . Wait and hope. . . Wait and pray. . .
Photograph released to the public domain by the Centers for Disease Control / James Gathany, photographer

While hope, prayer, and patience are all valuable pursuits in coping with Autism, it is direct and immediate action that makes all the difference. Waiting is rarely if ever the right treatment plan when it comes to Autism.

Yet, despite the fact that Autism can be identified by18 months with ever-increasing accuracy, the average age of diagnosis is still over five years old. Every week, at Butterfly Effects, we see seven, eight, and nine year-olds who are just being diagnosed. According to the Florida mandate, a child must be diagnosed by age eight to ever receive services. In Vermont, the window of opportunity for treating kids closes at six, and in Maine, it is five.

Pediatricians arent always right. Too many parents still report to us that it was their own observations rather than any pediatrician screening that uncovered the possibility of ASD. If your childs pediatrician isnt addressing your concerns with adequate answers or tells you that you should wait and see if your child grows out of a displayed deficit, you need to take your child to a different pediatrician.
Photo placed in public domain by Centers for Disease Control, James Gathany, photographer

As indicated by the progression of mandates being passed by state legislators (31 and counting), we are beginning to understand just how critical it is for children to receive Looking for ABA Services? What questions should you ask? 888-880-9270

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ABA-based therapy. Ten years ago, no state mandated that private insurers cover Autism; five years ago, it was just a handful. And now, with Delaware getting ready to pass legislation, only 18 states remain resistant to a mandate.

But if you are raising a child, you cant wait for common sense to take over. Even waiting six months can dramatically impact any positive outcome for your child.
Over time, the irrational resistance to Autism insurance will begin to give way to reason. Eventually, we will come to understand as families and as a society that early treatment is not only the kindest and most effective, but also the most costeffective approach. The costs realized for an intensive intervention seem dear until we compare those costs to costs for the lifetime of care that an individual will require when he or she doesn't learn essential life skills and develop the tools required for independent living.
Photo placed in public domain by Centers for Disease Control, Dawn Arlotta, photographer

An Ohio State study noted that if an individual with Autism fails to gain independent living skills, he or she will require $6 million dollars of support through age of 50. (Winerman, 2004) A 2007 Texas study demonstrated that if children with Autism received three years of ABA-based behavioral therapy, it would save the state $208,500 per child over 18 years of education, or $2 billion for the 10,000 children identified statewide as having Autism. (Chasson, Harris, and Neely, 2007) In the not too distant future, to deprive children on the spectrum of proper therapy will become as illegal as denying a children an education or treating them with cruelty or neglect.

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To deny a child the ABA-based services he or she needs is to ensure that they will fail to thrive.
We know that if children with Autism are treated as toddlers they can demonstrate a great jump in their abilities including a rise in measured IQ. We know that the academic issues facing a child with Autism need to be successfully addressed by the time that child enters third grade to give him or her the best chance of a successful academic career.

Even if you have to cut back elsewhere or dip into your savings, you dont have a choice, or at least not a good one. If you do not spend the money now, you will spend it -- and much more -- over the lifetime of that child who grows up without ever learning the functional, academic, and social skills needed to live a life of independence.

You cannot wait, wait and see, wait and hope . . . you cannot afford to wait until you can afford it. You have to find a way to make it happen.
At Butterfly Effects, we are strong believers in early intervention. Weve seen children who are lagging, catch up with and even overtake the development landmarks of their peers. In more challenging cases, weve witnessed children far exceed all predictions about their ability to function at home, in school, and in social situations.

Weve seen ABA-based therapy lead to:

Increased cognitive functioning and higher IQ levels Improved language skill development Improved socialization

Photos placed in public domain by Centers for Disease Control, Amanda Mills, photographer

And lowered parental stress

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How Much Therapy will My Child Require

Every situation is unique; however the goal with ABA-based therapy is to provide an intensive intervention. Children with Autism respond best when the intervention is at least 20 hours a week and ideally 30 to 40 hours. These hours can be provided solely or in combination by a Behavior Consultant, an assistant consultant or tutor, or by parents, teachers, and other adults in the childs life. To manage the great need for therapists and to keep costs down, a Board Certified Behavior Analyst (BCBA) will oversee treatment and supervise the therapeutic relationship. The actual therapy itself will often be performed by an assistant behavior analyst (BcaBA) or a trained tutor. While the standards required of a BCBA are high, parents should be aware that the tutor may not be required to possess anything more than minimal requirements providing that he or she is supervised by a BCBA. Ideally, the tutor should be BcaBA or very trained in ABA and childhood education. Because it requires many hours of direct support to be most effective, ABA-based therapy can be costly, especially if you have to pay for it out of pocket. The trick is to be creative with your resources, become personally involved, and chose the right therapist rather than the least expensive or most convenient. When you follow that plan money can be saved through the efficient achievement of goals and realization of growth.

You will also need to have an assessment performed by us.

This necessary step matches the deductible of many policies. Its essential to make sure that we get off on the right foot, targeting the right issues and identifying the right strengths that we can build on to establish better communication. You need to look at the details of your own policy to determine just how much difference in cost you will realize for going out of network.

Looking for ABA Services? What questions should you ask? 888-880-9270

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Parent Training
Our theory and practice behind parent training is very simple. Parents have been designated by nature to be a childs first teacher. Your Autism therapy provider should do what whatever can be done to promote that and grow that relationship Not just because it is natural, but because research shows that parent involvement can increase family functioning as well as help decrease parental stress.
Photo placed in public domain by Centers for Disease Control, Dawn Arlotta, photographer

Through shadowing, direct training, supervision, reading, online courses and webinars, peer discussion, we hope to give parents as many opportunities to learn as possible. We look to teach parents what research as well as our own experience says they need to know: techniques and strategies for organizing the running of the home, managing routines and schedules, accelerating skill acquisition, and promoting communication, while replacing or eliminating destructive and counterproductive behavior. (Anan et al, 2008; Birkin, et al,, 2008; Gavidia-Payne & Hudson, 2002; Marcus et al, 2001; McConachie & Diggle, 2007; Trudgeon & Carr, 2007)

...Move on to the next page for tips on choosing the right ABA provider.

Looking for ABA Services? What questions should you ask? 888-880-9270

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Cost of ABA Therapy

When considering the cost of ABA Therapy, parents need to measure it against the cost of No Therapy . . . or Inadequate Therapy, because not all therapy is equal.
Photos released to the public domain by the Centers for Disease Control, Amanda Mills, photographer

Improved funding and better insurance are on the way . . . but if you are raising a child with Autism, you cant wait for common sense to win out.
Even waiting six months can dramatically impact any positive outcome for your child.
Compared to other therapies, ABA-based interventions are not charged at an especially high hourly rate. What makes therapy expensive is that 20 to 40 hours a week of direct intervention is required for optimal results.
Photo placed in public domain by Centers for Diseas e Control, Amanda Mills, photographer

$58 x 20hrs a week x 50 wks = $58,000 year

Over the course of a year, it is to be expected that adequate ABA services will cost $36,000 a year for a child with Autism and can even run up over $70,000.
You will also have to bear the one-time cost of the original assessment, typically $500 and have to pay for in-home supervision services, most typically twice a month at $150 per session. Check out of network providers, so you know that you are considering all options. Looking for ABA Services? What questions should you ask? 888-880-9270

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Paying for Autism Services

Ultimately, considering the current trend, Autism will be covered by most insurance providers, and ideally, most families will have access to insurance. As costly as treatment seems, it is nowhere near as costly as treating heart disease, diabetes, and other catastrophic conditions that are often spurred on if not directly caused by poor life choices. Autism, which strikes without any tie to a cause, is random and has little to do with choice, beyond the parents choice to have a child. Initial estimates from insurance groups claimed that covering Autism would raise premiums for all policy holder one to three percent, which would add between two and six dollars to most people's monthly premiums.

However, the reality is that over the last six years wherever a state insurance mandate has been implemented, insurance premiums have gone up less than a single percent and in most cases less than half a percent.
We believe that if most Americans understood the issue and the costs, they would be okay with a small hike in their premiums if it meant that all children with Autism had access to treatment.
Photo placed in public domain by Centers for Disease Control, Amanda Mills, photographer

Until that time, parents need to be resourceful and creative in getting the needs of their children met. Funding can come from a number of sources that are dependent on geography as much as anything else. While we can provide guidance on the availability of funding, we encourage families to check with their states Autism coalition to get the most current information on the status of insurance legislation and money that is currently available. Early Intervention Funding - The federal government makes matching funds available for early intervention programs, which are run by each state. And while most states stress early intervention, the programs are largely underfunded and losing ground each year as more cases occur and funding continues to be slashed. In most states you should be able to find money for early screening, but funding for ABA services is limited. For children under the age of three, a formal diagnosis is not required for early intervention funding. The child must only evidence a developmental delay, most typically in speech.

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School District Funding- Insurance companies continue to insist that Autism is a developmental condition, which would make it an educational issues that should be addressed by local school districts. In the IDEAL world as it was originally conceived by the Department of Education, early intervention funding is designed to cover children's needs until they enter first grade, when their responsibility is passed to the school district. Some school districts have money for direct ABA services but those schools are becoming more and more rare. However, schools can still be pretty good at providing speech, occupational, and physical therapy to meet specific needs, as well as academic support. If your child is approaching school age, check to see what services the school district can supply and what paperwork needs to be in place. But don't expect your school district to pay for one-on-one support for the required 20+ hours of behavior therapy that should be the core of any program addressing the needs of a child with Autism.

If you have an IEP in place that needs review or you need to write one from scratch. Butterfly Effects can help.
Photo placed in public domain by Centers for Disease Control, Amanda Mills, photographer

Insurance (In Network) - Even if you are in a state that mandates ABA insurance, or work for a company that elects to carry an ABA benefit, you need to make certain that you select that option during enrollment. But also remember that even if you have insurance, you need to understand that not all insurance is equal. Terms vary, but more significantly, reimbursement rates differ greatly from carrier to carrier. Some have fees set at so low a rate, that it will be impossible to find top quality people if you stay in network. Its important that you question any potential provider very thoroughly to make sure that he or she is qualified to work with your child. (see page ) Insurance (Out of Network) - If you have the ability to go out of network for medical purposes, the insurer is now required by a provision of the Affordable Care Act to allow you to reach out of network for mental health and behavioral providers. You will pay a higher percentage going out of network, but you will have access to high quality providers who refused to work for the low rates set by the insurance company. you have to appreciate the fact that this is just the beginning of wide use of and wide demand for behavioral specialists. Buyers need

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to be aware of the dramatic differences you will find from one provider to another in terms of quality, experience, and flexibility. Self-Pay - A large portion of our clients are self-pay. Some have no insurance and no other choice. Others come to us because they are not happy with the choices their insurance provides or have been disappointed with their child's progress under an in-network provider. Self-pay allows you to have complete control over your program and encourages you to get the most out of your services. Unlike most providers, at Butterfly Effects, we don't have any set formulas. You can purchase the direct hours of contact your child requires and / or the amount of support that you require. There are some grants, and opportunities for alternative early intervention and school district funding that you may be able to pursue. You may even be able to purchase or encourage your employer to purchase insurance with an ABA rider. But you can't get yourself into a three-legged race attached to some bureaucracy when your childs future is at stake. If possible, get your child the services he or she needs now, even as you continue to chase the money.

If your child presents with Autism, you need to find a way to provide him or her with ABA-based support.
Even if you have to cut back elsewhere or dip into your savings, you dont have a choice, or at least not a good one. If you do not spend the money now, you will spend it over the lifetime of that child who grows up without ever learning the functional, academic, and social skills needed to live a life of independence You cannot wait until you get better insurance

You cannot wait until your company decides to cover ABA You cannot wait until you find a better diagnosis You cannot wait the two or three years it will take the Affordable Care Act to level the playing field You cannot wait for a new cure or miracle drug because if there is such a thing, it will happen long after it might have made a difference for your child.

You cannot wait, wait and see, wait and hope .

Nor can you afford to choose an ABA provider based only on price nor allow your insurance company to dictate that you use only the cheapest and least qualified providers....
...Move on to the next page for tips on choosing the right ABA provider. Looking for ABA Services? What questions should you ask? 888-880-9270

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Choosing the Right Provider

If you are a parent searching for help, youve probably run across any number of miracle workers who will tell you that they can cure your childs Autism. Preying on your panic and sense of loss, they will promise you a cure. The most disreputable will promise you some breakthrough miracle therapy supported by wild claims of success. Others who are merely loose with their marketing will assure you that what they mean by cure is that your child will achieve a level of normal functioning that will make him or seem and act like any other child. At Butterfly Effects, we think it is important that parents not allow themselves to be deluded into the idea that Autism can be cured. Quite simply and honestly put, Autism is treatable but it is not curable. We now know that a child with Autism possesses a brain that functions differently than what we consider normal, that it is physically, neurologically, and biochemically different than those of other children. And in every child, those differences are unique. No two children with Autism ever present with the same exact symptoms and differences.
Photo released to the public domain by the Centers for Disease Control, Amanda Mills, photographer

Most typically, when first confronted with a diagnosis of Autism, parents want to find a cure, they want to find a way to make their children behave and interact like everyone elses. But as they come to understand the immutable truth of their childs Autism, they return back to the place where they hold unconditional love for their children. Then instead of trying to wish their child normal, they accept that their child is different and make the choice to love that child for who he or she is. Sometimes that acceptance comes gradually, other times it hits parents like a bolt of lightning. Either way, once that realization is made, parents are able to direct their focus onto making sure that their children are realizing lives of happiness and connection. All parents instinctively want to love each of their children for who that child is, but sometimes they need to give themselves permission to do so. Before you contract with a provider for ABA services, make sure you ask some pointed questions. Be concerned with those providers who promise too much. To hire quality people requires quality pay. If a provider is promising your 40 hours of direct support a week for $600, you should be concerned about the quality of the assigned tutor. Maybe you will get lucky, but remember you cant afford to waste time with misguided gambles. Looking for ABA Services? What questions should you ask? 888-880-9270

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Questions to Ask Potential ABA Providers

1. How much training do your tutors and consultants receive? 2. Are they vetted for criminal records and personality 3. Do you perform services in the childs natural environment or will we need to go to a center?

4. If the tutor you match with our

child isnt working, do you have staff enough to make a change? 5. If we need to relocate, can we do so without disrupting services?

6. Will we always have ready and ideally online access to all the progress notes and treatment plans even if we stop services with you? 7. Is there someone we can go to if we have concerns about treatment plans or progress being made? 8. Do you have access to other resources such as speech or occupational therapy? 9. Are you able and willing to work in coordination with my childs school? 10. Will you teach me how to use ABA-based principles to communicate with my child and help him or her progress? 11. How quickly should we expect progress? 12. Can you help us with the paperwork and forms that we need. The above are questions any ABA provider should be able to answer easily and to your satisfaction.

When you hire an ABA tutor, you are right to expect that:
Progress will be evidenced promptly and more quickly as the weeks progress Your questions and concerns will be addressed ASAP and adequately You will be treated as a respected member of the treatment team Your tutor has resources to call on to deal with changes or the unexpected Your child will be treated as a valued community and family member, with much to gain from and contribute to the world about him or her

Photos placed in public domain by Centers for Disease Control, Photographers: Above, Dawn Arlotta,, Left , Richard Duncan

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Why Butterfly Effects

At Butterfly Effects, we understand that your child needs and deserves our best effort. To achieve that effort requires the ability and willingness to tailor an intervention that can build on your childs strengths while addressing his or her specific needs. It is essential to develop communication, social, and academic skills but they must be acquired in the proper order so that a foundation is developed as well a means of learning that works and is transferable. Teaching your child how to learn and teaching you how your child learns are the two most important goals that we look to accomplish When properly taught, skills can be readily generalized. When methods are effectively developed, parents and others can step in and use them to expand learning opportunities throughout the entire day so that the learning process becomes exponential and progress is made at a surprisingly fast rate. When you work with Butterfly Effects, the real differences are seen in the results and the childs outcomes. You will never pause to wonder if your child is learning.
Above photo placed in the public domain by Centers for Disease Control ,Amanda Mills photographer.

Along the way, you will start to see what it is that sets us apart and come to understand and appreciate our approach to ABA.
The progress may be subtle at first, but you will be surprised at how rapidly your child learns. All children are sponges, ready to learn some just require different approaches. All of our work is done in the childs natural environments, which means primarily in your home. All of our therapies including ABA and speech are delivered one-on-one. For every child, we build a unique treatment plan. Our plans are continually updated and revised to keep pace with the childs progress and changing needs. We have people who can work with you anywhere you might move or transfer. Weve the resources and the confidence to always take a collaborative approach. We invite and encourage the active participation of parents in helping us devise, implement, and revise plans.

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Our tutors look to develop a partnership with each student so as to get the best effort from him or her, including a willingness to initiate learning.
With a team of 350 professionals from across the country, we have the resources and the experience to bring into play whatever is needed. We work readily with schools, care facilities, and other providers to coordinate services and make sure needs are being met and that the learning is consistent.

We are state-of-the-art.
All of our methods are research tested and evidence based. Not bound by geographic limitations, our staff are continuously involved in continuing education and supervision with some of the very best in the field. Our CentralReach software platform was specifically designed to meet the needs of our clients. It offers 24/7 access to essential notes and plans, provides communication with team members, stores both written and video notes, and can follow you and your child wherever you might move.

Most importantly, our tutors are hand-picked and carefully trained.

We won't hire anyone we would not trust our own children with. We will not put your child's future in just anyone's hands. Our tutors and consultants are all trained and continue to receive ongoing training and supervision no matter how experienced they are. Our tutors and consultants are expected to encourage collaboration and communication.

We try to save you money however we can, but we always hire the best.
You will not work with anyone who considers the time spent with you and your child as just a job. Anyone providing services to your child has chosen this field as his or her life long profession. The progress of your child is the largest measure of his or her success. At Butterfly Effects, we will try to match you with the perfect behavior specialist from the first day, but we understand that human matches are dynamic and not 100 percent predictable. If your match isnt working, we will be glad to bring in someone else. Go to the next page to see how we can help you get to your budget without sacrificing quality and progress.

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How to Get the Best ABA Services on a Budget

At Butterfly Effects, we can help you get to your budget without sacrificing quality and progress. We understand that budget restraints are a concern for you and your family. And we wish that we could do it all for free, but thats impossible. We hire the best people, continually train them, provide them with the very best supervision, and have to pay them accordingly.
Photo placed in public domain by Centers for Diseas e Control, Amanda Mills, photographer

However, we can work with you to help make our therapy more affordable. Your child deserves the very best and we will do what we can to make sure he or she receives just that. You can buy do-it-yourself ABA programs; you can read books; buy tapes, and attend seminars. You can learn a great deal about ABA, especially motivated as you are. But ABA-based therapy is all about the human element and its true uniqueness can only be learned human to human. We are willing to help you get to the point that you can be your childs principle behavior specialist, but we want to start out right so you don't ever have to start over. What we mean by right is getting a complete assessment so that everyone has a good understanding about what needs to happen in terms of developing or replacing behaviors, teaching skills, learning how to socialize, learning how to communicate. Only then, can we build a plan and understand what needs to be learned first. Ideally, ABA therapy should be performed 30 to 40 hours every week, 20 at the very least. Even if you cant afford ongoing therapy for 30 to 40 hours a week, bring us in for a little while as close to full time as you can possibly afford.
Photo placed in public domain by Centers for Disease Control, Dawn Arlotta, photographer

We can help you get started in the right direction. Looking for ABA Services? What questions should you ask? 888-880-9270

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We can begin teaching you how to communicate with and motivate your child with encouragement and positive reinforcement. Through CentralReach, you can start taking courses and begin building your ABA toolkit. We have online self-paced courses designed for both ABA professionals and parents. Each is full of a wealth of practical tips and real examples that you will be able to transfer to your own situation. Then when you feel ready, we can begin to cut back our hours of direct support, allowing you to become the principle tutor for the child.
Photo placed in public domain by Centers for Disease Control, Amanda Mills, photographer

We can cut back to half time and then to ten hours a week and if you feel that you are ready, we can simply come in on a supervision basis every week. We can make it even more affordable by conducting that supervision via telecommunication. While you are probably not yet ready, at some point you will become disciplined, knowledgeable, and confidence enough to benefit from a simple discussion of your concerns with a senior consultant. You will not find an ABA provider that is more flexible and creative than Butterfly Effects. We can help you adapt to the realities of any situation even when two realities are in disagreement with one another such as your desire to provide your child with the best ABA supports possible and the lack of funds needed to cover such. Hopefully, you have the right insurance. If not maybe you can work towards getting it or maybe you can get the bulk of services paid for out of network. Often it requires persistence and time to get the right insurance in place. We can help you with that. Meanwhile, don't delay in getting your child the services he or she needs. Ultimately, you will want to get your child the best help possible. Once you begin to connect and communicate with your child; once you begin to see him or her interact with the world you will know you made the right choice. Read and watch what other parents have said about working with Butterfly Effects by visiting our website at http://butterflyeffects.com/.

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A Word on Insurance
No is a request for more information. If you are trying to get Autism benefits for your child, get used to hearing the word no. No, your insurance doesnt cover Autism services No, you cant go out of network for Autism benefits No, your employer isnt interested in picking up an Autism rider No, your legislators arent interested in mandating Autism insurance
Photo released in to the public domain by Centers for Disease Control, James Gathany, photographer

The no is intended to discourage you. Often it is the easiest and safest answer. It is typically based on misconceptions such as Autism services are too expensive and consequently, push premiums through the roof. This simply isnt true. In those states that have enacted an Autism insurance mandate, premiums have gone up less than one percent and in most instances less than half of a percent. You may also find that the best providers, the ones that are recommended by peers and by doctors arent in your network. The reason for this is that some insurance companies are still trying to get away with paying as little as possible, and better providers with high quality staff cannot work for below industry rates. However, if you are allowed to go out of network for physical-medical needs, they have to allow you to go out of network for behavioral services. You will always be able to find providers who will work on the cheap, but you will end up getting just what you paid for.

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A Few Insurance Terms you need to know

Fully-Insured Refers to insurance policies totally underwritten by insurance companies. In most cases these insurers are subject to the state insurance laws for the state in which the policy is written. Self-Insured Refers to those large companies that cover all insurance benefits on their own. Usually, these are administered by a national insurance company such as United Health. These policies are not subject to state laws but are regulated by the Federal government. Autism Insurance Mandate Now passed in 31 states. law stating that insurance companies must provide ABA services for children diagnosed with Autism. ABA Rider Optional Autism insurance that some employers opt to add to employee insurance Habilitative Services ABA services are often included as part of habilitative services, services which are used to teach new skills rather than rehabilitation. Mental Health Parity Act That part of Affordable Care Act enacted in 2010, which states that if they provide mental health / behavioral services, they must be done under the same terms as for physical conditions. This means they must permit out of network purchases and adhere to caps set on medical services rather than arbitrarily limit spending and amount of visits.

If you believe that your child needs Autism Services and you have insurance:
1.

Check with your HR department and/or insurer to see if you are covered Ask for a written copy of your up-to-date policy if you dont have your own. Remember that if you are in a state with a mandate, Autism insurance needs to be an option. In some cases Autism insurance might be optional requiring you to sign on. If you have an individual policy, you can adopt that optional rider at any time. If you are insured by your employer you will need to wait for the next open enrollment period. Some insurance companies still have ABA restrictions written into the language. That doesnt make them valid if they are not legally allowed. Give Butterfly Effects a call We can help you with the paperwork and even act on your behalf with the insurance company. If you need to go out of network, we can talk to you about what costs you will incur and ways to keep costs down while securing the best assistance available for your child.

2. Submit your paperwork Get exactly what is requested into your insurer in as timely a fashion as possible. 3. Stay the course You may have to resubmit paperwork, be requested to provide different codes, or simply be put on hold. These are all efforts to get you to give up. They are simply hurdles to be overcome not locked doors.

Looking for ABA Services? What questions should you ask? 888-880-9270

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If you dont have Autism insurance, you can. . .

Move to another state In those states where the legislators are refusing to budge, families are giving up and moving to states where their child with Autism can receive treatment. Thats a judgment call that only you and your family can make. Visit our website for a list of those states actively considering an insurance mandate Go to work for a self-insured company A number of larger companies fund their own insurance and several of these have adopted an Autism rider. In some families, the secondary earner has taken a job with one of those national chains to get the Autism benefit that more than makes up for any salary degradation. Go to our website for a list of self-insured companies with an Autism rider. Join the military TRICARE insurance provided by the armed services offers the families of active service personnel excellent Autism benefits. The Pentagon recognizes that many choose to reenlist to keep that benefit. Unfortunately, it is not available to non-active personnel or veterans. Recent legislation to include all service personnel died in Congress. Advocate with your company The insurance industry prides itself on being at its best when it adheres to free market principles That noted, they should also be willing to meet the demands of the market rather than telling the market what it wants to provide. If more employers shopping for insurance regarded no ABA/Autism rider was a deal breaker, the insurance companies would have to respond. Let your employer know what you want and get others in the company to support you as well. Ask to review the policy before it is adopted so that you can make sure there are Autism diagnosis and treatment provisions that specifically identify ABA-based therapy as a defined treatment. You should also review the providers available to make sure they are not allowing only the cheapest into network. Advocate with your state Write and call your state legislators. Demand that an Autism mandate be proposed. Collect personal stories, for in the end that is what turns the tide in most states. For information on your state efforts, go online and visit your states Autism Coalition. Support the Affordable Care Act as it is intended The Affordable Care Act is a compromise. Therefore it is easy for both conservatives and liberals to find things about it that they dont like. However, by 2014 it will likely have a very dramatic impact on services for children with Autism. It may remove caps to service and challenge age limits such as in Maine and Vermont where services stop at first grade. Affordable Care Act Over time, the ACT will likely have a major impact on the delivery of Autism services because the courts will see to it that it does. Court cases will probably decide whether both yearly and lifetime caps on ABA services are legal. Some customers are reporting that their insurance companies are not strictly adhering to caps so as to avoid lawsuits and public recognition of the caps invalidity. Looking for ABA Services? What questions should you ask? 888-880-9270

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References
Anan, R. M., Warner, L. J., McGillivary, J. E., Chong, I. M., & Hines, S. J. (2008). Group intensive family training (GIFT) for preschoolers with Autism spectrum disorders. Behavioral Interventions, 23, 165-180. Birkin, C., Anderson, A., Seymour, F., & Moore, D. W. (2008). A parent-focused early intervention program for Autism: Who gets access? Journal of Intellectual & Developmental Disability, 33(2), 108-116. Chasson, G S, Harris, GE, Neely, WE, 2007, Cost Comparison of Early Intensive Behavioral Intervention and Special Education for Children with Autism. J Child Fam Stud (2007) 16:401413. DOI 10.1007/s10826-006-9094-1. Retrieved from http://www.springerlink.com/content/52q6k240l5125294/fulltext.pdf Department of Education (2003). Early Intervention for Children with Disabilities Works, Report Finds. Accessed at http://www2.ed.gov/news/pressreleases/2003/09/09102003.html Gavidia-Payne, S., & Hudson, A. (2002). Behavioural supports for parents of children with an intellectual disability and problem behaviors: An overview of the literature. Journal of Intellectual & Developmental Disability, 27(1), 31-55. Marcus, B. A., Swanson, V., & Vollmer, T. R. (2001). Effects of parent training on parent and child behavior using procedures based on functional analysis. Behavioral Interventions, 16, 87-104. McConachie, H., & Diggle, T. (2007). Parent implemented early intervention for young children with Autism spectrum disorder: A systematic review. Journal of Evaluation in Clinical Practice, 13, 120-129. Trudgeon, C., & Carr, D. (2007). The impacts of home-based early behavioural intervention programmes on families of children with Autism. Journal of Applied Research in Intellectual Disabilities, 20, 285-296. Weiss, M. (1999). Differential rates of skill acquisition and outcomes of early intensive behavioral intervention for Autism. Behavioral Interventions, 14, 3-22. Winerman, L, 2004. Effective education for Autism: Psychologists are working to help struggling schools--faced with limited budgets and increasing enrollment--educate children with Autism. Monitor on Psychology, Vol 35, No. 11. American Psychological Association. Retrieved at http://www.apa.org/monitor/dec04/Autism.aspx

Looking for ABA Services? What questions should you ask? 888-880-9270