Intensive Behavioral Intervention for Autism: The Fight for Coverage

Allison Dean is a writer bringing to us the latest information on the legal fight for the reform of autism insurance laws to cover Intensive Behavioral Therapies. We welcome her thoughts on this important issue.

With recent medical innovations in both technology and treatments, new therapies have been developed and shown to benefit those children with Autistic Spectrum Disorders. One in particular is Intensive Behavioral Treatments (IBT). The legal fight for children to receive this treatment has been an ongoing one.

But first, what is IBT? IBTs include Applied Behavior Analysis (ABA), Early Intensive Behavioral Intervention (EIBI), and Intensive Behavioral Intervention (IBI). These treatments are exercises and techniques consistently applied to autistic children for several years, for 25 to 40 hours per week; children usually work with a therapist, paraprofessional, parent, or some combination of some or all of said people. However, the involvement of children’s parents throughout the process is imperative to its success.

Beginning treatment concentrates primarily on improving behaviors such as:

  • General social responses

  • Self-stimulating behaviors

  • Socially non-aggressive behaviors


Early on, children are rewarded for good behavior with food although this reward is very quickly faded to non-food reinforcers; all throughout therapy, bad behaviors are rewarded with neutral responses.

Intermediate treatment concentrates primarily on:
  • Peer interaction.

  • Teaching children language skills.


Advanced treatment concentrate primarily on:
  • Observational learning in social settings.

  • Proper social emotional responses and expression.

  • The teaching of basic education skills.


So where is the U.S. in terms of making these therapies not only more available, but mandated for insurance to cover?
As of November 1, 2011, the following 29 states have passed autism insurance reform laws according to austismvote.org:
  • Arizona - Enacted March 21, 2008

  • Arkansas - Enacted March 4, 2011

  • California - Enacted Oct. 9, 2011

  • Colorado - Enacted June 2, 2009

  • Connecticut - Enacted June 9, 2009

  • Florida - Enacted May 2, 2008

  • Iowa - Enacted April 29, 2010

  • Illinois - Enacted December 13, 2008

  • Indiana - Enacted May 3, 2001

  • Kansas - Enacted April 19, 2010

  • Kentucky - Enacted April 14, 2010

  • Louisiana - Enacted July 2, 2008

  • Maine - Enacted April 12, 2010

  • Massachusetts - Enacted August 3, 2010

  • Missouri - Enacted June 10, 2010

  • Montana - Enacted May 5, 2009

  • Nevada - Enacted May 29, 2009

  • New Hampshire - Enacted July 23, 2010

  • New Jersey - Enacted August 13, 2009

  • New Mexico - Enacted April 2, 2009

  • New York - Enacted Nov. 1, 2011

  • Pennsylvania - Enacted July 9, 2008

  • Rhode Island - Enacted June 30, 2011

  • South Carolina - Enacted June 7, 2007

  • Texas - Enacted June 15, 2007

  • Vermont - Enacted May 27, 2010

  • Virginia - Enacted May 6, 2011

  • West Virginia - Enacted April 1, 2011

  • Wisconsin - Enacted October 19, 2009


The following 14 states, according to autismvote.org, will pursue autism insurance reform laws in 2012:

  • Alabama

  • Alaska

  • Delaware

  • Georgia

  • Hawaii

  • Maryland

  • Michigan

  • Minnesota

  • Nebraska

  • North Carolina

  • Ohio

  • Oregon

  • Utah

  • Washington



And unfortunately, the following states are not pursuing autism insurance reform laws at this time:
  • Idaho

  • Mississippi

  • North Dakota

  • Oklahoma

  • South Dakota

  • Tennessee

  • Washington, DC

  • Wyoming


The fight for coverage of IBTs is ongoing, but it has been a successful one. If things continue as they have, it is only a matter of time before all states mandate that IBTs be covered by insurance.

Allison also writes about medical malpractice on her website, Medical Malpractice Lawyers.