Getting Started: The Need for an Autism Diagnosis
Getting started with applied behavior analysis (ABA) can be overwhelming. When you are the parent of a child who needs ABA, the process can seem daunting. We are here to help you, every step of the way. This article answers common questions you may have as you get started in this process.
Does my child need an autism diagnosis to start ABA therapy?
It is important for you to know that insurance will help cover ABA services but only if your child has a medical diagnosis of autism. There are some insurance providers who cover ABA without an autism diagnosis, but those are few and far between. Some parents come to us and tell us that their child has an autism diagnosis from the school district. This is not a medical diagnosis of autism.
Can a school diagnose autism?
School districts do not diagnose children or young adults; they determine whether or not the child meets specific criteria for a recognized disability AND if the child needs unique support and curriculum in their school day.
What is a Full and Individual Evaluation?
The report that the school completes to determine eligibility in special education is called a Full and Individual Evaluation or FIE. The data that is collected in this evaluation is important for many reasons. However, insurance providers do not recognize school eligibility as a diagnosis and this report cannot be used as the diagnostic report that is necessary to cover ABA services.
The report can be used to gather more information and aid in the development of a comprehensive, diagnostic report.
How is autism diagnosed?
Medical providers diagnose children or young adults with autism or autism spectrum disorder (ASD). This includes pediatricians, psychologists, psychiatrists, neurologists, and developmental pediatricians.
They should use multiple sources of information to determine if a diagnosis of autism is appropriate. This includes information from the parents, interviews, checklists, school reports, and other appropriate evaluations. Some of these interviews, checklists, and assessments include:
● Modified Checklist for Autism in Toddlers, Revised (MCHAT-R)
● Autism Diagnostic Observation Schedule (ADOS)
● Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition (MIGDAS 2)
● Camouflaging Autistic Traits Questionnaire (CATQ)
● Vineland Adaptive Behavior Scales, Third Edition (Vineland Adaptive Behavior Scales-3)
● Autism Diagnostic Interview, Revised (ADI-R)
● Autism Spectrum Rating Scales (ASRS)
● Childhood Autism Rating Scale, Second Edition (CARS-2)
● The Gilliam Autism Rating Scale, Third Edition (GARS-3)
What will my insurance need for approval?
Your insurance provider will likely require a diagnostic report before ABA services are approved. This report needs to come from a medical provider and include information on how the provider determined that your child has autism. This includes the name of the assessment(s), interview(s), or checklist(s) that were used and any scores that were obtained on these items. If you need a sample report, please reach out to us and we will share one with you.
What are my next steps after diagnosis?
ABA Spectrum is your community of support. If you suspect your child could benefit from ABA and you do not have a diagnosis, reach out to us and we can help you get started with resources and referrals to medical providers we trust.
