With the start of Autism Acceptance Month in April, Senior Manager of Clinical Care Services Cara Albanese is focused on creating innovative and inclusive ways to better serve the needs of individuals with autism spectrum disorder (ASD). Albanese, who has been with Magellan for over six years, oversees the Applied Behavioral Analysis (ABA) operations in the California markets, including ABA Services for some commercial accounts. As manager of a team of eight employees, Albanese and her team review treatment plans and work directly with ABA providers to ensure adherence to the main objectives for their membership and that treatments align with the Magellan Health standards that provide members with the best care possible. Continue reading to learn more about what innovative programs and new initiatives for individuals with ASD Albanese is working on:

What sort of projects are you currently working on?

We started piloting a value-based model for ABA in October in our California market. Magellan is pioneering this type of program for ABA services. Now we are working on evaluating the findings to establish evidence-based practices and drive outcomes-based programs across the ABA industry. Implementing this program will allow us to evaluate treatment planning and delivery to continuously improve care for children with ASD and help the families who care for them.

What are your thoughts on the culture here at Magellan? How does that culture make Magellan the best place to do these innovative projects?

Magellan has a very strong culture of innovation and values our members’ satisfaction. We’re always looking to grow the field and improve data-driven outcomes for our membership. At Magellan, we continue to expand our knowledge and look at autism services across the industry as we continue the growth of our department. We work with a multidisciplinary team giving us insights from a variety of medical professionals. Being able to work with a variety of medical professionals ensures that our members are receiving the best care, as we can provide a holistic and prudent approach to care. Our clinical leadership at Magellan creates a supportive and collaborative environment to think outside the box and increase innovative thinking.

What does Autism Awareness and Acceptance Month mean to you?

The prevalence of autism has continued to rise to a rate of one in 36 children in the United States. Most individuals know someone who has autism or some experience with someone diagnosed with autism. This increased awareness allows us to start to support this population as a community. We can do this as clinicians by modifying and changing the science around ABA to support the current needs of the ASD population and their families. We can continue to increase inclusivity of children and adults with ASD, as they may learn and engage differently. Everyone should be embraced for their individual abilities.

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.

According to the CDC, 1 in 54[1] children is diagnosed with autism spectrum disorder (ASD), with some states reporting 1 in 32[2] children receiving a diagnosis.¹ One of the most common treatments for ASD is Applied Behavior Analysis (ABA), a therapeutic intervention that helps individuals with autism:

• Improve communication, social, daily living and motor skills
• Maintain positive behaviors
• Transfer skills and behavior from one situation to another

Because ABA is a newer treatment than psychotherapy and other therapies, limited academic literature exists to support providers in effective decision-making for intensity and length of care. In addition, treatment plans are individualized and require extensive monitoring with heavy reliance on caregivers, nearly 50%[3] of whom need help managing emotional and physical stress. This makes it difficult for families to gauge treatment effectiveness and contributes to the rising costs of mandated ASD treatment. In fact, according to the CDC, in addition to medical costs, intensive behavioral interventions for children with autism cost $40,000 to $60,000 per child per year.[4]

A shift from fee-for-service models, in which ABA providers are compensated for each procedure, test, treatment, etc. performed, regardless of whether they lead to better outcomes for the patient, to value-based care models that link payments for the provision of services to the quality of services provided and reward providers for efficiency and effectiveness, can help address these challenges and deliver stronger clinical outcomes when the models:

• Emphasize efficacy—Value-based ABA care models should define benchmarks that determine when the maximum benefit of ABA services has been achieved, measure progress against the benchmarks and empower providers in the decision-making process to ensure that intended outcomes are achieved during ABA treatment and beyond.
• Improve member engagement—It is essential that providers and caregivers work together as a team. By participating in regular discussions with providers on progress trends barriers, and ongoing assessment, caregivers are empowered to understand the overall direction and impact of ABA services and how their active participation in their child’s treatment planning and delivery has a strong impact on outcomes.
• Drive-data-informed decision-making—From the onset of ABA services, behavior analysts should set targets or specific behaviors selected for change based on skills assessments. Progress toward these targets should be monitored, analyzed for trends, and continuously discussed with caregivers. This high-engagement, data-informed process drives decisions on the next steps for ABA services, including whether to continue or slowly reduce the number of therapy hours, and enables providers and caregivers to select and use clinical services that will meet children’s needs.

Visit here to learn about Magellan Healthcare’s value-based collaboration with Invo Healthcare to define standards of care for children with ASD undergoing ABA treatment and improve ABA outcome

[1]https://www.cdc.gov/ncbddd/autism/data.html

[2]https://worldpopulationreview.com/state-rankings/autism-rates-by-state

[3]https://www.workforce.com/news/working-parents-finding-support-for-their-special-needs-children

[4]https://www.autismspeaks.org/financial-resources-autism-help

About 1 in 54 children in the U.S. has been diagnosed with autism spectrum disorder (ASD), according to estimates from the CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network.[1] Getting an ASD diagnosis is a life-changing event for families that can trigger feelings of panic, fear and distress. You may be uncertain or confused about what to do next and how to navigate your new reality. Here are tips to help you and ensure your child lives their best life.

Do your homework—Learn everything you can about ASD and how it may affect your child throughout their life, including the laws and rights that you and your child have under the Individuals with Disabilities Education Act. The knowledge you gain will help you be an effective advocate for your child.

Become a voice for your child—As a parent, you are your child’s first, strongest and lifelong advocate. No one knows your child better than you do. You are the best qualified person to shape your child’s situation in the most caring way and speak out when it comes to their well-being and ensuring that they have the supports they need to flourish.

Seek help—The autism community is full of parents and professionals willing to help others in their ASD journeys. Allowing others to help can lighten your load, help you become a better advocate and protector for your child, and make the sometimes difficult journey more enjoyable. Seek out support groups, teachers, therapists, social workers and others for help.

Give help when you can—If you can, helping other parents on their ASD journeys can help you to put things in perspective, feel more positive about your own circumstances and create a sense of belonging. Helping others has shown to lower levels of stress and anxiety, which improves overall well-being.

Express yourself—As human beings, we need connection. Sharing your feelings with someone you trust, such as your partner or spouse, parents and/or siblings, can be liberating and go a long way in deepening your relationships, and improving your physical and mental well-being, making you a better person, parent and family member.

Make self-care a priority—Spending most of your time caregiving can quickly lead to burnout. Proper hydration, a healthy diet and sufficient sleep can help you cope best with daily challenges. Finding time for activities that are fun and fulfilling, such as going to the gym, going for walks and meeting friends, can help you recharge and be the best parent you can be.

Find the right providers—While it is important that your child’s providers use evidence-based practices and keep abreast of treatment options, it is also important that they are culturally aware and respect your ideas and traditions. Each cultural group has its own customs, thoughts and taboos regarding physical and mental health care. Find a doctor who not only speaks your language, but is also sensitive to your cultural, religious and personal beliefs.

Foster healthy eating habits—Children with ASD often experience issues such as insomnia, eczema, constipation, diarrhea, behavioral outbursts and more. If your child has any of these issues, you might want to see if it is a reaction to foods that are not good for their system or if their intestines are out of balance. Healthy eating habits can make a big difference in the lives of children with ASD.

Nurture your child’s strengths—Children improve faster when they work on strengths. Focusing on your child’s strengths, not weaknesses, puts them on the path to their personal best, allows them to develop and excel in things they’re good at, and can greatly improve their self-esteem and well-being. It can also foster a better parent-child relationship.

Magellan Healthcare is committed to improving all lives affected by autism. Visit our Autism Awareness website here for free resources that increase awareness, celebrate differences and support inclusion.

Read more Autism content from Magellan Health Insights

[1] https://www.appliedbehavioranalysisedu.org/top-10-awesome-things-about-being-on-the-autism-spectrum/

Every April, we recognize National Autism Awareness Month, which focuses on spreading awareness, improving understanding and promoting acceptance of autism spectrum disorder (ASD). Most of us are aware of the challenges families impacted by ASD may face throughout their lives. Research studies, media reports, social media and events help us keep up to date. But do we really think about the many amazing positive qualities people with ASD possess?

Traits that make people with Autism Spectrum Disorder awesome people, friends and coworkers

• Creative—People on the spectrum look at the world differently and process information in a unique way, making them independent and creative thinkers who can visualize solutions to problems that others may not see.
• Detail-oriented—People on the spectrum are highly attuned to detail. Little things that most of us might overlook, such as spelling or punctuation, stand out to individuals on the spectrum. They take note of specific details such as colors and names and remember directions.
• Honest—Many people with ASD are often black-and-white thinkers, so it makes no sense to them to lie. They are not afraid to tell us what they really think, but they tell the truth quite openly and accurately reflect their feelings, whether positive or negative.
• Non-judgmental—Because of their black-and-white thinking, people with ASD rarely compare others to any set of standards or expectations. Therefore, they are more likely to accept differences, see us as we are and not expect us to change.
• Passionate—Many people with ASD have a wide range of interests and are extremely impassioned about the things, ideas and people in their lives. They pursue interests with 100% of their energy and research obsessively until they have a deep understanding of the subject. They spend the time, energy and imagination needed to really master their interests and stick with things through difficulties and frustration.
• Reliable—People with ASD appreciate routines. Once a routine or rule is set, you can rely on them to follow it precisely. If it is on the calendar, you can be sure they will be there and arrive on time.

Keeping an eye on the positive characteristics of people with ASD is key to promoting wider acceptance. Help your family, friends and others learn why they are amazing and special by sharing this blog post.

To learn more about Magellan Healthcare’s work with Autism Spectrum Disorder, click here. 

Sources:            

• https://www.appliedbehavioranalysisedu.org/top-10-awesome-things-about-being-on-the-autism-spectrum/
• https://autismawarenesscentre.com/the-positives-of-autism/

April is Autism Awareness Month and another opportunity to promote inclusion and self-determination for those on the autism spectrum. Like many impacted by this challenging disorder, my family has our own story and my hope is that by sharing it, we can help others.

Our now nine year old son, Vaughn, was diagnosed with autism at 18 months. A mere 13 months younger than his typically-developing sister, my husband and I could tell that something was not quite right with our son. Vaughn wasn’t walking or talking and was overly-obsessed with anything that spun. He wouldn’t make eye contact with people and wasn’t motivated to engage with our family. It was both scary and heartbreaking and we knew we needed to do something. Little did we know how much our next steps would change, and continue to shape, our lives.

Artwork by Vaughn

The day we were given the diagnosis was one of the hardest days of my life. I worried about my son’s future and whether he would ever learn to communicate his needs, make friends or even live independently. As a mother, you want those things for your children and you worry when the future path isn’t clear. Thankfully my husband and I parked our tears and bonded together to do everything we could to change the trajectory of Vaughn’s life. We quickly immersed ourselves in learning all we could about this complex and wide spectrum disorder, discovering just how important it was to intervene early and often for the biggest impact. And we did just that; fully determined, we dove in and never looked back.

While most children were enjoying the freedoms of exploration and play, Vaughn was working as many as 35 hours a week for years on things that would seem so simple to some—things like learning how to speak and shape sounds, how to play appropriately with toys and even how to properly engage other children and people. My husband and I often marveled at how hard Vaughn worked and how little he complained. However, as parents, we often struggled to strike the balance between being therapists consistently executing interventions and being just a regular mom and a dad to both of our children.

Fortunately, and with the help of many wonderful people and organizations, we were able to effectively navigate the system and provide Vaughn with comprehensive services and support, some of which he still receives today. Vaughn is in a typical classroom, participating in typical activities and has many friends. He is a talented artist with a creativity and sense of design well beyond his years. And, most importantly, he has a loving and supportive big sister that celebrates his success, despite the years of being in her brother’s autism shadow. We are fortunate.

In an effort to honor those that have helped us and to give back to our community, I have joined the board of directors at Arizona Autism United as they have played, and continue to play, a key role in Vaughn’s treatment and success. It is my goal to do whatever I can to support this organization that has done so much for my family and share what we have learned to help other families struggling with autism in our community.

I’ve said it a million times, and will say it again. If I could go back in time to the day Vaughn was diagnosed and change things, I wouldn’t. He is such a special and creative person that has positively shaped how our family sees the world. Our journey has made us who we are and we are grateful for the lessons we’ve learned and the people we’ve met along the way. This Autism Awareness Month, take the time to learn more about autism and what you might be able to do to help those in your own community.

April marks Autism Awareness Month, which focuses on increasing awareness and understanding of autism spectrum disorders (ASD). People with ASD may learn, communicate, and behave in ways that are different from others. Learn more about ASD below, and click on our tip sheets to find additional resources, including ways that you can help support others around you who may be impacted by ASD.

1. In the United States, 1 in 68 children is diagnosed with autism. Boys are 4.5 times more likely to be identified with ASD than girls.^[1]
2. Signs and symptoms of autism often start between 12 and 18 months of age. Sometimes a child will develop normally until the second year of life, then develop autism. ^[2]
3. Some people have had concerns that autism is caused by childhood vaccinations. However, extensive research over the past twenty years has shown there is no link between vaccinations, or the ingredients in vaccinations, and ASD. ^[3]
4. Children with ASD are prone to wandering or bolting from a safe, supervised place. This common behavior can cause great stress for families. ^[4]
5. People with ASD often suffer from other medical conditions which may include allergies, asthma, epilepsy, digestive disorders, obesity, persistent viral infections, sleeping disorders, and more. ^[5]
6. While many children with autism also have intellectual disabilities, almost half (about 44 percent) have average to above average intellectual ability. ^[6]
7. Although there is no cure for ASD, there are early intervention services to help children from birth to three years old learn to talk, walk, and interact socially with others. ^[7]
8. Many children with ASD are not diagnosed as early as they could be. The American Academy of Pediatrics recommends autism screening for all children twice before 24 months. ^[8]
9. Children with special needs, including ASD, may be eligible for treatment services under state and federal laws including the Individuals with Disabilities Education Act (IDEA). ^[7]
10. Autism itself does not affect life expectancy. However, studies show that the mortality risk among people with autism is double that of the general population, largely due to accidents. ^[9]

There are many resources to turn to if you are looking to learn more about Autism spectrum disorder.  Begin your search here:

Understanding Autism Spectrum Disorder (ASD)

How to Support Parents of Children with Autism

Resources for Autism Spectrum Disorder (ASD)

Sources

1. Centers for Disease Control and Prevention: Prevalence and Characteristics of Autism Spectrum Disorder Among Children
2. Autism Speaks: FAQ
3. Center for Disease Control and Prevention: Vaccines Do Not Cause Autism
4. Autism Speaks: Autism Wandering
5. National Autism Association: Autism Fact Sheet
6. Center for Disease Control and Prevention: Data & Statistics
7. Center for Disease Control and Prevention: Facts About ASD
8. American Academy of Pediatrics: Autism
9. Autism Speaks: Mortality and Cause of Death in Autism Spectrum Disorders

1 in 68*. It’s not the number – it’s the impact.

Increasing prevalence and high treatment costs make providing quality care and supportive services for children with autism and their families more important than ever.  Many families struggle to obtain access to appropriate autism services.  Providing care for a child with autism can be challenging and can create significant stress impacting a caregiver’s health and even their productivity at work.

Autism Connections from Magellan Health on Vimeo.

Employers are feeling the impact. 

Balancing life’s demands is hard enough, but for parents of children living with autism, it can impact their productivity and lead to lost time at work.

To retain these valuable employees, increase productivity and decrease benefit costs for issues such as stress, depression and even physical health challenges, it’s critical that employers and health plans develop solutions to help address their needs.

Autism Connections

Our industry-leading Autism Connections program provides children and their families with the support they need to navigate the complex healthcare system, enhanced care coordination, access quality providers and receive support both for themselves and their children.

Please view the video above to learn more about this program and our specially trained, caring and supportive clinical specialists in our Autism Center of Excellence.

*The Centers for Disease Control and Prevention (CDC) estimates that 1 in 68 children in the United States has been identifi ed with autism spectrum disorder (ASD). March, 2014.

Sources: CDC Data and Statistics on Autism, 2014; Autism Fact Sheet, National Autism Association, 2013; The Autism Society, 2013; Autism Speaks, 2013; National Business Group on Health: Therapies for Children with Autism Spectrum Disorders, May 2012, p.1.