The COVID-19 pandemic has had a profound affect on everyone, particularly children with emotional health concerns. Many support structures in place prior to the pandemic to help children thrive have disappeared or been changed significantly, resulting in increased pressure on caretakers and overwhelming stress for children. New and innovative solutions are needed to meet these challenges. Magellan Healthcare’s Emotional Health for Kids by Mightier is a clinically proven video game solution that helps children build emotion regulation skills through play and caregivers build emotionally healthy homes.

Developed at Boston Children’s Hospital and Harvard Medical School, Mightier helps children ages 6 to 14 who are struggling with emotional health concerns, such as irritability, aggression, and anger, as well as children diagnosed with oppositional defiant disorder, attention deficit-hyperactivity disorder, autism spectrum disorder (ASD) and general anxiety disorder.

Mightier’s impact on children’s emotional health

In a pilot program, Magellan provided members access to the Mightier program for a period of twelve weeks during the COVID-19 pandemic. Families were recruited and randomized into a group that received Mightier in addition to applied behavior analysis (ABA), or a group that received only ABA as a control.

• Children engaged with Mightier at a high rate. On average, Mightier families played for 30.4 minutes above the 30 minutes per week recommended to see clinical change.
• Clinical symptoms improved. Eighty percent of children with ASD who used Mightier showed an improvement on primary symptoms, compared to only 50% in the control group.
• Children showed twice as much decrease in aggressive behaviors. Adding Mightier to ABA resulted in a reduction in aggressive behavior in children with autism by twice as much compared to ABA alone.
• Families reported a less stressful and more supportive environment. Families using Mightier showed 50% improvement in family stress, 114% improvement in parent confidence, and 114% improvement in access to resources relative to control.

Visit  Magellanhealthcare.com/kids-emotions-mightier/ to learn more about the pilot and how Mightier helps children build self-regulation skills and supports caregivers in building emotionally healthy homes.

Even before the COVID-19 pandemic entered our world, the prevalence of mental illness and suicidal ideation in the US was increasing. In 2019, 61.2 million American adults (24%) had a mental illness and/or substance use disorder, an increase of 5.9% over 2018.[1] Depression – a sad mood that lasts for a long time and interferes with normal, everyday functioning – for those under age 50 increased steadily from 2016 to 2019:[1]

• 6% increase among those aged 12-17
• 1% increase among those aged 18-25
• 6% increase among those aged 26-49

From 2009 to 2019, suicidal thoughts, plans and attempts increased among:[1]

• Young adults aged 18-25, 95%, 98.8% and 62.4%, respectively
• Adults aged 26-49, 23.3%, 50% and 24.5%, respectively

Increased stressors brought about by the pandemic – grief and loss, social isolation, financial instability, fear, etc. – have exacerbated the state of mental health in the US. More people from January – September 2020, compared to all of 2019, sought help for anxiety (93% increase) and depression (62% increase).[2] Since COVID-19 began, suicidal ideation in the US has more than doubled, with younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers experiencing disproportionately worse effects.[3]

Recognizing the symptoms of depression

Depression can have different symptoms depending on the person, but in most people, a depressive disorder changes how they function day-to-day, and usually for more than two weeks.

Learn the FACTS:

• Feelings: Being extremely sad and hopeless, losing interest or enjoyment from most daily activities
• Actions: Exhibiting restlessness or feeling that moving takes great effort, having difficulty focusing, concentrating on things, or making decisions
• Changes: Gaining or losing weight due to changes in appetite, changing sleep patterns, experiencing body aches, pain, or stomach problems
• Threats: Talking about death or suicide, attempting suicide or self-harm
• Situations: Experiencing traumatic events or major life changes, having a medical problem or family history of depression

A serious symptom of depression is thinking about death or suicide. If you are in crisis or considering suicide, or if someone you know is currently in danger, please dial 911 immediately.

We encourage you to watch a recording of our webinar, “Depression is more than just a rough patch,” and find additional resources addressing depression at MagellanHealthcare.com/Mental-Health.

Jamie Hanna, MD, serves as the medical director for the Magellan of Louisiana Coordinated System of Care (CSoC) program. She is board certified in Psychiatry and Child and Adolescent Psychiatry. Prior to joining Magellan in 2020, Dr. Hanna served as an assistant professor and assistant training director with Louisiana State University School of Medicine, working with the acute behavioral health unit, and leading the psychiatric consultation-liaison service and emergency psychiatric services at Children’s Hospital of New Orleans. Dr. Hanna completed medical school at the University of Alabama School of Medicine and a subsequent internship in Pediatrics, residency in General Psychiatry, fellowship in Child and Adolescent psychiatry, and fellowship in Infant Mental Health with Louisiana State University in New Orleans.

[1] https://www.samhsa.gov/data/sites/default/files/reports/rpt29392/Assistant-Secretary-nsduh2019_presentation/Assistant-Secretary-nsduh2019_presentation.pdf

[2] https://mhanational.org/issues/state-mental-health-america

[3] https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm

By Caroline Bohn, R.N., Senior Care Manager, Magellan Behavioral Health of Pennsylvania

Millions of Americans suffer with chronic pain issues, every day of their lives. Conditions such as migraines, back injuries, fibromyalgia, or neuropathy, for example, can cause serious, ongoing pain. Ongoing chronic pain can be a debilitating problem for those suffering with it. Dealing with a chronic pain issue can lead to additional problems, such as a loss of pleasure in life, inability to work, poor sleep or depression. People often seek treatment for chronic pain, to be able to live a better life.

We live in a fast-paced world where we can access just about anything, 24 hours a day, 7 days a week. We can shop and order things on the internet at any time of the day or night, or even go to stores that are open 24/7. No longer must we wait for someone to get home and check an answering machine to receive our messages because we can reach out to others in an instant via cell phones, email, texting, and instant messaging. Going to the movie theatre or buying a DVD in the store are almost obsolete. The limitless availability of television and internet streaming services allow us to watch our favorite shows and movies at any time. The ability to get so many needs met instantly, leads us to expect this type of immediate fix for everything in our lives, including medical issues.

It is understandable that people desire immediate relief from pain, and there are many ways in which pain can be treated successfully and alleviated. One option, which people often choose, is the use of prescription pain medication. But the natural desire to relieve pain immediately can cause people to opt for taking pain medication before trying less invasive alternatives. There are many options for treating chronic pain without prescription medication. For example, interventions such as physical or occupational therapy, transcutaneous electrical nerve stimulation (TENS), acupuncture, biofeedback, or cold laser therapy. Wearing supportive braces or orthotics can be helpful with eliminating pressure on inflamed areas. Yoga, weight loss, and therapeutic massage can aide in reducing muscle and joint pain. Mind-body techniques are also effective methods to address pain, such as meditation, mindfulness, progressive muscle relaxation, and deep breathing exercises. To clarify, the use of prescription pain medication is not an inappropriate choice, but it is wise to explore other options as well. Pain itself, is not a disease. Pain is a symptom or signal used to alert us that something is going wrong within the body. Use of medications to eliminate the pain signal, is not helping fix the problem that is causing the pain. The first step to solving a pain issue is to identify and address what is causing the pain so you do not have to experience pain in the first place. There are situations where it is not possible to eliminate the source of the pain completely, but in cases like these, there could be treatments available to lessen the severity of the pain, so it is manageable with less medication or without the use of medication at all.

Regular use of prescription medication to alleviate pain could cause other issues to arise, even when a medication is appropriately prescribed by a physician and taken according to the physician’s orders. Unfortunately, it is possible for your body to become dependent on certain types of prescription pain medication. Dependence on pain medication is evident when an individual experiences symptoms of withdrawal when taking less of the medication or stopping it altogether. If a person feels they must continue taking pain medication to avoid experiencing withdrawal when not taking it, this could indicate that their body has become dependent on it. If this occurs, a consultation with your physician to discuss next steps is essential.

There are different classes, or types, of pain medications which can be prescribed by your physician. One of these types, called opioids, has a greater risk for dependence than other types of prescription pain medication. If your body becomes dependent on opioid pain medication, it can be difficult to stop taking it. Opioid pain medications have a higher risk for causing withdrawal symptoms when discontinued than other types of pain medication. People could experience nausea, vomiting, sweating, feeling excessively hot or cold, or muscle aches throughout their body, when taking less of or stopping the opioid pain medication. If this were to happen, alerting your physician is crucial. Your physician can assist you with safely discontinuing an opioid pain medication, so you do not have any withdrawal symptoms. If you do not feel comfortable telling your physician you may be dependent on opioid pain medication, there are other ways to seek help. If you have access to the internet, you can visit the SAMHSA website (https://www.samhsa.gov/find-treatment) to get education and information about seeking help with opioid pain medication dependence. If you do not have access to the internet, SAMHSA offer a toll-free helpline as well (SAMHSA’s National Helpline: 1-800-662-HELP (4357).

There is nothing wrong with seeking help when your health is at stake. Reaching out to a trusted family member or friend, to ask for their help, is also a great way to start on the road to your recovery. Above all, it is important to remember that maintaining your physical health and well-being, is crucial to living your best life.

Over the past year COVID-19, community protests and increased social awareness have highlighted the impact of racism on the mental health of Black, Indigenous People, and People of Color (BIPOC). On April 8, 2021 Rochelle Wolensky, director of the Centers for Disease Control and Prevention, said that racism, “directly affects the well-being of millions of Americans. As a result, it affects the health of our entire nation.”

Magellan Healthcare is committed to increasing awareness about BIPOC mental health, wellness, and the importance of recognizing and addressing concerns. Learn more about racism and mental health.

Racism is a mental health issue because racism causes trauma. Racial trauma is the ongoing result of racism, racist bias, and exposure to racist abuse in the media and everyday life. Racial trauma can affect many aspects of a person’s life, including their ability to have relationships, focus on school or work, and feel safe. People who experience racial discrimination and injustice can develop trauma that causes anxiety, chronic stress, depression, and other mental illnesses.

How racism affects mental health

For those who are affected by racism, it is important to remember that you are not alone. The push for social change is strong and there are many things you can do to protect your mental health during this time.

4 things you can do for your mental health

The following strategies can help you gain a sense of strength, build resilience and stay healthy.

Share your feelings—It is normal to be angry, to feel hopeless, to cover up your experience of racism, or to pretend that it has not affected you. Talking about your feelings is not a sign of weakness, but part of taking charge of your well-being and doing what you do to stay healthy. The simple act of talking to someone who makes you feel heard and understood can trigger hormones that calm the nervous system, reduce stress, and relieve the symptoms of depression and anxiety.

Embrace your ethnicity and culture—Racism is often used as a weapon to belittle you as a human being and lower your self-esteem. You can counteract this and help deflect the pain of racism by developing a strong sense of your ethnic identity and strengthening your attachment to the community. Closer ties with people who share your experiences can help reduce the sense of isolation that often stems from racism.

Channeling your anger—No matter how justified your anger is, venting it uncontrollably will affect your judgment, reduce your chances of being heard, and negatively affect your health. Use your anger and channel it in a constructive way to bring about meaningful change. Join a community or activist group, engage in creative activity, or create a journal.

Take care of yourself—Because your body and mind are so closely linked, it is important to take care of yourself in times of overwhelming stress. You can improve your mood and your health by moving your body every day, learning ways to reduce stress such as deep breathing, making nutritious food choices, focusing on getting enough sleep, and finding a safe place to rest and recharge.

There are no easy answers to dealing with the pain of racial trauma. To move forward we need to take care of ourselves and our communities. We invite you to visit MagellanHealthcare.com/BIPOC-MH to learn more about Magellan events and other resources that are available to the public for BIPOC Mental Health Awareness Month and to like and share our contributions on social media.

Sources: Mental Health America, HelpGuide.org, Medical News Today, Mentalhealth.org.uk

Read more about mental health topics.

Many of us can now say we have experienced the trials and tribulations of parenting during a pandemic. We have attempted to juggle full-time work and regular household duties, along with being a full-time teacher or daycare worker and entertainer for our kids. While we’re all doing the best we can in taking on these new and challenging roles, some parents and caregivers may be wondering about their child’s mental health after they have missed out on so much and dealt with new stress and uncertainty – certainly as many of us know that our own mental health has been affected.

If you’re worried about your child’s mental health or noticing any issues, read on for tips and knowledge shared by Magellan’s Linda Y. Evans, MD, FAPA, child psychiatrist and medical director, and Greg Dicharry, CPRP, youth empowerment director.

Children behavior changes

Changes in your child’s behavior may be a sign of mental health difficulties that should be closely monitored. Depending on the age of your child, stress can manifest in different ways. Toddlers and young children aged 2-6, may show signs of regression and lose the ability to do things previously learned, like toilet training. School-aged children and teenagers may show a disinterest in going to school and/or begin to see falling grades. The most common symptom in teenagers is irritable mood. Kids of all ages may experience vague body complaints, like a headache or belly ache, changes in sleep or appetite, difficulty concentrating, loss of pleasure in activities previously enjoyed, and withdrawal from social interactions.

Often, even the child may not recognize these symptoms as the result of mental health issues. It is important for parents and caregivers to be a barometer for behavioral or other changes in their children – as they may be the first to notice – to be able to identify if their mental health may be suffering. When parents keep the lines of communication open, allowing their kids to share their thoughts and feelings, they are better equipped to identify any troubling signs of childhood depression, anxiety or other mental health conditions.

The child’s primary care physician (PCP) also plays a role in screening for mental health concerns and can be a good first point of contact if parents are seeking additional help. With the shortage of child psychiatrists and mental health professionals trained to work with children in our country, PCPs are increasingly adopting a model of collaborative, or whole-person, care to screen and treat children for mental health issues before they get worse because of potentially waiting long periods to see a specialist.

Interrupted school and family routines

While there’s not much we can do about changing work, school and social arrangements due to the pandemic, it’s important to consider the stability of our kids’ environment and instill predictability in their lives to the extent that’s possible.

Additionally, there are many things that parents and caregivers can do to keep their kids content and engaged amid the chaos and unprecedented change we’re all experiencing. To make up for lost in-person social time with friends and family, virtual meetups can be scheduled. That could be a fifteen-minute Facetime call with grandma and grandpa every Wednesday night at 7:00, or a periodic Zoom/interactive video game gathering with friends. Parents can also take time with their kids away from the screens to play a board game or do a project to make home-time more fun. Exploring and supporting your kids’ passions is a way to get them involved in activities that will bridge the gaps of interrupted routines and help prevent negative mental health outcomes.

Family stress affecting children

We have all been affected by the drastic changes, uncertainty, loss and isolation caused by COVID-19. And it’s not hard for our own stress and worry to be noticed or even absorbed to some extent by our kids. While we’re focusing on our family’s well-being, it’s important to practice self-care and recognize that our own mental health is of paramount importance. Having healthy caregivers is an essential component in the normal development of kids.

When parents are navigating divorce and co-parenting arrangements during COVID-19, it can be even more difficult to filter out the negativity for our kids, especially when parents have different points of view about things like in-person vs. virtual learning, the vaccine and mask wearing. Although it can be difficult to share your kids with an ex-spouse, it’s important to remember they need both of their parents. When parents work together for the benefit of their children and keep the focus on them, the impacts of divorce can be mitigated. Implementing a flexible custody arrangement during COVID-19 is also encouraged; for example, if the child wants to see a parent when it’s not their day for visitation, it might be beneficial to the child to honor their request.

To alleviate stress and some of the burden, parents and caregivers can consider connecting with others who understand the struggles and support each other. They can look for parent support groups in their communities.

Back to school and bullying

For kids who experience any level of social anxiety, the transition back to school, or even a new school, from the comfort of home may be more difficult. While some kids may be happy to get right back to the in-person learning environment, a gradual adjustment may work better for others.

Teachers can be especially helpful in ensuring that children are adjusting well and that a child withdrawing from the group is noticed. When the teacher has a trusting relationship with students, they can initiate conversations to try to understand how a child is doing and if their emotional needs are being met. The teacher’s insights are critical for parents and caregivers who cannot be with their kids at school.

Parents and teachers should be especially sensitive to look for bullying and have a zero-tolerance policy for kids being cruel to one another. Children must understand that bullying is unacceptable, as it can lead to serious and disastrous consequences for those who are targeted.

In general, what kids need for healthy development is a stable routine, predictability, a safe environment and healthy parents or caregivers. COVID-19 has disrupted all of these conditions, leading to increased mental health disorders and interrupted development. There are many things that parents and caregivers can do to nurture their child’s mental health and address what they need for healthy development. We encourage you to explore Magellan’s following resources for additional information and support:

• Mental Health Month website for comprehensive tips and resources to support yours and your family’s mental health.
  • Be sure to check out the recording of our webinar, How are your kids doing? under “Previous events”
• Understanding and Meeting the Needs of Children and Adolescents at High Risk: Foundations of a Model clinical monograph highlighting evidence-based research on the prevention and treatment of problematic behaviors and various types of behavioral health challenges in children and adolescents.
• Stay Home for MY LIFE virtual youth fest, featuring inspirational speakers, uplifting entertainment, fun activities and more, taking place on the 4^th Thursday of each month, from 6:00 – 7:30 p.m. ET, for youth and young adults who have experience with mental health, substance use, juvenile justice and foster-care-related issues, as well as professionals and caregivers across the country.

In January 2021, the United States (US) Food and Drug Administration’s (FDA) Center for Drug Evaluation and Research (CDER) published Advancing Health through Innovation: New Drug Therapy Approvals 2020. This report provides a summary of a number of approvals and highlights the novel therapies approved in 2020, continuing the generally upward trend in approval volume seen over the past decade, despite the impact of coronavirus disease 2019 (COVID-19). Compared to 2018 and 2019, in which CDER approved 59 and 48 new drugs, respectively, 53 novel agents were approved in 2020. This number does not include new and expanded uses of already approved drugs, new formulations, new dosage forms, vaccines, blood products, cellular or gene therapy, or biosimilar approvals. Once again, the number of approvals exceeded the average of 41 novel approvals per year in the past 10 years. Figure 1 outlines approvals over the past 10 years.

Despite the ongoing pandemic the FDA continued their strategic initiatives to expedite the safe review of treatments in 2020. With the unprecedented challenges incurred in 2020, the FDA acknowledged that maintaining their commitment to bringing forth innovative therapies was difficult. Remarkably, the numbers reported by the FDA do not include the several emergency use authorizations (EUAs) issued by the FDA for COVID-19.

Last year, all 53 novel drug approvals again met their Prescription Drug User Fee Act (PDUFA) goal dates, cementing this as a priority for the Agency. In 2020, 40% were considered first-in-class, and 58% were approved for rare diseases (Orphan Drugs), the latter of which increased from 44% in 2019. Priority Review was granted to 57% of novel drugs, 23% received Accelerated Approval, 42% were designated as Breakthrough Therapy (up from 27% in 2019), and 32% garnered Fast Track designation. Overall, 68% of all drug approvals in 2020 used expedited development and review methods. In addition, 92% were approved in the first review cycle, and 75% were approved in the US prior to receiving approval in other countries. A breakdown of the types of drugs approved in 2020 is illustrated in Figure 2, with agents within the oncology spectrum representing over one-third of 2020’s novel approvals.

The notable 2020 approvals encompassed new advances for the treatment of infectious diseases, including a new medication class for the treatment of human immunodeficiency virus-1 (HIV-1). Garnering perhaps the most attention, the FDA also approved the first medication for hospitalized patients with COVID-19. Unique infectious diseases in the US also received attention, with a new drug for malaria, two new options for the Ebola virus, and a new treatment for Chagas disease approved in 2020. In the neurology arena, there were multiple approvals of agents for more common conditions, such as migraine or Parkinson’s disease. Moreover, there were significant advances for rare neurological conditions, including the first oral agent for spinal muscular atrophy and new treatments for rare seizure disorders. In addition, two immunological agents were approved for the treatment of neuromyelitis optica spectrum disorder. Additional treatment options emerged for several autoimmune conditions in 2020 as well. Not surprisingly, numerous advances were made within the oncology umbrella, including both novel approvals and new or expanded indications for several existing agents. With over half of the novel approvals being classified as Orphan Drugs, in 2020, the FDA has fortified their dedication to providing innovative and often targeted treatment options for all individuals.

Mental health is an important part of our overall health and well-being. While mental illness is incredibly common, two-thirds of Americans do not actively seek help or receive the proper treatment¹.

Plenty of treatment options are available to help patients with mental illnesses, but navigating care can be difficult. It is also important to consider the social and physical factors rather than focus only on mental health symptoms because mental health and physical health are directly related. This is why a behavioral health care manager’s role is essential. They provide care for the whole patient and ensure that treatment plans focus on health, wellness, and preventive care.

Here are five key ways care managers are helping guide patients to better mental health:

Coordinating Care
Care managers are typically nurses, clinical social workers, or licensed counselors who take a holistic approach to mental health. They work collaboratively and alongside physicians, nurses, providers, and other medical staff to ensure more continuity of care for patients. “Getting people to the right place is really our number one goal,” says Michael Adamson, LCSW, manager of clinical care services at Magellan Rx.

Preventing Escalation
If not treated properly, mental illnesses can lead to emergency room visits, hospitalization, or suicide. Care managers can help mitigate this risk by helping patients maximize their existing benefits for mental health and medical care. “If we can intervene before they think of suicide or before they need the hospital, that benefits everybody,” states Jordan Johnson, LMFT, senior care manager for Magellan Rx.

Checking In and Following Up
After a doctor visit or being discharged from a hospital, a patient may be feeling overwhelmed. Care managers check in on patients, make sure they understand their treatment plan, and eliminate gaps in care. “If I have a member who is discharged without a care plan, the member says, ‘I’m so glad you called, what do I do now?’” discloses Silvia Pantoja, senior care manager.

Supporting Parents and Caregivers
Depression and mental illness have increased over time in children and teens. Care managers not only help individual patients, but they can also support and provide resources for parents or their caregivers.

Education and Resources
Care managers help patients learn about all the resources and educational materials available to them. Especially during the COVID-19 outbreak, members need to rely on resources they are not normally used to. Care managers help find virtual care, online support groups, mail-order pharmacies, online resources, and more.

¹ National Network of Depression Centers. Get the Facts. Retrieved July 21, 2020 from https://nndc.org/facts/

In light of recent events, Yagnesh Vadgama, BCBA, vice president, clinical care services, autism, Magellan Health, shared his perspective about how COVID-19 and racial and ethnic disparities may be combining to delay diagnosis and important early treatment for autism spectrum disorder in children.

 Magellan Health Insights: Yagnesh, thank you for chatting with us today. In the past there have been marked differences in the rates in which Black and Hispanic children are diagnosed with autism spectrum disorder (ASD). Why was that?

 Yagnesh Vadgama: For years, there was a disparity in the rates of ASD diagnosis of Black children versus White children – as recently as 2014 White children were 1.1 times more likely to be diagnosed with ASD by age 8. And in the 1990s, Black children were identified as having ASD later and were more likely to be diagnosed with conduct disorder or adjustment disorder than were White children. For the first time, the CDC has reported that this gap has closed as of 2016 for Black children, which is encouraging news, but was not the case in every state studied.

And, a gap still exists for Hispanic children. White and Black children were 1.2 times more likely to be identified with ASD than Hispanic children. Reasons for this difference include lack of access to healthcare services, differences in Medicaid vs. commercial insurance coverage of ASD services, parents and children speaking a primary language other than English, and potentially fear of seeking out care because of one’s immigration status. It’s still the case that Hispanic and Black children receive evaluations at a later age than White children. Often, children with Medicaid don’t get diagnosed until they begin attending school.

Magellan Health Insights: Why does age of evaluation and diagnosis matter?

 Yagnesh Vadgama: With ASD, time is of the essence. The earlier we get kids into services, the better the health outcomes are going to be. If an individual gets treatment early, there is less risk of developmental delays becoming permanent. A recent University of California San Diego study indicates children should receive ASD services as early as 18 months. During this time, the brain is able to acquire new skills at an earlier age. Also, as individuals get older, they are more likely to develop a comorbid diagnosis, so it’s important to begin services prior to the onset of other comorbidities.

 Magellan Health Insights: How might COVID-19 be affecting the age at which children are being evaluated?

 Yagnesh Vadgama: People are avoiding nonurgent care. Utilization rates of elective services have plummeted. Also, since school is the first place many children get evaluated for ASD, that may not happen with schools closed or moving to remote learning. And since many individuals’ health insurance is provided by their employers, many newly unemployed individuals may not be able to afford COBRA premiums and may lose coverage. Time is of the essence, and delays may have long-term or permanent effects.

 Magellan Health Insights: What can healthcare providers do to help ensure early, accurate diagnosis?

Yagnesh Vadgama: Healthcare providers should conduct early and frequent screenings as recommended by the American Association of Pediatrics. But, as important, providers should make appropriate recommendations for follow-up care and really help parents understand the next steps. They need to create a sense of urgency for follow-up care – encourage parents to act now, not to sit on it, see someone now. Then follow up with additional testing and screening on subsequent visits, because ASD can evolve over time. But never use a “just wait and see” approach, because time is of the essence.

Magellan Health Insights: What can parents do to help ensure a correct, early diagnosis if they have concerns?

Yagnesh Vadgama: Understand developmental milestones for your child’s age and the signs of ASD. Speak up about your concerns, especially where a child has a hearing impairment or an intellectual disability – because both situations could lead to a later ASD diagnosis. Be your child’s biggest advocate and ask about concerns and next steps.

One of the beautiful things is that in all 50 states, there is a mandate that commercial insurance carriers provide autism coverage. Covered members now have access to screenings, psychologists, developmental pediatricians and services that weren’t available when I began practicing over 16 years ago. And keep pushing until you get the care that best meets your child’s needs. Don’t wait!

Magellan Health Insights: We couldn’t agree more! Thank you, Yagnesh!