#Presidential Candidates Let’s Talk #Autism Plan

By Lisa Ackerman

2016 is an election year that will bring new leadership to the USA. We are being barraged with messaging, commercials and debates from every direction and it will continue to build as we get closer to election day. What I am hoping is perhaps that the autism community can drive some unified messaging and support for individuals living with autism.

As a 501c3, TACA cannot tell members how to vote. TACA can only share information and let them decide.

I am writing this blog to share key points for presidential candidates to consider for their autism plan. Personally, I will also be reaching out directly to each candidate and their staff. My goal is that for families to share these points with their representatives and favorite candidate. Families living with autism have a voice. I hope they use it and either share this plan or speak up with a plan that will help influence action for autism.

WHY HAVE A PLAN IN THE FIRST PLACE? As a country, we need to address this important health issue affecting 1 in 68 every US Children (1.) A more recent parent survey shows the number even higher at 1 in 45 (2.) Candidates need to know this should be a front-of-mind issue affecting many families living with autism. They also need to know we need help.

Sadly, autism is still the least funded disability in America facing the most children. Since 1999, I have watched three presidents, in almost six terms, watch autism prevalence go from 1 in 5,000 to 1 in 68 yet we are no further along in a strategy to provide meaningful change and help for families living with autism.

Here is the autism plan I feel is needed, based on my work with TACA as well as TACA’s 15-year history supporting tens of thousands of families:

Plan item One: Perform an autism census

Why: We need to count EVERYONE with a formal diagnosis of autism in an actual census. At TACA we have been asking for this since 2007 through our interaction with the Interagency Autism Coordinating Committee (IACC) (3.) We need to know about everyone; two-year-olds, 52-year-olds and every age in between. We also need to know their needs and the severity of the diagnosis. We are missing crucial data.

To be clear, this full census only needs to count those diagnosed with autism by medical professionals. In addition, we have to include children and adults outside our school system as many families are choosing homeschool due to the lack of appropriate placement.

Plan Item Two: Provide support to caregivers

Why: Very little to no support is provided now. Families are being crushed with stress, debt, complexity of issues and multiple areas of need as the child ages, not typically faced by typical families without a child with autism. We need to provide the necessary support from diagnosis and along the lifespan of the person affected.

Plan Item Three: Ensure states meet their obligations under IDEA Child Find program to identify, screen and refer children with disabilities for services

Why: At TACA, I can tell you this is still a huge problem for families. Again, based on the thousands of support calls TACA receives from parents, this is one of the top issues families face. Often families are told misinformation from the entities meaning to help due to underfunding and staff shortages. Much work needs to be done to meet the need, resolve wait lists and ensure a free and appropriate education mandated by law.

Further, because autism is a spectrum, we need more options, not less. We don’t want to remove any choices, but rather want to expand the options for families and individuals to seek what suits their needs. To that end, limiting options to “inclusion-only” is detrimental to our community.  Not everyone can, or wants to, tolerate “typical” placement in jobs, schools, housing, and relationships, so the services and resources need to support all choices.

Plan item four: Increase state compliance with Medicaid and Medical coverage requirements

Why: Families need this help yesterday. Treatment across the United States varies greatly. The American Academy of Pediatrics Standards of Care for Autism should be followed. Based on the thousands of instances of support we provide every year we know these standards are rarely followed. This must change.

Plan item five: Improve access to autism services in the Affordable Care Act (ACA) marketplace and through private insurance for all families

Why: For most of the TACA families that we serve, insurance has become harder to navigate in order to procure coverage for best practices, scientifically proven therapies and treatments. The exclusion of my last statement: in states where no insurance act was available or for families new to insurance have better coverage than before. For many families, the red tape and co-pays are cost prohibitive. These two factors stop some families from trying altogether.

Let’s make that better for families. If we invest early in young children with autism, we can see tremendous cost savings later on in their life. And forget cost savings! Some children can recover from autism and their symptoms and become tax payers. We should at least try with every child. They have a bright future. The ACA is not fixed for families living with autism and needs improvement to eliminate red tape and co-pays for each treatment or visit. Perhaps a monthly co-pay on a sliding scale based on income could be the solution.

An important part of ACA is to make this benefit available to military, state and federal employees. Right now these families are left uncovered. Our heroes who serve and have served are completely left out of ACA requirements for autism treatments. That should be immediately remedied along with the above health care recommendations. As well as adding all state and federal employees for coverage.

Plan Item six: Address issues harming individuals with autism: wandering, restraint, bullying and seclusion

Why: I love the work of National Autism Association. They have done the research and definition of need in the areas of bullying, restraint, seclusion and wandering. No need to spend millions to do a study! The answers are right here (4).

We need to add this to the autism plan to address this crucial issue. We need the assistance to pass Avonte’s Law S. 163 to protect the almost 50% of those living with autism who wander from safe environments often with deadly results. We need to group these important issues in the safety act proposed. We would also like to see federal funding for first responder training included and mandatory across the country.

Plan item seven: Plan for adults – what happens when the bus stops coming?

Why: I want to mention something about what happens at age 21 when the school bus stops coming and our kids age out of all supports. Parents become full-time caretakers and have to quit working because there are no programs in place for the affected, so we go from having one person on government assistance to two, then add isolation and it becomes a recipe for despair. While the long-term goal is to create employment for most, it’s not feasible for all, especially in the short-term. We need appropriate “adult day care” and other life skills opportunities for our adults when employment opportunities are not available.

Plan item eight: Re-evaluate the “Learn the signs, act early” funding with the goal to boost early screening rates with a nationwide outreach campaign

Why? This has been a big part of the Interagency Autism Coordination Committee (IACC) efforts since 2006. They have spent $3 billion in taxpayer revenue and we are no further to prevention, treatment or help for families. Specifically, they have supported spending $42 million for the CDC’s campaign “Learn the signs, act early.” Since the inception of this campaign the average age of diagnosis has gotten worse, not better, by a month (5.) At TACA, we have suggestions where to go forward in truly assessing and diagnosing autism more effectively.

Plan item nine: Encourage all states to enact ABLE legislation and ensure consumer protection for ABLE account beneficiaries

Why: The recent laws passed do help. Early start and service providers need to assist families in navigating the need to know about, set up and benefit from savings accounts for individuals with autism. For too long, people with disabilities have been relegated to living in poverty because of the government asset test, so this is a good start for parents to save for their children, as well as adults to be able to earn and save for themselves (6.)

Plan item ten: Educate and expand the Adult Vocational Rehabilitation Program

Why: Many families are unaware of currently available programs for adults. We need to scale this program up to educate families about its existence and prepare for the additional children who will become adults. A large point to consider: adults will not be able to work if they don’t receive the necessary treatment and therapies early on at suspicion or time of diagnosis.

This plan needs to accommodate all areas of ability and disability. We need to shoot for the stars but also address the needs of all functioning levels. Consult with groups like TACA who have been working in the areas of autism for over 15 years and can provide insight to drive a well-thought-out plan.

Plan Item eleven: Promote multi-sector awareness campaign

Why: We have two distinct groups to help in a multi-sector awareness campaign. Group one is families living with autism. We would like to drive them to treatment based on their child’s needs. We need to be in front to help families and end the “hopeless” diagnosis, no hope or and lack of help given to most families at the time of diagnosis. Group two is the general public. We would like the general public to understand the autism spectrum.

Plan item twelve: Ensure access to assistive technologies

Why: Technology can change the life of an individual living with autism, especially individuals who cannot speak or have trouble communicating.

Often in schools, technology is outdated, broken or unusable. So many families are offered technology that does not help the individual. The plan needs to include a variety of options and more importantly a way to evaluate options based on an individual’s needs.

One example is the TACA iPad video project from 2011 (7.) Once outdated and expensive technology can now be replaced easily. Training, appropriate applications, and monitoring of these solutions must also be part of the plan.

Plan item thirteen: Continue vigorous enforcement and education of Olmstead Housing Act

Why: There are tens of thousands on wait lists for help in the area of housing. We are very close to two critical tipping points: children aging out of support and aging parents. A special task force is needed to identify the needs.

Plan item fourteen: Significantly increase funding and revamp autism research funding

Why: Sadly, past autism research is a big area of concern. This is where the US government has dropped most of the $3 billion in funding with the IACC recommendations. We are no closer to any new treatments or prevention for families since the IACC started in 2006. We have dumped millions in genetic research. I do not suggest having the government run this anymore as their programs are not generating results with taxpayer dollars. You can read more about the history of the IACC and their lack of accomplishments here (3.)

We need the government to fund innovation. First, we need to start with subtyping. By subtyping groups, those who wish to have help or need help can be our focus. Some research has been completed but we need to do more (8.) There are some incredible universities and physicians working with autism every day for decades who, with the right resources, could drive positive change with fewer dollars required. We have seen more innovation and effective treatments from smaller universities and research entities that are privately funded than the government or it’s funded programs has ever produced.

Plan item fifteen: Dedicate new funding to autism protection and advocacy

I would like to see an autism czar that could drive this and help guide the president on action for the pressing autism issues. The IACC is proving to not be a good investment as it stands today. We need to follow best practices used in similar chronic conditions such as what the AIDS, cystic fibrosis and elderly communities have established as guidelines and modify them slightly to meet the needs of the autism community.

Conclusion

In conclusion, any plan needs to address the rapid increase in the prevalence of autism and the growing needs of this community. We are very behind in addressing the needs and with the dire predictions of the autism increase becoming more and more prevalent each year (9.) The autism community needs a leader that can take on the issues and drive solutions.

We can no longer continue with autism being the least funded disability in the US affecting the most children. We cannot afford the $237 Billion and rising annual costs (10.) These costs are projected to reach $1 Trillion dollars by 2025. Besides, the dollar costs are the human costs. Every person should be valued. Individuals with autism should not be left behind.

Each candidate should have an autism plan. In addition, it shouldn’t be a campaign promise left behind after the election it as has been in the past. It needs to be a priority. We cannot afford the future of 2.5% of the population to continue to grow in size, cost and lost potential.

 

References:

1. Autism prevalence http://www.tacanow.org/news/cdc-releases-autism-prevalence/

2. 1 in 45 US children have autism – parent survey: https://tacanowblog.com/2015/11/13/autism-is-now-1-in-45-will-anyone-listen/

3. IACC TACAnow blogs: https://tacanowblog.com/2016/01/04/the-iacc-needs-to-address-autism-and-wandering-how-can-parents-help/ https://tacanowblog.com/2015/08/07/why-would-a-government-panel-question-universal-autism-screening/http://www.tacanow.org/blog/the-iacc-reconvenes/https://tacanowblog.com/2013/12/31/if-the-iaccs-strategic-plans-were-ieps-would-they-be-in-non-compliance/

4. http://www.tacanow.org/blog/what-constitutes-an-emergency/

5. http://www.tacanow.org/blog/what-the-iacc-must-consider/

6. National Autism Association: Wandering, Bullying, Restraint, and Seclusion: http://awaare.org/

7. CDC Learn the signs, act early campaign: http://www.cdc.gov/ncbddd/actearly/

8. ABLE ACT reference and response http://www.ndss.org/Advocacy/Legislative-Agenda/Creating-an-Economic-Future-for-Individuals-with-Down-Syndrome/Achieving-a-Better-of-Life-Experience-ABLE-Act/ https://www.congress.gov/bill/113th-congress/house-bill/647

9. TACA autism iPad project: https://www.youtube.com/watch?v=tWtn8MjJx2M

10. Subtypes in autism https://tacanowblog.com/2014/04/11/science-and-subtypes-in-autism/

11. MIT dire prediction http://www.autismdailynewscast.com/warning-half-of-all-children-will-have-autism-by-2025/12873/laurel-joss/

12. Annual autism costs soar https://tacanowblog.com/2015/07/30/the-annual-cost-of-autism-continues-to-soar/

 

Special note: Thank you to the families reading this blog. I would like to ask you a favor. Will you please forward this to your favorite Presidential Candidate and ask them to enact their own plan and to call TACA for help.

Extra special note: I would like to thank Holly, Janice, and Jackie for helping me edit this large blog. It takes a village to help families and for over a decade they have been part of mine.