A Review of Therapy Resources in South Carolina
ABA: What is Applied Behavioral Analysis?
Applied behavior analysis (ABA) uses a scientific method of identifying and studying a behavior in order to then be able to respond appropriately in order to change the behavior. ABA therapy is the only evidence-based treatment shown to improve functioning in children with autism spectrum diagnoses.
ABA principles generally are applied on an individualized basis, and therapy usually is carried out one-on-one. ABA can be used both to decrease maladaptive behaviors and to increase adaptive functioning. Communication, social, academic, self-care, motor and play skills all can be targeted for improvement in an ABA program.
How can families access ABA following a diagnosis of autism/pervasive developmental disorder (PDD)?
In South Carolina, families can access professional ABA services after receiving an autism diagnosis in four ways:
1. They can self-pay for services – the average cost is $40,000 a year.
2. Children under age 3 can receive ABA therapy through BabyNet.
3. Families may receive coverage through their private insurance company if the policy honors Ryan’s Law.
4. Children can receive services through the SC PDD Waiver.
South Carolina BabyNet
BabyNet is the state’s interagency system of early intervention services for families who have infants and toddlers, birth to age 3, with developmental delays or conditions associated with developmental delays.
Children diagnosed with autism who are served by BabyNet may be eligible to receive ABA therapy (at no cost to the family). Families should speak to their child’s early interventionist for more information about applying for this service.
Ryan’s Law requires insurance companies doing business in South Carolina (with four exceptions noted below) to cover up to $50,000 a year in behavioral therapy for children diagnosed by age 8 (coverage is available until a child turns 16). It also prohibits insurance companies from refusing to cover someone because that person has autism.
• People employed by the federal government and thus covered by Tricare (military insurance) or one of the FEHBP plans (federal civilian insurance).
• People who get insurance through a self-insured company. Parents/caregivers MUST check directly with their employer to find out if their company is self-insured.
• People who get insurance through a small business (fewer than 50 people).
• People who buy individual insurance policies.
Families should contact their insurance company to determine if they are eligible for services under Ryan’s Law.
South Carolina PDD Waiver
The Pervasive Developmental Disorder Waiver provides for early intensive behavioral intervention services to children (ages 3-10) diagnosed with a PDD, including autism and Asperger’s Syndrome. These services are limited to non-educational settings.
• Children must be ages 3-10.
• Children must be diagnosed with a PDD before the child turns 9 years old. The diagnosis must be made by a qualified professional.
• Families must meet eligibility criteria for either income-based or TEFRA Medicaid, or they must provide documentation of application (even if denied).
Families should talk to their child’s service coordinator or another representative from the Department of Disabilities and Special Needs (DDSN) for a full explanation of waiver eligibility requirements.
To Apply for PDD Waiver Services
• Families Currently Receiving DDSN Services: Contact the child’s service coordinator and request that the child go through the intake process for the PDD Waiver.
• Families Not Receiving DDSN Services: Call the PDD Waiver Intake and Referral toll free number (1-888-576-4658).
Some children who meet educational diagnostic criteria for autism may be eligible to receive behavioral therapies or supports at school. Please speak with your district’s special education department for more information.
Some families choose to design and implement their own at-home ABA program. Below are several helpful resources for helping a family create an at-home program:
• http://www.polyxo.com provides an excellent overview of ABA and specific instructions on developing a parent-run program at home. It also includes many free printable forms.
• Behavioral Intervention for Young Children With Autism: A Manual for Parents and Professionals by Catherine Maurice is a good starting place for many families. This book contains sample curricula and programs, as well as many of the forms needed to track progress.