1. What does the New Jersey’s Autism Insurance Act do?

New Jersey’s Autism Insurance Act does three main things:

1.     It requires many private insurers to begin covering the costs of screening and diagnosing autism or another developmental disability.
2.     It requires many private insurers to provide coverage for expenses incurred for medically necessary occupational therapy, physical therapy, and speech therapy, as prescribed through a treatment plan.
3.     It requires many private insurers to provide coverage for expenses incurred for medically necessary behavioral interventions based on the principles of applied behavioral analysis and related structured behavioral programs, as prescribed through a treatment plan.

2. When does the law requiring insurance companies to cover services for children with autism spectrum disorder go into effect?

The Act shall take effect February 9, 2010, however benefits may not start right away. For existing plans, the benefits take place on the renewal date of the health plan on or following February 9, 2010. For new plans issued on or after February 9, 2010, the Act goes into effect when the new plan is issued.
3. Once the Autism Insurance Act goes into effect, will my employer-provided health insurance be required to cover my child’s autism services?

Not all insurance plans are required to provide coverage under the New Jersey Act. Insurance companies regulated by the state of New Jersey and state and local government plans must comply. Health plans that are self-funded or federally-regulated are not required to provide coverage. If your child is enrolled in the FamilyCare Program or you are enrolled in the New Jersey State Health Benefits Program the New Jersey Act applies to your health benefits plan.
4. What do I ask my employer to find out if my plan is covered under the New Jersey Act?

    Is my health plan self-funded or fully insured? Only fully insured plans regulated by the State of New Jersey are required to comply.
    If my health plan is fully insured, in what state is the policy written?
    o If my plan is fully insured and written in New Jersey, what is the plan renewal date?
    If your plan is not fully-insured, you can inquire to see if they will voluntarily comply with the law.

5. Are there limits on what our private insurance is going to be required to cover?

Insurance companies are not required to cover the costs of services that fall outside the mandated services defined in the New Jersey Autism Coverage Act.
6. What coverage is mandated by the law?

The New Jersey Autism Coverage Act requires coverage for screening and diagnosing autism or another developmental disability. When the insured’s primary diagnosis is autism or another developmental disability, the Act requires coverage for expenses incurred for medically necessary occupational therapy, physical therapy, and speech therapy, as prescribed through a treatment plan. When the insured is under 21 years of age and the insured’s primary diagnosis is autism, the insurer shall provide coverage for expenses incurred for medically necessary behavioral programs, as prescribed through a treatment plan, subject to provisions of this subsection.
7. Is applied behavioral analysis (ABA) covered?

Yes, if the insured is under 21 years of age. In addition, according to Bulletin No: 10-02 provided by the New Jersey Department of Banking and Insurance, ABA must be administered directly by or under the direct supervision of an individual who is credentialed by the national Behavior Analyst Certification Board as either a Board Certified Behavior Analyst – Doctoral (BCBA-D) or a Board Certified Behavior Analyst (BCBA).
8. Will all of the Autism Spectrum diagnoses be covered, or just those diagnoses with the keyword of “autism?”

Autism and developmental disabilities are covered.
9. Will my early intervention cost share now be covered by insurance?

Families that participate in the New Jersey Early Intervention System (NJEIS) may have a cost associated with the early intervention services identified on their Individualized Family Service Plan (IFSP).

The New Jersey Act includes coverage for expenses incurred through NJEIS family cost participation system. Families will be required to satisfy their family cost obligations directly with the NJEIS and then seek reimbursement for those costs. (Additional information about family cost share can be accessed in Bulletin No: 10-02 provided by the New Jersey Department of Banking and Insurance.
10. Who determines what services are medically necessary?

The patient’s physician prescribes the treatment plan. A treatment plan includes a diagnosis, treatment type, frequency and duration and the anticipated goals and outcomes. From the treatment plan, the health plan makes the determination of what services are medically necessary. Additionally, there is a utilization review process once every six months within the insurance company that may review the services ordered on the treatment plan.
11. Will insurance companies be able to deny services if my child is not making “sufficient progress” or has reached a plateau in his/her progress?

No. The law specifically requires that benefits will not be denied on the basis that the treatment is not restorative.

Will private insurers be developing their own medical necessity criteria?
Private insurers will use their own medical necessity criteria. The patient’s physician or psychologist indicates on the treatment plan what services are medically necessary, however there is a utilization review process within the insurance company that may review the services ordered on the treatment plan.
12. If my insurance company denies my child’s autism diagnostic or treatment services, where can I go for help?

Families can appeal any denial or partial denial of an autism diagnostic or treatment service to your insurance company and obtain a decision on an expedited basis. If your appeal is denied by the insurance company, your family can appeal for an independent, external review. If the independent external review denies your appeal, you can further appeal to a court of competent jurisdiction.

If you have questions about implementation in general, according to the New Jersey Division of Business and Insurance, you should contact them directly via electronic mail at legsregs@dobi.state.nj.us.

Specialists at the Kennedy Krieger Institute here, who focus on disorders of the brain, spinal cord and musculoskeletal system, are testing the use of early intervention groups to improve social and communication skills for 1- and 2-year-olds who are considered at high risk for autism and related disorders.

Stephanie David

Anna David barely spoke before the program, but now talks, sings and dances.

The average age of children diagnosed with autism in the U.S. is around 4 years old, according to the Centers for Disease Control and Prevention. Interventions typically start later than that to treat the spectrum of disorders that leave about one in 88 children struggling to socialize and communicate. Many also exhibit repetitive behaviors.

Early diagnosis and intervention is a mantra in the field: The earlier children can get help, the brighter their long-term prospects, say experts. But it isn’t certain what, if any, type of intervention is helpful with very young children, so researchers have been testing different approaches.

Kennedy Krieger’s programs aim to help children improve basic skills like noticing what other people are noticing, coordinating and imitating behaviors and activities with others, and sharing positive emotions, says Rebecca Landa, a speech pathologist who directs Kennedy Krieger’s Center for Autism and Related Disorders and designed the intervention model.

Jason Schneider

Play: Playing with the child is important, but keep things simple and avoid batteryoperated toys, researchers say. Follow the child’s lead and use duplicate toys to mimic the child’s actions. Talk about what the child is doing to help forge a link between actions, concepts and language.

Kids are trained in classroom sessions lasting between 90 minutes to 2½ hours, two to four days a week. They play games, sing songs and do book-sharing exercises—all standard fare for any small child, but done in a simplified manner highlighting the relevant social cues. Parents also are taught how to apply the skills learned in the classroom at home.

The key to the interventions’ success is “saturation and routine,” says Dr. Landa. “We just give every child everything we can at every moment.”

Children who develop more typically, beginning early in infancy, gain an understanding of other people’s behaviors. Babies, for instance, lift up their arms when they are about to picked up, anticipating the adult’s intention, says Dr. Landa.

Kids with autism, however, don’t appear to understand what other people are doing or thinking, and therefore what is expected from them.

Dr. Landa and other researchers say these skills can be learned and improved with practice. And they think the earlier the better.

Jason Schneider

Sing: Songs with gestures, like ‘Itsy Bitsy Spider,’ may be good for developing social and cognitive skills. Children with autism and related disorders can struggle to imitate others’ gestures, or sense what others are looking at. Singing and gesturing may help reinforce those skills.

Classrooms at Kennedy Krieger, an independent research and clinical institute, look similar to any for young children, with brightly colored rooms filled with toys, books and drawings. The children have circle time, read books and play games and sing during sessions. But each activity and the clinicians’ every movement has a therapeutic purpose, says Dr. Landa.

She says some colleagues have told her the programs looks like glorified preschool, but she says she doesn’t want the classroom to appear unusual, and the strategic design and execution of the programs are useful to parents and children.

One clinician and two assistants typically work with five children at a time. They usually speak in unison when directing the children and use coordinated hand gestures. For instance, children with autism often don’t look in the direction where someone else is pointing. So clinicians constantly coach the children by simultaneously calling out for their attention and pointing, then praising them if they look. If a child doesn’t pay attention, the clinicians knock on a surface to make a noise.

The children in a program for 2-year-olds have all been diagnosed with autism. Another group of 1-year-olds is considered high risk because they exhibit signs of an autism-spectrum disorder and have a sibling with the condition, but it isn’t clear whether all of them have autism or if they are developing somewhat differently or slowly.

Being in such a program should yield benefits, even if it turns out a child isn’t autistic, says Dr. Landa.

Jason Schneider

Read: It is never too early to start reading activities, and ‘reading’ can be as simple as sitting with the child, looking at, pointing to and identifying pictures in books. It’s important to keep it fun and adapt the language in the book to the child’s comprehension level.

Children with autism also have a hard time forming concepts. They may recognize individual car parts, like the wheels, but not how the pieces fit together to form a recognizable shape called a car, researchers have found. So, when the clinicians teach concepts, they fill the classroom with related objects and images, splashing car pictures on the walls, reading car books and playing games about cars. When the next concept is taught, all of the décor and learning materials are swapped out.

In classroom sessions with 1-year-olds and their parents, the adults are shown how to direct and praise their children, as well as teach flexibility and creativity in thinking that many with autism find difficult.

In a recent class, a mother pushed her son, who sat in a toy wheelbarrow, through a wall of play blocks. The mother and her son repeated the action until the boy learned he could knock over the wall by lifting his feet. Each time he did it, a clinician and his mother cheered and clapped.

After doing it several times, he clapped—for the first time ever—and appeared pleased. The mother looked up at the clinician with tears in her eyes, saying she couldn’t believe it.

Dr. Landa, along with colleagues at Kennedy Krieger, is systematically evaluating the programs. Early results are promising.

Jason Schneider

Schedule: New settings and unfamiliar activities can upset children with autism, making routine and repetition important. One technique involves setting up a picture schedule. Kids can place images of activities like hand washing onto the schedule, marking the transition to a new event.

In one study, published in 2010 in the Journal of Consulting and Clinical Psychology, 50 toddlers between 21 and 33 months received intense training from parents plus 10 hours a week in the classroom. Half of those children were randomly assigned activities focused on improving “interpersonal synchrony,” targeting social skills. Standardized tests and play-based interaction showed a reduction in core autism symptoms compared with the group that didn’t do those activities.

The next step in the research is to isolate which components of the overall program are most effective in order to further refine treatment, Dr. Landa says. They also are working to translate the interventions for use in public settings, like schools.

The researchers say they have noted substantial improvement in children over the course of a school year. When kids first arrive, few of them can even sit in their chairs at circle time, videos of the early sessions show. Some throw tantrums, kicking and screaming on the floor, for the entire two-hour session.

Anna David, 2½, was barely talking when she started the toddler program, says her mother, Stephanie. She wasn’t pointing or interested in other people.

Now, about nine months in, she talks, sings, dances and shares things with others. Says Ms. David, 32, of Alexandria, Va.: “She’s waking up.”

Write to Shirley S. Wang at shirley.wang@wsj.com

(CNN) — Watching a child take his first steps is one of the biggest milestones for a parent.

Lindsay Williamson says the moment she heard her son, Reed, call his father “Daddy” instead of “juice box” was just as amazing.

He was a month shy of his third birthday, and the family had spent months in autism evaluations that Reed wouldn’t participate in.

“We were not sure we would ever hear ‘Daddy,’” said Williamson, whose family lives in Lewes, Delaware. “It meant so much to us.”

On World Autism Awareness Day, CNN iReport asked families affected by the developmental disorder to tell the world what their lives are like. Parents of children along the autism spectrum described incredible highs and lows: Desperation for answers about why autism rates are rising, fears about their children’s prospects in adulthood, but also great pride in watching them develop and overcome obstacles.

‘Never give up’

Early diagnosis and better access to treatments have helped families reach goals they weren’t sure were possible.

Lindsay Mansfield’s son, Travis, made little to no eye contact when he was diagnosed with autism in the first grade. Loud sounds frightened him. He would clap his hands and rock or jump up and down in crowded places.

It was draining for the family until they learned how his brain worked.

“We all began to learn the skills. It wasn’t just about him; it was also about us, the people who interacted with him,” Mansfield, of Queen Creek, Arizona, wrote in her iReport. “We all began to learn how to communicate through these situations. If something is loud, cover your ears. Too many people? Maybe there’s another way we can get through this store.”

To get through stressful homework sessions, she used blocks for addition and subtraction “so he could touch every one.”

Today, Travis is thriving in fourth grade. Mansfield said he has friends and sits at the dinner table and talks with his family.

“Never give up,” she said.

Waiting for ‘Mama’

Parents of children with autism say they learn to measure milestones differently. They appreciate the successes, however late they come.

Mothers of children with autism can wait years to hear their child say the words, “I love you, Mommy” — or even call them “Mommy,” said Lin Wessels, whose son, Sam, is 10.

“I remember distinctly the first time Sam said ‘Mama’ and he was actually meaning me. I started bawling,” she said.

Sam was about 3 years old at the time and had stopped speaking. He was learning to express himself using sign language and cards with pictures on them.

“That all helped Sam to realize that words have use — that by using them, something happens. It was just kind of a progression that ‘Oh, that’s Mom, and I can call her Mama and she will come.’”

Wessels, who lives in Rock Rapids, Iowa, felt another wave of pride last year when she saw Sam swinging in the backyard all by himself. Other children are able to learn how to swing just by watching others. Sam, who struggles with coordination, required years of therapy to be able to pump his legs while pushing and pulling the ropes, all while balancing his body on the seat.

“He was 9, and I started crying, because you don’t know if you’ll ever see your child do those things — things other children do when they’re 4,” she said. “Those kinds of things give you a lot of hope that there’s more to come.”

Milestones missed, dreams revised

Still, as hard as families try, some rites of passage are missed. Wessels says Sam still doesn’t have the coordination to ride a bicycle or play other sports, aside from Special Olympics once a year.

“It is not for lack of trying. We have tried the entire gamut of sports activities, but Sam just does not have the executive functioning skills, coordination or motor planning they require,” she said.

Raising three boys with autism: A father’s story

Crystal McCoy of Conway, Arkansas, said she had to accept the truth that her daughter “just doesn’t think like us.” Seven-year-old A’jaylin started hurting herself last year — picking scabs, then knocking her own teeth out — and was briefly placed in a mental hospital.

“We thought that if we did the right things she would be able to live a normal life,” McCoy wrote. “I used to dream of all the things she would be. Now my every hope or thought goes to whether she will hurt herself too bad, or if she will even live to that point and if she does if it will be in a hospital.”

Similarly, Luke Ferguson of Lebanon, Pennsylvania, said it was painful to revise the dreams he had for his little boy. His son, Sammy, is 6 and suffers from severe autism. He doesn’t speak, and still wears diapers.

“When he was one, I wanted to teach him how to play soccer and chess,” Ferguson said. “By the time he was three, I just wanted to be able to understand him when he is sad. The turning point … was for me to understand that my role is not to fix him but to love him.”

Future unknown

Even as she celebrates her son’s milestones — like calling his father “Daddy” — Lindsay Williamson often worries what will happen when Reed reaches adulthood. He is only 4, but group homes and other services for adults with autism are frequent topics of discussion in the parents group Williamson belongs to.

“Who will care for our kids when we are gone is a huge concern,” she said. “Who will be there to help them? Where will they live? What will they do?”

An estimated 500,000 children with autism will become adults in the next decade, and parents “have every right to be concerned,” said Peter Bell, executive vice president at Autism Speaks and father of a 19-year-old with autism.

Even adults with mild forms of autism face high unemployment rates because of social, communication and behavior problems, advocates say. A small study published in 2010, tracking 66 young adults after high school, found only 18 percent of them had jobs, and none were full-time. In some states, families have been waiting years for spots in group homes, vocational programs and other services.

“We know a lot more about autism today than we did 10 years ago, we continue to do much more research, and I think where we fail is in really providing appropriate services lifelong for individuals,” said Jim Ball, chairman of the Autism Society national board of directors.

The early diagnosis and therapies more prevalent than a couple decades ago appear to be improving that prognosis, but it’s not clear what percentage of the population will be able to live on their own, need 24-hour care or something in between.

Lin Wessels hopes that her son, Sam, will one day live on his own, find a meaningful career, maybe get married. She will never sell him short. She says she and her husband will continue to work with Sam as long as they live, advocate for more autism research and resources, and they give thanks to the parents who raised children with autism before her.

“The parents that went before us 20 and 30 years ago … a lot of times they were told, ‘Don’t have expectations, just plan on finding a permanent placement for your child.’ Now that kind of thinking is very backwards,” Wessels said. “Hopefully we’re blazing that trail even wider and bigger for the parents that follow, so there’s even more for their kids.”

Supraja Seshadri contributed to this story.

04/4/12

Randolph, Mass. – People can be cruel even when they don’t mean to be. A disapproving look, careless reference, or impatient gesture directed at an individual with an autism spectrum disorder (ASD) or a member of their family can be as painful emotionally as any physical injury sustained. Yet, despite the explosion of information on the Internet about autism, the disorder is still often misunderstood by many outside the autism community. New and sobering statistics from the Centers for Disease Control and Prevention (CDC) indicate that one in every 88 children in the U.S. has an autism diagnosis.

Autism is a developmental disability that typically appears during the first three years of life. It is a neurological disorder causing difficulty with communication, learning, and social interaction. There is no known cause of autism and there is no cure.

To help inform the public during National Autism Awareness Month in April, parents of children with autism enrolled at May Institute’s special education schools were asked to identify hurtful or insensitive remarks that have been directed at them and their families. They also shared suggestions for how the community can be more supportive.

What not to say: 

1. “What’s wrong with her?”
2. “Why do you let him do that? He is scaring my child.”
3. “You know, there is no cure.”
4. “Have you tried ……? If you did, she would be more normal.”
5. “I don’t know how you do it.”
6. “Is she getting any better?”
7. “Why don’t you just leave your kid at home? It would be so much easier for everyone.”
8. “My child doesn’t know how to play with your autistic child.”
9. “Funding would be better spent on normal children.”
10. “Don’t worry – he’ll be okay.”

“Autism is a very complex disorder. These comments typically come from having a limited understanding of what autism is and what it isn’t,” says Hanna C. Rue, Ph.D., BCBA-D, Vice President of Autism Services at May Institute and Director of Evidence-based Practice at the National Autism Center. “Take opportunities to learn more about autism and other developmental disabilities. Reserve judgment of parents and caregivers who are trying to raise their child on the spectrum in the best way they know how. And remember that individuals with autism have the capacity to feel joy and sadness, and share the need for emotional bonds and connection to others.”

What families want you to know:

May Institute also polled respondents about what they believe most people “don’t get” about autism. Here are facts that families of children with autism want you to know about the disorder:

• Autism is a spectrum disorder – each child is uniquely affected.
   
• Autism is not the result of bad parenting or lack of discipline.
   
• Autism can “look” like your daughter, son, niece, or grandchild.
   
• Parents of children on the spectrum are not paranoid or always overwhelmed with grief.
   
• Just because a child with autism is non-verbal or does not make eye contact, it does not mean he or she doesn’t notice the looks or feel pain from being ignored, bullied, or disregarded.
   
• Don’t treat kids with autism as if their diagnosis is contagious.
   
• Many people with autism are social and want to interact but don’t know how.
   
• Please don’t reference anyone – be it an individual with an autism diagnosis or any other diagnosis – as “retarded.”
   
• Be kinder than you need to be, because just about everyone is battling something you know nothing about.
   
• Parenting a child with autism is difficult and rewarding, just like it is for parents of typical children. It just takes a little more patience and understanding.

People can make a difference when they know how. In the words of one parent, “We need our community to support us. Help us not to feel isolated. Everyone can help in their own way, and everybody’s contribution is appreciated.”

About May Institute and the National Autism Center
May Institute is a nonprofit organization that provides educational, rehabilitative, and behavioral healthcare services to individuals with autism spectrum disorders (ASD) and other developmental disabilities, brain injury, mental illness, and other behavioral health needs.

The National Autism Center is May Institute’s Center for the Promotion of Evidence-based Practice. It is dedicated to serving children and adolescents with ASD by providing reliable information, promoting best practices, and offering comprehensive resources for families, practitioners, and communities.

Haley Elementary in Chandler this week staged performances of a play that was unique in one respect: Alongside typical students were autistic students.

The school’s drama club integrates special-education students with those in general education to help both thrive.

“It’s a lot of peer relationships,” music teacher Nicole Kamboukos said. “We expose not only special-education kids to general-education kids, but we want the general-education kids to have experiences with special-education kids.”

Haley has become a magnet school of sorts for autistic students in the Chandler Unified School District. Forty-three students in the 700-student school have some form of autism, from severe cases to Asperger’s syndrome.

More than 100 students wore mermaid, seagull, sea turtle and sailor costumes to act, sing and dance in the 90-minute play “Under the Sea: Ariel and Friends.” Students with autism performed with other students with few hitches during dress rehearsal.

The production was the brainchild of Amy Miller, a special-education teacher at the school.

“Autism has always been a passion of mine,” Miller said. “I’m in love with the potential to get them (autistic children) to the max, to be as successful as they can be.”

Children with autism learn more by modeling typical behavior of non-autistic children, Miller said.

“It’s better for them to see their peers in social settings like this,” she said.

For parent Cathy Logan, the drama club and the school have been key in helping her 10-year-old son, Freddy, develop.

“He was completely non-verbal till he was 5,” Logan said.

Freddy dressed as a sea turtle and had two speaking parts, for which he admitted being nervous.

“He has sensory issues so he doesn’t like things on his head,” Logan said, referring to the hooded top Freddy had to wear for his part. “This is a big deal, and he doesn’t even realize it.”

Logan said the school play is a highlight for her son.

“As a parent, it makes you feel like everyone else, not like an outcast.”

by James Lehman, MSW

As a parent, sometimes it seems like your day is filled with an endless stream of backtalk from your kids—you hear it when you ask them to do chores, when you tell them it’s time to stop watching TV, and when you lay down rules they don’t like. It’s one of the most frustrating and exhausting things that we deal with when we raise our kids.

Backtalk comes from a sense of powerlessness and frustration. People don’t like to feel powerless, and that includes children. So when kids are told “no” they feel like something’s been taken from them. They often feel compelled to fill that empty space with backtalk. I want to make the distinction here between backtalk and verbal abuse, because many times people confuse these two very different things. If your child has started saying hurtful or harmful things, the line between backtalk and verbal abuse has been crossed. For instance, if a child is cursing you, calling you names or threatening you, that’s verbal abuse. If your child is saying, “This isn’t fair, you don’t understand, you don’t love me,” that’s backtalk.

Verbal abuse is a very negative behavior and has to be dealt with aggressively and up front. It’s not that backtalk is harmless, but it’s certainly not as hurtful and hostile and attacking as verbal abuse is. For parents who are dealing with verbal abuse in their home right now, rest assured that we’ll be addressing this topic in an upcoming article.

Related: Does your child yell, call you names or swear at you?

Backtalk itself can take several forms. One is the kid who can’t keep quiet, no matter what you say: he or she has got to have the last word. And then there’s the child who wants you to understand their point after you’ve already said “no.” It’s easy for kids to get into the mindset of, “If I could just explain it better, you’d understand my situation.” So you’ll get kids who present their problem or request repeatedly in the hopes that their parents will give in and respond to it. If their parents don’t give them the answer they want, those kids will then try to re-explain, as if the parent doesn’t understand. Often, as they launch into their explanation for the third or fourth time, the child and the parent will both get more frustrated until it ends up in an argument or a shouting match.

Don’t Respond to Backtalk: You’ve already set the limit
Why do parents react to backtalk after they’ve already won the argument? I think parents often see it as their job to respond to their children: to teach, train and set limits on them. And backtalk is an invitation to do just that. Just as the child re-explains things to the parent if they’re told “no,” the parent “talks back” and re-explains things to their child. So the parent’s mindset seems to be, “If you really understood what I was saying, you wouldn’t talk back to me—you’d accept my answer.” Let me be clear here: That’s not a rational mindset. It leads parents into attending and prolonging arguments in which they don’t need to engage. Parents sometimes see backtalk as a challenge to their authority, but as long as you accomplish your objective, the fact is that your authority is fully intact.

Here’s an example:

Your child: “Can I stay out until 10 tonight?”
You: “No, because you have to get up early tomorrow for soccer practice.”
Your child: “Who cares? I don’t need that much sleep.”

You should stop right there. Any conversation you engage in after that is meant to convince your child that you have sound judgment. Know this: that’s the wrong objective because it addresses a completely different issue—whether or not you made a good decision. So once you give a reasonable explanation for the rule you’ve stated, your job is done. You can repeat it again if need be. You’ve already won the fight. But when you try to convince your child that you’re right and they continue to challenge you through backtalk, you’re just going to get more frustrated. Your job as a parent is not to get your child to accept the reasonableness and rationality of your decisions. You just need them to follow the rules. Look at it this way: when a cop stops you for speeding, he doesn’t care if you think that 35 miles an hour is too slow. He just tells you what the law is. If you argue with him, he repeats what the law is. If you don’t accept it, he hands you your ticket and walks away. If you become verbally abusive, he arrests you. Try to think of yourself as the cop here—you’re the parent making the rules, and your child needs to accept them or pay the consequences.

Related: How to disconnect from your child’s backtalk

Shutting Down Backtalk: The Plan
In order to put a stop to backtalk, there are several things you have to do. First of all, when things are good, sit down with your child and lay down some ground rules. Discussions about these rules are critical to good communication and to cooperation down the road. I guarantee that you’ll feel better as a parent if you set up rules and follow them with your children. Your goal then becomes following the ground rules instead of trying to achieve your child’s acceptance. The first rule is, “I’ll explain something once and I’m not going to talk more after that. If you try to argue or debate, I’m going to walk away. If you follow me or if you continue there will be consequences.” You set limits on backtalk and you don’t give it power.

Another option is to set up a certain time of day in which your kid can talk back to you. You can say to them, “From 7-7:10 p.m., you can ask me to re-explain all my decisions. Save it for then. If you need to, write it down in a journal. Then at 7 o’clock, we’ll sit down and I’ll explain to you why you can’t date a 22 year old or how come you got grounded for smoking. But at 7:15, our discussion is done. If you try to keep it going there will be consequences.” That way, if you feel like you want to give your child an outlet to air his or her grievances, there’s a way to do it without getting bogged down in constant arguing.

Remember, there are two kinds of days that a kid has: there are good days and then there are days when things don’t go their way. Don’t try to fight the tide of disappointment that kids experience. They will use backtalk to get their way, but as a parent, you have to accept the fact that they will not always be happy with your decisions. Your job is to set the rules and enforce them because those roles are for your kid’s development and safety. Whether they like those rules or not, they have to learn to live with them.

CDC Releases New Autism Prevalence Information:
1 in 49 NJ children, 1 in 88 nationally

Centers for Disease Control and Prevention (CDC) releases the report Prevalence of Autism Spectrum Disorders – Autism and Developmental Disabilities Monitoring Network, 14 States, United States, 2008. The findings are outlined below:

New Jersey:

• 1 in 49
• Boys: 1 in 29
• Girls: 1 in 172
• Average age of autism diagnosis is 3 years, 2 months old (earlier than in previous studies)

National:

• 1 in 88
• Boys: 1 in 54
• Girls: 1 in 252
• Average age of autism diagnosis is 4 years old (earlier than in previous studies)
• 78% increase in prevalence comparing the 2012 study that looked at the data from children who were 8 years old in 2008 to the 2007 study that looked at the data from children who were 8 years old in 2002 data

Main findings:

• NJ has the 2nd highest prevalence (Utah and Arizona are 1st and 3rd.)
  (While NJ had the highest prevalence rate according to a study published in 2007, NJ was ranked 3rd behind Arizona and Missouri in a 2009 study.)

• CDC Community Report – http://www.cdc.gov/ncbddd/autism/documents/ADDM-2012-Community-Report.pdf

For a full report, visit http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6103a1.htm?s_cid=ss6103a1_e

For a transcript of the CDC Telebriefing on the Prevalence of ASDS, visit www.cdc.gov/media

Initial Reflections:

“The results tell us that many NJ families need help. NJ must commit to a comprehensive, state-wide plan to work toward a continuum of services and supports through the life span, as needed, when needed. Advocacy is essential to Autism New Jersey’s mission. As advisors on laws and regulations to state and federal decision makers, treatment professionals, educators, media, families and the general population, Autism New Jersey directly impacts individuals with autism and NJ’s autism community everyday and for a lifetime. 1 in 49: Now is the time to join us.”
-Dr. Linda Meyer, Autism New Jersey Executive Director
 
 
“As a parent, the rates affect my family when they are used to direct funding, help agencies develop necessary services and create community awareness about the scope of autism.  As the Conference Director at Autism New Jersey, the rates put into perspective the need for valuable information found at Autism New Jersey’s Annual Conference.”
-Barbra Wells, Autism New Jersey Conference Director and Ian’s Mom
 
 
“In my advocacy role as a professional and a parent of an adult with autism, I believe prevalence rates must be responded to with evidence-based treatment and compassion for each individual on the spectrum.” 
-Bob Titus, Autism New Jersey Public Policy Director and Joe’s Dad

“As a parent, it hopefully will make the healthcare and educational professionals more aware of the issues that face our families and take notice that autism is not going away. As a professional, I feel my job is more relevant than ever in helping families obtain needed services for their children.”
-Sarah Andrews, Autism New Jersey Information Coordinator and Jacob and Benjamin’s Mom
 
“I hope the new information on autism prevalence rates will have a positive impact on individuals like my daughter, regardless of where they are on the spectrum. This also applies to my viewpoint as a professional.  People with autism have needs ranging from quite profound to subtle.”
-Elena Graziosi, Autism New Jersey Information Coordinator and Katia’s Mom

How can Autism New Jersey Help?
Autism New Jersey’s toll free helpline, 800.4.AUTISM, is open 8:30am-5:00pm, Monday – Friday. From diagnosis to early education services, education, transition and adult services, our skilled compassionate autism specialists provide information and assistance.

Updated Publication:

“Because you always need a place to start…”
Autism: Start Here, What Families Need to Know. A new publication coming from Autism New Jersey in April.

When parents receive a new diagnosis of autism, their world is turned upside down. This publication contains essential information to start parents on their journey and connects them to the best resources available.

This publication includes information on autism diagnosis and criteria, autism professionals, state and local services, early intervention, special education, parent-professional collaboration, evaluating potential treatment options, ABA, and other important topics.

Support Autism New Jersey

We remain dedicated to serving the needs of New Jersey’s autism community.  In these difficult economic times, we must rely on the financial support of our friends in the community.  Our services and outreach activities are only possible with the support of our members and generous donors.

Make a donation! Please consider making a tax-deductible contribution online today.

Become a Member! Join together with other members of the autism community and become a member of New Jersey’s largest autism advocacy organization.

As always, if you require support or information, please contact us at 800.4.AUTISM, 609.588.8200 or visit autismnj.org.

Sincerely,
 
Your Friends at Autism New Jersey!
www.autismnj.org
Visit us on Facebook – www.facebook.com/AutismNJ

The screening used in the study also flagged some babies who later turned out to be developing normally, raising a false alarm for families. But early diagnosis and treatment of autism and other developmental delays are thought to improve outcomes, and researchers said the benefits of early intervention outweighed the downsides.

“This does show that a respectable percentage of babies who eventually get a diagnosis [of autism-spectrum disorders] show subtle signs at one year,” said Karen Pierce, lead author of the study and assistant director of the University of California, San Diego’s Autism Center of Excellence. “The only chance we have right now in changing that path to having full-blown symptoms is early intervention, and there’s no reason not to try.”

Autism, characterized by deficits in social interaction and communication, is extremely difficult to detect in very young children, some experts say. Children often aren’t diagnosed until age 2 or 3, when symptoms like lack of engagement and eye contact with parents and peers become more obvious.

But in Thursday’s study, UC-San Diego researchers found pediatricians were able to use a five-minute questionnaire to successfully identify potential problems in communication and language skills during a 12-month-old’s wellness checkup. Questions included whether parents could tell if their infant was happy or upset, or responsive to certain cues.

Of the nearly 10,500 infants screened, 184 scored lower than expected and were referred for further evaluation and tracked for up to three years. Ultimately, 32 of them were diagnosed with an autism-spectrum disorder, while an additional 101 were determined to have a language or developmental delay or a related condition.

“This is the first and only study to demonstrate the feasibility of using a really broad screening measure like this in a medical setting,” said Lisa Gilotty, who leads the research program on autism-spectrum disorders at the National Institute of Mental Health, which helped fund the study.

Based on previous research, the study likely identified about half of children who later would turn out to have autism.

There are 22 autistic students at Glenn Dale Elementary School, but in the classroom and on the playground, you often can’t tell who they are.

“Kids are the most compassionate people,” said Laura Carr, the coordinator of the school’s autism program. “It’s crazy to see the kids play together.”

Glenn Dale is one of seven schools in the Prince George’s County school system that runs specialized programs for students with autism that include children in general education classrooms while offering additional support in self-contained classrooms.

Kindergarten students start in a classroom with no more than seven autistic children, and as students become academically and socially ready, they spend a few hours each day in a general education classroom with the support of a special education teacher and paraprofessionals, Carr said.

“We do our best to make sure they have every opportunity to be fully included and get the full school experience,” she said.

Autism affects one in 110 children and is 4.5 times more common in boys than girls, said Amanda Glensky, a media specialist with the Autism Society.

People with autism show slowed speech development, repetitive motor mannerisms such as hand flapping or jumping, and social skills deficit, said Glensky, noting that April marks Autism Awareness Month.

Fourth-grader Finnian Sheerin of New Carrollton has been taught solely in Glenn Dale’s general education classrooms for the past two years, said his mother, Erin Sheerin.

“He has just flourished,” Sheerin said. “It’s given him more confidence, he likes school now, and he’s made more friends.”

Finnian’s not alone.

Since Glenn Dale shifted in 2005 from only self-contained classrooms for students with autism to its integrated autism program, students have made extensive progress in learning social skills, Carr said.

“Socially, the kids excelled,” said Carr, who took her first teaching job at the school in 2006. “What the peers were doing was teaching them things we couldn’t.”

Integrating students with special needs with the general student population gives autistic children more opportunities to form friendships and become comfortable around their peers, said Kate Moraff, the school psychologist.

“By including (students with autism), our neuro-typical kids are learning there are all kinds of people in the world, and everyone’s unique,” Moraff said. “They’re getting used to one another.”

The program has made the Glenn Dale staff more conscious of differentiating instruction and has fostered a sensitivity among general education students to the diverse needs of their peers, said Principal Lia Thompson.

“We’re building a generation of students who are more accommodating of everyone’s uniqueness,” she said.

Some general education students who are especially accommodating and helpful will join the 22 students in the autism program on their annual overnight camping trip to Camp Pecometh in Centreville, Md., next month, Carr said.

“To see these kids with social disorders sitting around a campfire is amazing,” Carr said.

And even though Finnian fell in the river last year, he said he can’t wait for this year’s trip.