Question about why it's advantageous to "get the diagnosis"??

[Anonymous]

My daughter was just diagnosed with ASD. I've had numerous people tell me that it's "great" that she has an official diagnosis, and that will help with getting treatment covered. Forgive my ignorance, but how does getting the diagnosis help with paying for services? Aren't most of the state programs that would help income-based anyway (which I doubt we'd qualify for)? Any light anyone can shed would be much appreciated. Thanks

[Anonymous]

My child was diagnosed when he was 4 yrs old in preK4 with ASD/Asperger's. He attends a language immersion school. Having the diagnoses got us an IEP and he gets all the supports and services he needs at school - for free. The school is an excellent fit.

He is now a rising second grader, happy at school, does great academically and has friends. No behavioral issues. Having the diagnosis and IEP, made it possible since it anticipated any issues that could have arisen given his diagnosis.

[Anonymous]

School based programs are not need based.

Some state support services are not tied to need and having a specific diagnosis may help you qualify for some of them.

Research what your insurance plan covers. Mine covers PT, OT and speech for autism.

This is why in some instances it can be easier to navigate the system to say 'autism' rather than 'struggles with language pragmatics' or 'sensory sensitivities' etc.

[Anonymous]

What they said.

My son was diagnosed with ADHD in K, and his IEP was set up with the "Other Health Impairment" category - this is where they stick the ADHD kids. I know Autism is a category all on its own.

Actually, we strongly suspect my son also has High-Functioning Autism. We have not had him formally diagnosed with this, since he is getting all he needs from his current IEP! It is however something we keep in mind for the future.

So... a label can be very useful to receive the services you want from the county, and get reimbursed from your health insurance.

[Anonymous]

Depending on what the disability and challenges are for the child getting the full range of testing done at age six or older, then opens up the ability for one to apply for the Developmental Disabilities Medicaid Waiver or if there is a cognitive impairment the Intellectual Disabilities Medicaid Waiver. There are long waiting lists for both, BUT especially for "low information" families and if one's child is on Medicaid, once a child is placed on the DD Waiting List or an ID Waiting List (Urgent or Non-Urgent), one can request Targeted Case Management on an as needed basis. The Case Manager can be a key resource during the years while waiting to help parents perhaps understand the disability more fully, learn about service that one can apply for now and later on in life and even local programs such as therapeutic recreation or summer camps which may come up and offer scholarships or sliding fee scales. Also, at age 18, one can help the son or daughter then apply as a legal adult "family of one" for key benefits one might need such as Supplemental Security Insurance (SSI) and Medicaid Insurance as an adult as well as job support services through the now called Department of Aging and Rehabilitative Services.

Also, it is my opinion that while a Case Manager does not deal with school issues directly, one might be able to help a parent figure out if there are local resources to learn basic information. Finally, with the waivers undergoing major reform and the aspect of "emergency" criteria going to be uniform in the future, it only stands to reason that if a Case Manager can get to know a child and the family - over time - one will be able to capably and completely document the emergency on paper or in person than if one just suddenly showed up the first time in with an emergency. I know most families here are not "low information,"and Case Management is not a cheap service, but it is key to understand that Medicaid will cover this service AND at age 18, even while still a full-time student, it will be time to start to promote the independence of those who are able to learn to work with folks who can help them access services.

[Anonymous]

For our health insurance, we had to have a diagnosis to get speech, ot and PT. Without it, we hit brick walls. We went fully private with all services and did not use county services. If you use county it does not matter as much but many insurances require it.

[Anonymous]

This is a list of states that have laws mandating that insurers cover certain services for insureds diagnosed with ASD:

http://www.asha.org/Advocacy/state/States-Specific-Autism-Mandates/%23ct#IL

[Anonymous]

My three year old son was diagnosed in November so we've had the diagnosis for about six months. I've been using it to get him the services he needs and coming up against a brick wall. His school teacher didn't think that the preschool autism PAC program was an appropriate environment and said No to transferring him there. She said he's more social than the kids in the PAC program and the non-cat class is more appropriate. So I decided to keep him there and found some private ABA therapy for him. Insurance covers hardly anything, even with the diagnosis and Virginia mandate. Out of $1100 monthly costs they give us $42. We can only afford 4 hours a week. The good news is that he's made great progress with ABA that we're just not seeing at school. I mentioned this to the school teacher and we're meeting to revisit the possibility of transferring him to the PAC. A PAC teacher also came out and observed. She had reservations, the issue was brought up again about him being more social than the other autistic kids. So we're meeting again next week to talk about it. I just need my son to get the services he needs, I'm having the hardest time even with a diagnosis.

[Anonymous]

Anonymous wrote:My three year old son was diagnosed in November so we've had the diagnosis for about six months. I've been using it to get him the services he needs and coming up against a brick wall. His school teacher didn't think that the preschool autism PAC program was an appropriate environment and said No to transferring him there. She said he's more social than the kids in the PAC program and the non-cat class is more appropriate. So I decided to keep him there and found some private ABA therapy for him. Insurance covers hardly anything, even with the diagnosis and Virginia mandate. Out of $1100 monthly costs they give us $42. We can only afford 4 hours a week. The good news is that he's made great progress with ABA that we're just not seeing at school. I mentioned this to the school teacher and we're meeting to revisit the possibility of transferring him to the PAC. A PAC teacher also came out and observed. She had reservations, the issue was brought up again about him being more social than the other autistic kids. So we're meeting again next week to talk about it. I just need my son to get the services he needs, I'm having the hardest time even with a diagnosis.

Who diagnosed him? A developmental pediatrician or child psychologist should be able to tell you the appropriate educational environment for your DS including what kind of therapies are helpful. The spectrum is very wide and not every child with ASD needs ABA which is why you are getting the push back about the PAC placement. Having the developmental pediatrician or psychologist weigh in that PAC will be more helpful than non-cat class will help.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My three year old son was diagnosed in November so we've had the diagnosis for about six months. I've been using it to get him the services he needs and coming up against a brick wall. His school teacher didn't think that the preschool autism PAC program was an appropriate environment and said No to transferring him there. She said he's more social than the kids in the PAC program and the non-cat class is more appropriate. So I decided to keep him there and found some private ABA therapy for him. Insurance covers hardly anything, even with the diagnosis and Virginia mandate. Out of $1100 monthly costs they give us $42. We can only afford 4 hours a week. The good news is that he's made great progress with ABA that we're just not seeing at school. I mentioned this to the school teacher and we're meeting to revisit the possibility of transferring him to the PAC. A PAC teacher also came out and observed. She had reservations, the issue was brought up again about him being more social than the other autistic kids. So we're meeting again next week to talk about it. I just need my son to get the services he needs, I'm having the hardest time even with a diagnosis.

Who diagnosed him? A developmental pediatrician or child psychologist should be able to tell you the appropriate educational environment for your DS including what kind of therapies are helpful. The spectrum is very wide and not every child with ASD needs ABA which is why you are getting the push back about the PAC placement. Having the developmental pediatrician or psychologist weigh in that PAC will be more helpful than non-cat class will help.

We went to see Dr Beverly Powell in Springfield. She recommended he be placed in the PAC program, as well as a range of therapies (ST, OT, ABA). Thanks for the advice, I will contact her and see if she's available.