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May 10, 2018

How Geography Influences Autism Treatment

There are many different treatment options for children with autism ranging from speech therapy to behavioral intervention and medication, but which ones families choose appears to depend on where they live.

A new study finds that children residing in the Northeast are most likely to have tried a variety of therapies while kids in the South are more commonly taking medications.

“Where families lived was significantly associated with treatment use,” according to findings published in the Journal of Disability Policy Studies. That’s the case even though location is “not a factor that influences symptom manifestation or treatment need,” the authors wrote.

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For the study, researchers at the University of Houston and Baylor College of Medicine looked at data on more than 2,600 families of those with autism living across the United States and in Montreal, Quebec.

All of the families were asked if their child was currently receiving — or had received since age 2 — private or school-based speech therapy, private or school-based occupational therapy, intensive behavioral therapy, biomedical treatment like a special diet or any other type of therapy to address social skills or otherwise. In addition, they were asked about any use of psychotropic medications.

Families in the Northeast were “significantly more likely” to have used school speech and occupational therapy, behavioral and biomedical treatment. Those in the West favored intensive behavioral treatment and biomedical approaches, the study found.

By contrast, Midwesterners more heavily relied on medications and less frequently used behavioral treatments. And in the South, medication use far outpaced other approaches. At the same time, families in the South and in the Montreal area were most likely to report no treatment use.

Even within regions, however, the study findings indicated that there were variations in treatment usage. For example, families in the Mid-Atlantic were far more likely to have used behavioral or biomedical interventions than their counterparts in New England, even though both areas were part of the Northeast region for purposes of the study.

Researchers said the trends in treatment use may have to do with regional differences in the frequency of autism diagnosis. The findings have implications for policymakers, service providers, schools and researchers, they said.

 

April 30, 2018

 

The Trump administration is moving to make it more difficult for immigrants with disabilities and their families to get a visa or attain permanent residency in the United States.

proposal from the U.S. Citizenship and Immigration Services, part of the Department of Homeland Security, would alter how immigrants are evaluated as they seek the right to permanent residency — the step before citizenship. The use, or potential use, of public services by immigrants or their family members are considered “heavily weighted negative factors” in the draft document.

 

Some of the examples cited as negatives include high-cost medical conditions and many uses of social services, like food assistance, Medicaid, unemployment and disability benefits. The category “mental disorders” is on a list of the five most expensive health conditions contained in the draft regulations.

Disability rights groups have raised concerns about the proposed changes and said that even though the proposal has yet to be adopted, it is already having an impact in the disability community.

 

According to the draft document, the goal of the proposed changes would be to make sure those seeking a visa or residency would be self-sufficient and less likely to use public services. Those who may need such services are defined as a “public charge” in the proposal. The proposed changes would primarily impact immigrants who are applying for a green card through a family-based petition.

 

The proposal seeks to update existing federal guidance that’s been in place since 1999, said Gabrielle Lessard, senior policy attorney for the National Immigration Law Center. That guidance only considered two benefits as negatives, she said: cash assistance and long-term hospitalization care. The proposed regulations expand that list to a wide range of social services, including most government-funded health care, Lessard said.

 

“Everyone should be concerned about this,” Lessard said. “This is asking people to make cruel choices between getting assistance with health and nutrition and being able to join their family members.”

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