Autism poses challenge in risks and benefits

Most of the topics mentioned in Business Insurance tend to fall into the realm of either risk management or employee benefits, but occasionally we encounter subjects that touch both.

Autism is a prime example. This pervasive developmental disorder is alarmingly common. A recent Centers for Disease Control and Prevention study found that autism afflicts one in 150 children. That makes it more prevalent than pediatric cancer and juvenile diabetes--combined.

If that fact is underreported, even less appreciated are the risks posed by autistic behaviors and the costs of treating them.

What causes autism is not known, and there is debate over whether environmental factors, such as mercury in immunizations, or genetics are to blame. Research suggests a genetic link, but ultimately what matters is finding effective treatment for the millions of children and adults with autism spectrum disorders.

My family has learned more on this than we ever wanted to, because we have an autistic child. We have met many families whose lives have been touched by autism and, like us, they struggle daily to help their loved ones.

People with autism are all unique, though they typically display impairment in social interaction, communication and exhibit behaviors that are repetitive or narrowly focused, such as preoccupation with an object. As a spectrum disorder, autism ranges from high-functioning to severe, with many variations in between. Many people mistakenly believe autistics cannot make eye contact, smile or show affection, or that they lack intellectual capability. In my son's case, at least, that is most definitely not true.

Autism cannot be cured, and people who have the diagnosis do not outgrow it. But they can, and many do, learn to function like most of the rest of us.

Various programs exist for treating autism, including speech therapy and occupational therapy. Experts advise early and frequent treatment to get the best outcome. Children may need multiple sessions per day--possibly for years. Those with severe cases may need lifelong care.

The financial burden on families is huge, and insurance shoulders only a fraction of that cost. Employee benefit plans generally cover therapy sessions, but typically they do not distinguish between ongoing therapy, such as occupational therapy, and short-term therapy, such as rehabilitation from an injury or illness. If a plan covers therapy sessions per year, for example, that coverage can be exhausted quickly.

By some estimates, autism in the United States afflicts 1.5 million people and costs $90 billion a year. Sadly, it's the fastest-growing developmental disability. The Autism Society of America estimates that by 2013, autism will cost $200 billion to $400 billion. It's clear to me that benefit plans in the future will need to look at how they cover autism therapies.

Autistic behaviors also present risks that need managing--at home as well as in public places. Today's autistic kids are tomorrow's autistic adults.

Parents with autistic children already know their kids can act unpredictably: Some run off, and many don't perceive danger. Law enforcement and emergency services are just beginning to understand that people with autism often have difficulty communicating and following instructions and exhibit behaviors that may be misinterpreted as aggressive.

It's not hard to envision a tragic encounter between a law enforcement officer and an autistic teen or adult, along with ensuing litigation. Likewise, knowing that many autistic children and adults have a tendency to wander and are attracted to water can help first responders save precious time. Disaster preparedness is hard enough for high-functioning people, but it gets infinitely more complicated when those plans must account for those with developmental disabilities.

Dennis Debbaudt, a law enforcement educator based in Florida who has an autistic son, helps first responders and parents understand these risks. His site, www.autismriskmanagement.com, offers a wealth of information.

Autism presents significant challenges, for those with it as well as those who interact with them. Understanding the disorder is the first step in overcoming those challenges. For more information, visit Mr. Debbaudt's site, the Cure Autism Now Foundation site at www.cureautismnow.org and the Autism Society of America's Web site www.autism-society.org.