EI did not approve the 20 hours of ABA training like the Dr. recommended

We just had his EI meeting to increase his services. The developmental pediatrician recommended 20 hours of ABA with his PDD diagnosis.

We got 10.5 hours. Apparently this is all that is allowable by NJ law. He will still be receiving the speech 2x a week that he has been getting and 1x a week of OT.

Would you pursue getting more services privately or do you think we should just see how the 10.5 hours go?

Re: EI did not approve the 20 hours of ABA training like the Dr. recommended

I think I'd try to persue it but without paying out of pocket, did you call your insurance co?

Re: EI did not approve the 20 hours of ABA training like the Dr. recommended

I would start out with what is given, and then see how things progress. If you feel that more hours would make for better progress after getting your ds accostumed to it, then add on. You can probably even then present your case further to the county (or whomever is funding it in NJ) why they would need to fund more therapy.

Sometimes "too much" therapy can be an issue as well. The whole reason why they want 20 hours is so that the child's day is spent "constructively" so that non functional behaviors may lessen. If you can supplement the time with really functional activities it could be even more valuable than therapy. (playdates etc)

It may also be difficult to hire someone right now not knowing 'exactly' what you would want. For instance, I hired a music therapist because I felt her therapy sessions lacked that aspect. I am also considering hiring an art therapist.

I would fight to get more OT though. 1x of OT is really nonsense. If I had to pay anything out of pocket it would be for an amazing OT and a PROMPT certified speech therapist.

Re: EI did not approve the 20 hours of ABA training like the Dr. recommended

I would fight to get more OT though. 1x of OT is really nonsense. If I had to pay anything out of pocket it would be for an amazing OT and a PROMPT certified speech therapist.




I couldnt agree more with this!!!!

Re: EI did not approve the 20 hours of ABA training like the Dr. recommended

Re: EI did not approve the 20 hours of ABA training like the Dr. recommended

I would push for at least 2x OT and 3x Speech. That could help a lot. In our case, we were late in getting OT because there were none available for a while after DS was approved. When he finally did begin OT, it was like a huge piece of the puzzle fell into place. I know every kid is different, but for kids on the spectrum, I think additional OT can make a HUGE difference, especially if they have sensory issues.

I would probably try to persue additional ABA if it wasn't cost prohibitive. Did they recommend a preschool program in addition to the ABA, or just ABA, speech and OT?

Re: EI did not approve the 20 hours of ABA training like the Dr. recommended

No more parent training in NJ for EI (thanks to our governor Chris Christie). So that's no longer an option.

The dr also recommended 2X of OT but we only got 1x. Funny thing is he used to get OT 2x a week. Then it was eliminated at his annual eval, they felt he met all his goals. I protested but they said they couldn't justify keeping it just to possibly prohibit regression and sure enoough, by 2 months later his sensory habits were back in full swing, even with me working on them with him. So they gave it back but only 1X a week.

I'm going to call our insurance and see what they can do. He already goes to a regular preschool 2 mornings a week. An ABA therapist will now be there with him 90 minutes of each 2.5 hour class to help with play and socialization. Those 2x a week are part of the 10.5 hours.

Since he ages out of EI in 3.5 months they said they are actually giving him more than they would have had he been younger which doesn't make much sense to me.

His OT does EI in both NY and NJ and she said EI services are easier to get in NY but the preschool program (when they turn 3) is easier to navigate in NJ. Every school district has a special needs preschool program.

Ugh, this is so frustrating. I'm so so angry at myself for not having him evaluated sooner, and also for "listening" to the EI therapists he already had who were confident he wasn't on the spectrum. I know they're not qualified to diagnose but I trusted their experience I guess.

Re: EI did not approve the 20 hours of ABA training like the Dr. recommended

Re: EI did not approve the 20 hours of ABA training like the Dr. recommended

Posted by cjik

Does NJ mandate that health insurance cover services for children on the spectrum? I know NY just had legislation signed re: this, and ABA services were on the list (though how many hours I do not know). I think Autism Speaks may have a section of the website that lists legislation in different states. If you can go through health insurance, then I would do that.

I would also keep pushing for another session of OT. You may need to be a squeaky wheel unfortunately, but use whatever you can, statements from doctors, teachers, etc. to prove that it is necessary. Are they doing sensory work in that one session or is it fine motor work or a mix of both?

Good luck!

Re: EI did not approve the 20 hours of ABA training like the Dr. recommended

One of DS's teachers told us be careful with using insurance for services, especially if you have a cap. The services can eat into that limit.