Maryland Should Require Insurance Companies to Cover Autism Therapy

The Maryland General Assembly is presently considering a bill that would require health insurance companies in the state to provide coverage for therapy designed to address the challenges of autism. Half the nation’s states have already passed similar legislation, in one form or another, and Maryland should too.

At primary issue is a type of therapy known as applied behavior analysis, or ABA. This is the most thoroughly researched and peer-reviewed method for addressing the challenges faced by those with an autism spectrum disorder. Resembling in some ways how Anne Sullivan taught Helen Keller, it relies, at least initially, on one-on-one therapy for many hours a day. The idea is to break down learning into small steps, gradually building attention, teaching imitation, shaping communication and ultimately working on language as well as social skills. Correct actions or answers are rewarded enthusiastically, so as to draw the child out of his or her “shell” and motivate further effort and progress. Results of the efforts are tracked systematically — hence the term applied behavior analysis — as a therapy team works through programs developed specially for the child with autistic challenges.

The modern originator of this method, O. Ivar Lovaas, who died last year, found that his young subjects were capable of learning more than anyone had thought possible. In 1987, he published a groundbreaking study in the Journal of Consulting and Clinical Psychology, describing the results of a controlled experiment in which roughly 47 percent of children treated in his program achieved “normal cognitive and intellectual functioning” and wound up mainstreamed in school. From this point on, while they might still need extra support, they could often keep up with their peers.

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