On January 4, 2010 Pediatrics, the official journal of the American Academy of Pediatrics, published online two articles related to the evaluation, diagnosis and treatment of gastrointestinal disorders in individuals with autism spectrum disorders.
Both articles are currently available in free full-text at the Pediatrics website,and professionals working with the ASD population may find them of value for their own education and in their roles in serving individuals with ASD.
The first is a consensus report based on the review of current available evidence by an expert panel (composition of the panel, evaluative process and resulting twenty-three statements described in the full report). Because evidence-based recommendation was not achievable at this time, this consensus report was produced, with a footnote included that,
"The guidance in this article is not intended to advocate for an exclusive course of treatment or to represent a standard of medical care. Individual circumstances will determine variations that may be appropriate."
Autism spectrum disorders (ASDs) are common and clinically heterogeneous neurodevelopmental disorders. Gastrointestinal disorders and associated symptoms are commonly reported in individuals with ASDs, but key issues such as the prevalence and best treatment of these conditions are incompletely understood. A central difficulty in recognizing and characterizing gastrointestinal dysfunction with ASDs is the communication difficulties experienced by many affected individuals. A multidisciplinary panel reviewed the medical literature with the aim of generating evidence-based recommendations for diagnostic evaluation and management of gastrointestinal problems in this patient population. The panel concluded that evidence-based recommendations are not yet available. The consensus expert opinion of the panel was that individuals with ASDs deserve the same thoroughness and standard of care in the diagnostic workup and treatment of gastrointestinal concerns as should occur for patients without ASDs. Care providers should be aware that problem behavior in patients with ASDs may be the primary or sole symptom of the underlying medical condition, including some gastrointestinal disorders. For these patients, integration of behavioral and medical care may be most beneficial. Priorities for future research are identified to advance our understanding and management of gastrointestinal disorders in persons with ASDs.Pediatrics 2010;125:S1–S18
includes differential diagnostic and treatment guidelines which make reference to the consensus report.
ABSTRACT:
Children with autism spectrum disorders (ASDs) can benefit from adaptation of general pediatric guidelines for the diagnostic evaluation of abdominal pain, chronic constipation, and gastroesophageal reflux disease. These guidelines help health care providers determine when gastrointestinal symptoms are self-limited and when evaluation beyond a thorough medical history and physical examination should be considered. Children with ASDs who have gastrointestinal disorders may present with behavioral manifestations. Diagnostic and treatment recommendations for the general pediatric population are useful to consider until the development of evidence-based guidelines specifically for patients with ASDs. Pediatrics 2010;125:S19–S29
With the state legislature sessions opening soon and the likelihood of insurance reform legislation submissions, it seems timely to point out information on reimbursement (and limitations) under self-funded health insurance Plans, and to make note either as an advocate or potential beneficiary of legislation as to the language of a bill (or law) in regards to the matter of self-funded policies.
"Even in the states that have passed autism insurance reform , many children are still unable to receive treatment because they are insured through self-funded plans that are not regulated by the state. If you work for a large company or government, there is a chance your health plan is a self-funded insurance plan. For self-funded insurance plans, federal ERISA [Employee Retirement Income Security Act of 1974 (ERISA)] law preempts most state insurance regulations, including benefit reforms like autism insurance reform..."
Some of the useful resources at Autismvotes are,
Self-funded plans: Establishing an autism benefit
How Private Health Insurance Works: A Primer
Companies with self-insured health plans that have opted to provide coverage for autism therapies
One other useful reference is from the State of Colorado, Division of Insurance - this has some Colorado-specific clauses, but in general is a clear, lay-friendly explanation of ERISA, self-funded plans, and information on departments in the Federal Government dealing with this area.
Disclaimer: This blog publishes news and announcements only as a service to interested persons, the posts are the responsibility of the individual author, and unless otherwise noted do not constitute nor claim to represent the official position of ABA International, its officers or associated entities. This blog makes no representation as to the accuracy of the report and readers are strongly encouraged to consult and reference the primary sources noted.
The National Standards Project of the National Autism Center announced in their December newsletter that a NEW manual targeting educators is available for free download or purchase at their website, and shared an update on the also available recently released National Standards Project Report.
National Autism Center Releases New Autism Educator Manual
"We are pleased to make available a comprehensive new manual by the National Autism Center entitled, Evidence-Based Practice and Autism in the Schools.
'We created this manual for educators as a means of promoting evidence-based practice for Autism Spectrum Disorders (ASD) in schools,' said Susan M. Wilczynski, Ph.D., BCBA, Executive Director of the National Autism Center. 'We know that research-supported interventions are most likely to produce positive outcomes for the ever-increasing numbers of students with ASD.'
The development and publication of the manuals were made possible through support from the American Legion Child Welfare Foundation, Inc., and the Niel M. Wreidt 2003 Revocable Trust. The American Legion grant enabled us to distribute the first 3,000 manuals free of charge to public school systems throughout the country.
Due to the overwhelming response to the manuals, we are making them available on our website. Visitors can now download them for free, or purchase a hard copy through our on-line Bookstore. We welcome you to take a look!"
This new manual is a complement to the National Standards Project Report, previously issued in September, which addressed the level of evidence for autism interventions.
In their update on the National Standards Project Report, the NAC December newsletter also stated that,
"The response to our September announcement of National Standards Project results has been tremendous! Individuals from every state in the United States, and from close to 50 countries, have visited our website in the past two months. They have downloaded tens of thousands of free copies of the Project results.
Help us to continue spreading the word! Forward our e-card to others who might be interested in learning about the National Standards Project.
We invite you to visit our website to view and download a free electronic copy, or to purchase a printed copy, of the report.
The primary goal of the National Standards Project is to provide critical information about which treatments have been shown to be effective for individuals with Autism Spectrum Disorders. The National Standards Report covers a broad range of applied treatments and identifies the level of scientific evidence available for each. The report serves as a single, authoritative source of guidance for parents, caregivers, educators, and service providers as they make informed treatment decisions. We are confident that these findings and recommendations will change lives and give hope and direction to people whose lives are touched by autism."
2010 Regina G. Claypool-Frey Disclaimer: This blog publishes news and announcements only as a service to interested persons, the posts are the responsibility of the individual author, and unless otherwise noted do not constitute nor claim to represent the official position of ABA International, its officers or associated entities. This blog makes no representation as to the accuracy of the report and readers are strongly encouraged to consult and reference the primary sources noted.
