Reply to How do you cope with having to physically stop or force your large child to do things?

Forum Index » Kids With Special Needs and Disabilities

Reply to "How do you cope with having to physically stop or force your large child to do things?"

Subject:

Emoticons





More smilies

Text Color: Font: Close Marks

[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]ABA is not just for autism. One hour a week is not enough. [/quote]

Op here. Our insurance won’t pay for it because we don’t have an ASD diagnosis, so we pay out of pocket. We need much, much more than an hour a week but we can’t afford it.[/quote]

Have you considered doctor shopping to get the diagnosis?   Then you can get insurance to pay more.  Try a developmental ped.  [/quote]

Op here, yes I have doctor shopped. My child is 5 and we already have a developmental ped, neurologist, pediatric psychiatrist, geneticist, and we’ve done a full neuropsych. He just doesn’t have ASD. I almost made the case for it when he was 2/3 but as he’s gotten older it’s clear that this is ID with severe ADHD, not ASD. He’s actually pretty strong on social/emotional communication. My docs know how badly I want the diagnosis but recently our developmental ped told me I should really let it go and that I wouldn’t be able to get that diagnosis.[/quote]

I think the approach with health insurance shouldn't be to try to get a diagnosis that your DS doesn't have, rather it should be to appeal the decision of the medical insurer.  Your insurer is saying we are denying ABA because it is not a valid treatment for people with ADHD, and your response should be to appeal and show what medical evidence there is for the treatment you are seeking for your child.  Your position should be - the evidence shows that ABA is effective for severe ADHD, which *is* your DS's diagnosis, and furthermore, the fact that he is ID shouldn't exclude him from ABA because ABA is successfully used with kids with autism and ID.  The fact that the health insurance company gates ABA only to autistic children is discriminatory - under the ADA, all companies are required to make reasonable accommodations to their policies for disabled people, and determining how to make accommodations has to be based on an individualized determination, not just a blanket policy only people with diagnosis X get this therapy, which is the opposite of "individualized".  I would look for some scientific journal articles, statements of Psychiatric or Psychological associations, etc. to support your position.  Also get your provider(s) (psychiatrist, psychologist and/or developmental ped) to write letters of medical necessity explaining how ABA can help with what specific aspects of your DC's diagnosis and "referrals" for ABA.  Consult a lawyer if necessary. [/quote]

Options

	Disable HTML in this message
	Disable BB Code in this message
	Disable smilies in this message

Review message

Search Recent Topics Hottest Topics