Seeking Help for Autistic Kids

The Oldhams and their two autistic sons are at the center of a debate over whether insurance coverage should be mandated for the costs of treating the disorder.
By Fredrick Kunkle
Washington Post Staff Writer
Monday, February 2, 2009

Gareth Oldham does not look like a child at the center of a growing debate over a childhood disease.

On a cold morning in Leesburg, the autistic 4-year-old scoots around his family's playroom in his bare feet. He hurls himself onto a giant tire swing dangling from the ceiling. He squeals in pleasure as it whirls him madly around. But other than a simple command -- "Push me!" -- Gareth has trouble saying anything at all.

Then his mother, Cassandra Oldham, asks him to say a prayer, the only complete sentence he is able to say. "Dear God, help me. Done," Gareth says in a rush.

His parents, along with many others in Northern Virginia, have their own plea. They have marched on Richmond to ask the Virginia General Assembly to require insurers to cover the cost of therapy for autism. The District of Columbia and 27 states, including Maryland, already do.

The help could would come none too soon for the Oldhams: The youngest of their three boys, Korlan, 2, is also autistic. They estimate that their out-of-pocket bills have hit $50,000 for both boys over two years. Although Bill Oldham, 38, runs a high-tech company that provides very well, they cannot afford the amount of occupational and speech therapy their sons need.

"In some ways, if this bill doesn't pass, we're going to get driven out of this state," said Cassandra Oldham, 36.

The national debate over the explosion in autism cases has arrived in Richmond this year, and the legislation is one of the few bills to draw attention in a session consumed by fixing a $2.9 billion hole in the budget. The measure, which brought about 200 demonstrators to the Capitol grounds last month, has been backed by Democrats and Republicans. Del. Robert G. Marshall, a conservative Republican from Prince William County who is co-sponsoring the bill with a Democrat, said Oldham, a stay-at-home mother, made a strong impression on him.

"She doesn't have enough money to take care of one," he said.

But private businesses, already facing the worst economy in generations, have lined up against another government-ordered mandate that would drive up health-care premiums. Every increase causes some companies, especially small businesses, to consider dropping their policies and leaving employees without coverage, they say.

"It's the cumulative effect of many mandates that we object to and we find damaging to the affordability of health care coverage for small businesses," Hugh Keogh, the Virginia Chamber of Commerce president, said in an interview.

Autism, first identified in the 1940s, is generally regarded as a lifelong disorder that affects a person's ability to communicate and relate socially to others. The Centers for Disease Control and Prevention says autism affects about one in every 150 8-year-old children, about a tenfold increase since the early 1990s.

Many people think of a severely autistic child as seeming locked inside his or her own world. Today, autism diagnoses fall along a spectrum of behaviors. States with autism laws require insurers to cover therapy for children into early adulthood, according to the National Conference of State Legislatures. That means until the age of 19 in Maryland, and 21 in the District.

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