Autism spectrum disorder (ASD) is a complex neurological disorder characterized by impairments in three core areas:

• Social interactions
• Verbal and non-verbal communication skills
• Repetitive, stereotyped, and restrictive behavior

• The causes are still unknown
• Current research suggests that there may be a genetic predisposition and an environmental trigger

• The CDC estimates that ASD now affects 1 in 59 children; as of 2018
• It is four times more likely in boys than girls
• It affects all races and nationalities

No, there is not. The FDA warns against therapies/products that make improper claims about a treatment or cure for Autism or Autism-related symptoms. Quick tips for identifying false or misleading claims include:

• Avoid products that claim to treat a wide range of diseases
• Scientific evidence should be trusted over personal testimonies
• Be suspicious of therapies that claim a quick fix, as very few conditions can be treated quickly
• So-called “miracle cures” which claim scientific breakthroughs may be a hoax

Autism is truly a spectrum. No two people with Autism have the same strengths or challenges, and their challenges can vary from mild to severe. Individuals who are mildly affected may have behaviors that resemble a learning disability, but often have handicaps in the areas of communication and socialization.

Common deficits include but are not limited to:

• Limited play and leisure skills
• Difficulty with emotional regulation and inhibition
• Poor eye contact
• Difficulty imitating others’ movements or facial expressions
• Difficulty with initiating and sustaining conversations
• Does not respond when called by name
• Appears disinterested or unaware of others in the environment
• Difficulty communicating needs or desires
• Difficulty following instructions
• Does not pick up on facial expressions, tone of voice and/or gestures
• Reacts unusually to sensory information (e.g., sights, smells, tastes, sounds)

Common behavioral excesses can include:

• Repetitive language or motor movements (e.g., hand flapping, rocking or repeating lines from a TV show)
• Tantrums
• Self-injury
• Aggression
• Rigidity with routines
• Difficulty adapting to changes (e.g., tantrums when taking a different route to school)
• Fixation with narrow topics of interest (e.g., memorizing and reciting facts about trains)

ASD usually appears in the first 3 years of life. Sometimes signs will emerge and be diagnosed as early as 18 months.

• Developmental Pediatrician
• Neurologist
• Psychologist

There are currently no known biological markers for Autism. Instead, specially training physicians and psychologists administer Autism-specific behavioral evaluations.

Monitor your child’s development by taking notice of when or if your child is hitting key developmental milestones. Keep in mind however, that every child develops at their own pace. Failure to meet developmental milestones does not necessarily indicate that they have Autism, but it is important to share your concerns with your child’s doctor.

• Applied Behavioral Analysis
• Speech-Language Therapy
• Occupational Therapy
• Physical Therapy

An ABA program should be overseen by a Board Certified Behavior Analyst (BCBA). BCBAs are specially trained to develop, implement, and manage ABA cases. ABA is very technical – it is important that the person in charge of ABA treatment is qualified.

The person who provides direct services will be trained and overseen by a BCBA. They are responsible for carrying out the behavior and treatment plans developed by the BCBA. It is ideal but not required for the person providing direct services to be a Registered Behavior Technician (RBT). It’s common for people to join this area of work at the direct level with little to no experience. It is very important that they a) receive ABA-specific training prior to working with a client, and b) complete extra workshops and training to build their skills.

ABA sessions will look different for each child. Skills may be taught in both structured and unstructured environments (e.g., skills can be taught at a table, on the floor, outside, and in the community).

Parental involvement is a crucial part of ABA. The BCBA should provide ongoing parent training and support to ensure that each family is able to understand and utilize ABA strategies with their child outside of structured sessions. These trainings may include lecture/power point training, role play, modeling of behavioral techniques, and formal feedback.

Thanks to the Act Relative to Insurance Coverage for Autism (ARICA) law passed in Massachusetts in 2010, all private insurance carriers must cover the diagnosis and treatment of Autism. MassHealth followed with a similar service policy update in 2015. Unfortunately, ABA is not covered to treat conditions outside of an Autism diagnosis.

Yes! DPH manages a small number of Specialty Service Providers (SSPs) in the State that provide ABA services as part of EI, but families always have the option of using their insurance to secure more intensive ABA services on their own.