Q: I'm struggling with how to decide how much treatment to get for my preschooler with autism. He's doing well in a special autism classroom in public pre-K, and he gets one form of therapy (applied behavior analysis), which is covered by insurance. I'm looking at a possible summer program that would be intensive daily speech therapy and occupational therapy — both treatments he really needs. He currently gets occupational therapy once a week through insurance and speech therapy at school, but he has been on the wait list for an insurance-approved speech therapist for months. The summer program will cost around $5,000, and insurance won't pick up any of that. The alternative is spending those six weeks in summer school, which is free. How do you make this sort of spending decision? If we truly couldn't afford it, that would be a simple answer, but we could. It would take careful budgeting, though. He's doing well with current treatments (developing language and classroom skills), but all the research seems to say that age 4 is prime language-learning time. I'm really torn.

A: Thank you so much for writing; so many parents struggle with finding the appropriate diagnosis and treatment for their children, and you are not alone in trying to make it all work without bankrupting your family.

In a perfect world, children would receive the best treatment options without parents taking out second mortgages, but let’s deal with reality. We need to find a way to get your son into this summer camp. Why? As every specialist in autism will tell you: Timing is important. We want your son to get the best treatment as soon as possible because early intervention is proven to make a huge difference for children.

The National Institutes of Health says that “early interventions occur at or before preschool age, as early as 2 or 3 years of age.” It’s during this time that a young child’s brain is still forming, which means it’s more changeable than older children’s. Therefore, treatments have a better chance of making more of an impact.

Because you already have your preschooler in applied behavior analysis, you know the importance of early and frequent interventions for children with autism.

With that in mind, you need to get creative about this summer. If the camp is vetted, the specialists are top-notch and other specialists recommend it, I am going to encourage you to do some “careful budgeting” and make this happen.

You may also be able to fight your insurance company for some coverage.

To help me understand how to navigate this endless and confusing system, I turned to Jen Dryer, an educational consultant, parent advocate and mother of two grade-school boys, one of whom is on the autism spectrum. She specializes in helping parents and teachers navigate the services that their children may need.

“This is indeed prime time to front-load as much brain development support as possible to help him bridge the language gap with his age-level peers,” Dryer says. Although the price of the camp is daunting, Dryer has a couple of ideas:

1. Check to see if the camp has a sliding scale or partial scholarship.

2. Ask if the camp can break down the occupational therapy and speech support into invoices and for resources to submit to insurance. (You will need the group therapy codes.)

3. Check into Medicaid funding for individuals with autism. Dryer warns that it is a lengthy application process but says that it’s still worth it.

Whatever happens this summer, you sound committed to helping your son reach his fullest potential, and I am sure that whatever path you take, it will be the best for your son. For more resources, I find the Autism Society website (autism-society.org) to be very helpful.

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