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Denied By Design? Inside the Fight for ABA Coverage · The Autistic Mile

• speaker-0: Welcome to another episode of The Autistic Mile. Today we're going to be discussing ABA and insurance and the some of the problems that arise sometimes. I'm here today with friends Lou and Jocelyn. we're we're gonna be discussing things that are particular to to some of their experiences with ABA and insurance specifically. I wanna welcome you to the autistic mile. glad to have you. you guys we've gotten to know each other pretty well since I've been at at JSA. So you know, from my perspective, you know, what I do at JSA, even though I don't work with ch children directly, I like being part of the mechanism, you know, of JSA. you know, I serve a certain function with as a billing coordinator, but you know, I help serve families. I don't necessarily I I get to interact with the kids and and do various things on field trips, and that's all great. yeah, my main focus is making sure families, especially in terms of insurance, and matters, matters pertaining to that, aren't being neglected or, you know. that we're taking care of. That's that's my, you know, that's a a job responsibility of mine is something I take very seriously. So the topic today that we're discussing, ABA therapy and some of the issues surrounding insurance are are things that I'm very close to and they do matter to me because I see the impact that it has on families. so why don't you tell us a little bit about JB, speaker-1: JB a vivacious seven year old, seven year and seven month old boy, extremely energetic, affectionate, when he's happy, it's the greatest thing in the world. and he has been diagnosed at a very early age with ASD. severe. Severe. And navigating the challenges throughout his life so far have been difficult. we've had a lot of wins, and recently we have a big challenge in front of us. And so that's where we're at. And by the way, thank you for having us on. I should have led with that. Thanks for having us and allowing us to communicate our situation with you. Okay. speaker-0: Okay. Well let's and JB's a great kid. I mean, energetic, yeah. So I mean he is all the kids, I mean I to see them day in and day out, you know, sometimes people in public they see them in small intervals. And you know, it's as as human beings we tend to we tend to formulate a perception based on these small little snippets. And that's unfortunate because, you know, as parents yourselves, as as somebody that works at at a school slash clinic, I spend a lot of time around these children. You know, I have an autistic son, so I know autism. so you know, I I see it in a I see it in a broader in broader terms and I really see the the special qualities each child has. and they're all you can see the wheels turning. I mean, they we all think differently. But you can see that he really it plays out on a daily basis. for ABA services, and this is just generally speaking, you know, we're starting to see trending where services are being not scaled back. They're not services are not being denied, but they're being shortened. and that places a lot of pressure on the process. because when you talk about ABA therapy and some of the work that goes into a treatment plan and some of the diagnostics, a shorter time frame is not a f not a friend when you're doing that. they used to the first time I started seeing shortened authorizations, is really in the vein of there there would be a special circumstance, maybe something something specific to a to a certain child. but it'll be very specific. It wasn't now we're starting to see it more broadly, where it's where it's it's noticeable, it's a trend now. now in my research, there's I have not been able to conclude that there's any changes in policy in insurance, not we're talking about insurance policies, but the policy of the insurance companies and how they're handling this. although six months is six a six month authorization is kind of the unspoken rule. But it's more than unspoken. Actually, in in a lot of the in a lot of the policies, they say twice a year, twice annually. so their own documentation speaks to this six months. Now it's not a hard, fast rule, but everybody in the industry has generally come to accept that it's six months, unless there's a special circumstance. And we ha I have seen that. and it hasn't necessarily continued. You may see it during a certain authorization period. And then the next one is back to six months because they've they've overcome that hurdle, the obstacle, whatever was whatever was the cause of that. But it was always a cause. It was always some legitimate reason. And now we're seeing these come back not so legitimately. If it you know, now i one or two, it's you know, you can say it's coincidence, but when you, you know, if you if you work day in and day out over the course of a year and you understand the history of it and you say, okay, Something's going on here, you know? And although in my research I can't show anything that that's written that says they're changing direction any given insurance company, this is real. It's actually playing out. I see I see it. You you've been impacted by it. so so you've recently experienced not not just a they're calling they're not calling it the when a shortened auth period is just that. It's it's they're not it's not a denial. So that's how they they're they're just shortening the amount of units and amount of time that they're approving for treatment. Most of the time it's it's been a three or four month range instead of six. three months is extremely short. When you think in terms of that a treatment plan and diagnostics are are relatively you're able to submit them about thirty days prior to the to the authorization, the current authorization expiring. So That doesn't leave you lot of time, three months. If it's if you're gonna start working on it and get it ready and get it staged, so that you can submit it for approval, that doesn't give you a lot of time for these for the diagnostics and to get the meaningful data that they're using to evaluate whether this authorization should be approved and how long it should be approved. So by the fact that they're changing, shortening this up, they're making it more difficult, they're placing more of a burden on the provider. it's it's placing a lot of pressure on the on the whole process, as it were. so just to to kind of give you the background as I know it, now JB has been denied. and although we're not gonna go into specifics, I know there's challenges there. I mean, you guys, there's frustration, Tell us a little bit just, you know, generically about the challenges and the you know, the frustration from your from your standpoint. speaker-1: I mean it's it's just it's a very stressful process. you know, it's affecting our child, it's check affecting our family, you know, financially, obviously. We have this financial hurdles. we're thinking about JB's future. and he obviously getting the ongoing care that he needs. And so that just been very, very stressful on us. Yeah. Yeah. I think on face value, you know, you just think, how can a insurance company just flat out deny someone who has these needs? Right. But to speak about what you were saying earlier, it makes sense. These are strategies. Insurance companies are a business. They're constantly coming up with new strategies to increase their bottom line. And this may be a situation where they just threw something against the wall to analyze how it stuck. And we come back with, you know, fact based evidence and through the appeal process and we we combat that. And they are going to analyze the entire process to see how they can do future strategies. And that's what I believe. speaking of how our lives are disruptive, we both have careers. Yeah. We have to provide for our family. And it's such an inconvenience. It's such an interruption. And you when you tell someone your child can no longer get services, you have to adjust on the fly to make things happen. And it goes beyond just the two of us. It it it affects, you know, everyone around us in our lives, everybody that we touch, everybody that we, you know, speak to on a daily basis and the significance of our relationship with them and how our relationship affects their lives. so it's a big deal, you know, and we just wanna make sure that out of all of this, this doesn't happen to other families and if there is a way that we can all learn from this, including the institution that he goes to, that they you know can learn from it and and we can be stronger. we're that's what we're all that's what we're doing. That's what we're doing right now. speaker-0: Yeah. And I I know the pressure because you're talking more appointments. and for those appointments you have to maybe some days I know he may not be receiving services 'cause you gotta go to appointment 'cause you've got a you have to have additional evaluations done. Evaluations that are necessary, but now you're going through this, they're always necessary at r at regular intervals, whether it's a year or two years, but now you're doing this in a consolidated time frame to deal with the this appeal process. So, you know, it's almost like You have to put your life on hold. You know, you're ch you're trying to navigate careers, you're trying to navigate family, you're trying to navigate everyday life and it's just boom, boom, boom. Yeah. speaker-1: That's great. Because clock is ticking against you. Right. And and you know, time is the most significant currency that a human being has. What you accomplish in that time, especially for your child and their care. So it's finite. not to mention the evaluations are incredibly expensive. Yes. And they are out of pocket. if you want to be seen right away. You know, there's a long wait period. Yeah. If you want to see we live in a where unfortunately money talks. Money gets things done. Yeah. And you know, I I feel for any family that doesn't have the resources. speaker-0: it's multifaceted. It's financial, it's time, it's quality of life. You know, there's there's so many different areas that that it touches upon, just not not just a single area. So and it's like I said, there's there's real measurable impact. e even from a provider standpoint, the extra work that they need to do to go through this and and work through it with the family. So everybody that's that's touched by that event i is gonna be impacted, but the the most most of it's gonna be on the family, unfortunately. and this is we we should we should say that, you know, this is not a new authorization. your son was receiving services, so he's already he's already in the system. This is not a new, you know, this isn't a glitch per se. This is something that's been approved previously, and now all of a sudden this denial comes out of left field. speaker-1: For example, from the get go, how this process started. our son was at school. He started this year, just receiving ABA services. He was in was here for one week, was it one week? and then the treatment plan was submitted and then we were denied. Yeah. I th it was within the first yeah, I think it was within a week's time. And the reason I wanted to bring that up is because let's put this all into context, what happened since we're talking about our child's denial. So at that point, we received a call from the school and they were clearly upset and rightly so. they requested a peer review. The peer review came extremely quick, suspiciously quick. And the person conducting the review basically came in with this is gonna be a denial and and we really don't care or we're not gonna r s receive the information they're giving us. We've already been already speaker-0: Compass no compassion and that's and and speaking from experience just generically, normally you know authorizations normally about fourteen to fifteen days is usually the ballpark and most some maybe a little quicker, some most of them don't take any longer than that. So for something to come back that quick, it's a little bit of a red flag, you know, because you're wondering how much how much work went in. speaker-1: Not much. They just sent someone in to give news, to drop the news that there is just gonna be basically a denial. At that point, we decided to take on the appeal ourselves and we got an e qu an evaluation. the process started very quickly. In fact, we just concluded with the evaluation. speaker-0: went through that. I mean that's A that that that you did and B that you were able to you know, because that that could have taken months. Not not because of you, but because of you know, scheduling. I mean that's speaker-1: My wife a fierce advocate for our son and has been has battled with insurance before And she's very savvy and she's you know, very she just goes in and she just doesn't quit. She's to her the determination level is off the charts. So luckily for us. speaker-0: As as autistic parents, and I know speaking from experience, I'm a little older than you guys, you know, we all become advocates when our children have autism. It's a necessity. because you're even even in the best of circumstances, there's going to be situations, maybe not even insurance related. It could be something at school or whatever other setting they're in, you know, there's some there's always gonna be areas you have to advocate. So we, you know, we really that in itself could be a full-time job, you know, and it takes a lot out of you. you know, I wonder you know the toll it takes on a family, on a on a relationship between husband and wife. you know, it's to me I always I think about the things that we don't always see or you maybe don't think about, you know, you know, the family structure. What does it do to that family structure? Are families being torn apart because because this is so difficult. you know, there's enough it's it's difficult enough for for people to succeed in a relationship without throwing some of this other complexity and so I applaud you guys for your advocacy. you know, I've I've gone through that. you know, I've my son wasn't an ABA service, in ABA therapy, so we didn't have to we will we were always dealing with with school with he went through the public school system And he's an adult now, but you know, he went through and and we had to advocate because he had an IEP and you know he was an ESE student. but you know, there were times where and it doesn't matter what county you live in, you know, from year to year, even every couple of years, a a county that was good or considered good in terms of ca not catering catering to but meeting the their obligation for ESE students. They could be very good for a certain number of years and then it can drop off. You know, because you have a lot of people are changing schools. You know, long gone are the days where a teacher is out of school from start to finish from the start time they start their career, they get shifted around the district. so the the best school for your child isn't always necessarily the school that they're in, even if they were at the time that they were considered a good school. very much in t in control of the of the current staff there, the the principal on down. So their philosophy and the way that they do things, if they're neglecting something, that can you know, if you have an administrator that's maybe not as capable in terms of ESC, that's not their specialty. you know, I've seen schools that have principals that have an ESC background and those are usually the best schools because they understand the importance of it. You have other schools that have teachers that don't have that experience. And I find that those schools are the schools where the ESE programs tend to lag a little bit. so it really depends on the makeup of that of that of the faculty of a given school I've always considered o ourselves kind of lucky that that our son was able to go through public school. he was able to go he was high functioning enough where he didn't ABA therapy, you know, twenty years ago really wasn't widespread. places you know, places like JSA, you know, they were few and far between. Now there's there's quite a few and it still can't keep up with the the the number the growing number of autistic children, the number of calls that we get. there JSA can only service so many students. there's is a a reality behind that. so there's there's more of the more places, but not every place is JSA to me is special. I don't just say that because I work here. I I just I I've been in other in other places. JSA is a very special place in the way that they do things. you know somebody asked me the question, I answered honestly, you know, well what happens in another in another ABA clinic or or slash school if some some of them are just ABA clinics, not they don't even have a school. so it's either ABA or so you get these hybrids. you know, JSA has both, which that is that is great because it allows a lot of flexibility for children. If if you if you're full time ABA, they can accommodate you. If you're part time they can accommodate you, you know, and you can be in a school setting. And those are so important. but JSA is is special in that regard in way that they've done things over the last twenty two years. They've really built it up in that way. There's a lot of careful thinking that went in behind it. A lot of the places that are popping up now, these ABA clinics, that's what they are. I they're kind of I almost, you know, you you you see the the You see the pharmacies that spring up on every corner. That's I I liken it to that because they kind of pop it up all over there. And it's a real need, but it almost they get to the point where it's cookie cutter and it does, you know, JSA it's special because it's it they're not everywhere. and then and they they really take care of what they do and and everything that goes into it. and speaking for Anybody, myself, we can always be better tomorrow than we are today. So it doesn't mean that we're not capable of mistakes, or capable of doing better. but JSA is always looking for ways to be better and acknowledging when when things may be lacking. And I think that really does set them apart from other from other institutions that I've seen. so another thing I've seen, and we talk about in terms of service, one of the issues and it it doesn't pertain to you directly, but another trend I've seen with insurance as it pertains to ABA, they're being a little heavy handed these days with and and different insurance companies have different policies about possibly having ABA services while you're in a school setting or while you're possibly off site, some kind of field trip or something. you know, JSA you know, they take their kids they take their kids out in public. They get them that exposure because it's part of life. and because the the social aspect that that impacts these children, it's it's especially important for them. so some of the some of the insurance companies they they put restrictions on they may not approve s you service authorization for a BCBA or an RBT to go into a classroom setting and treat a child. And I always say just because they're in a classroom setting doesn't mean they've stopped being autistic. You know? they may have a crisis in there. if assistance is needed, you want the you want the team that that child is most comfortable with to be able to be engaged and go in the classroom and kind of get them through that rough spot. so that's another thing, another caveat that we're seeing with insurance, that they're tightening up. Now I've heard people have said, you know, it's because of fraud in the system and things like that. And there's there's no doubt that companies commit fraud. you know, JSA for what they do and the way they do things here, that would never happen. but that's not to say it doesn't happen elsewhere. and to to s to see that they clamp down on that because of fraud, doesn't sit well with me. Although I understand, you know, it's almost like they should be looking at it on a case by case basis, and try to root out it's a probably a an impossible task, but root out some of the the bad apples if you were and and see the track record of some of the of some of the other providers. If you have a good track record, that those those services should be a little bit more should they should be more lenient in approving those types of services. 'cause normally I mean a a BCBA doesn't doesn't blindly go in and just put, you know, anything in a treatment plan that they don't agree with as far as what support they they know the child the best. That there's person supervising that child. So they know what the child's best interests are in terms of ABA, school, whatever the case may be. Not to mean the parents don't, it's always a collaboration, but from from a staff perspective. They are the supervisor. They know what's best for that child. And they're I mean, they're professional, they're medical professionals. So they're they're certified. and and when you get a denial or somebody saying something so the contrary, it's okay. Now you have two professionals in the same field butting heads. I would say that the person that works with that child every day has the advantage because they see they're seeing that child. Now the other person's just seeing a a stack of paperwork, you know? it's not time it's it's part time now, right? Yeah, yeah. speaker-1: unfortunately they didn't have a staff for for him. so and he was denied out of the classroom. And when the treatment plan, you know, I'm not gonna go into the specifics on the treatment plan, but I can tell you that what we've seen and is obviously insurance companies are probably using technology and they are s h going on a higher level of scrutinization and For those reasons, the data that they received from the institutions where JB goes is what they go by. And those are the things that flagged this denial to happen. And as a result, this is where we're at. We're trying to appeal it. you know, it's just really frustrating. Frustrating. speaker-0: Yeah, yeah. Now I get it. speaker-1: that everybody here at at or the school that he goes where he goes is invested heavily in his success. And I know that this is a real travesty for sure. speaker-0: I think one of the th I think one of the things that bothers me most specifically about J B and this this denial is it's he's seven. You know? I mean it's and the and some of the some of the details around surrounding the whole thing. it just doesn't sit well with me. But a seven year old, you know, you're denying ABA service. That doesn't mean you're not there's not they're not appealable, but there they're better communication should be forthcoming from the insurance company in that situation. You know, it's you know we gotta stop looking at these kids like they're just numbers and, you know, there's a real person. and even though hopefully this is a s a short duration that's impacting the services, Okay, guys. So in this last segment, we're gonna talk about we're gonna talk about the supervisor, we're gonna talk about who knows the we touched upon it earlier, but who knows your child aside from you yourselves, who knows you outside of a home, who knows your child best? and that really is meant to be the when BCBA is doing supervision, it usually accounts for about ten percent of the of the actual therapy time that they're receiving. So they receive direct services by an RBT and then they receive about ten percent of that, whatever that total is, and that is in supervision. So that is where even though the BCBA and RBT are engaged and they're they're engaged, even though they're not doing supervision maybe on a given day, they're in contact. They're asking questions. Even if they're not physically providing supervision billing for supervision that day, they're still always providing supervision of the RBT. It's a never ending job. Question. So it's a never ending job whether or not they're actually it's a they're actually billing for it or not billing. So but in a clinical setting, the BCBA is a supervisor. They know your child. During a break we were talking about video. If somebody's doing an assessment of your son that's that's not working with them every day, video could be a very powerful. when we're talking in terms of a of a treatment plan and somebody at an insurance company, they're seeing paper. and all there's there's numbers, there's statistics, there's facts based there. it still can be a little subjective based on who's reading it. You can have five different people. And again, these insurance companies, sometimes the people doing the initial val review of the paperwork, they're not all the same. You may have may all be certified, but you may have somebody who works for the insurance company directly. You could have somebody that's a third party that's doing it on the insurance company's behalf. So the the experience level of those people and what what the setting they're in can definitely play a role in the outcome of that authorization. it's just natural to assume you have different people doing this, i even though there's high level criteria, it at the end of the day it all depends on whose desk that paperwork lands on. They don't have the benefit of seeing the video of they're looking strictly at it. and that's really the if they if that if that treatment plan doesn't come across the way it should, if it's if it's lacking some information or something's not correct, that can lead to a negative outcome. It could lead to a reduction in services, it can lead to a denial, it can lead to a shortened authorization period. so the treatment plan is always so important. Tell me a little bit 'cause I'm fascinated about the video aspect of it. Because I you I'm a technology guy, you know, we're doing a podcast. Video is very important. The power of video, tell me a little bit from your perspective. speaker-1: therapies, he's they're able to provide us some evidence so that he's able capable of performing certain tasks. and so we get these videos, you know, we get these videos probably at least a couple of times a day, or not a couple of times a day, but a couple times a week. A week, yeah. A couple times a week. And then we get photographs as well, just providing, you know, showing us look, look, look at what your child did today. And I think that that is just so important to see You know, the things that he's learning through these ABA interventions. these are things you don't necessarily see on paper, right? So that's that's what's so important about video, capturing those moments that you may not see even in a C evaluation setting. Right. And you know, I mean, there's a million things that I could say the insurance companies could do better. gathering up more you know conclusive information if something seems subjective with the treatment plan, asking for more evidence, asking for, you know, where you know, where are we seeing improvements, can you back that up by by some empirical data, via or some sort of visual evidence or audible evidence or, you know, and and all this stuff is being gathered throughout the year by the school where he goes and could be presented to the insurance company. I don't think the insurance companies are interested in this. I think the insurance companies are scrutinizing the treatment plans that are being submitted and they're looking for reasons to deny and stop giving coverage because they're trying to increase their bottom line because again, it's a business. I think I think they, you know, they're there to insure and they're there to provide, but they're also there to appease their shareholders and that's a balancing act that they do. I just feel like if they were interested in helping more, they ask for more information instead of Coming with a denial, they would say, Well, right now we just need more so that we can more so that continue to approve his treatment. speaker-0: And most of the times that is the case. Most of the time, they will come back and say, We need this, we need that. There's communication. Communication is so important. If it if there's a breakdown, then everything goes goes the hell in a handbasket. And that's where situations like this happen. communication that's communication needs to be there. And and nothing's worse than bad no communication or bad communication. I have a part of me believes that some of this is again pressure on the system, pressure on the insurance companies with the growing number of the caseload. I speak with enough insurance companies that I I hear comments, you know, people just in passing, you know, it's we're so behind. you know, that that'll w we'll definitely get that tomorrow. So I I think that plays into it. And I think it's it's unfortunate because I think people get overwhelmed. And if you get the wrong person on the wrong day who maybe makes a rash decision, but even that, if there was a if if they're following the procedure about a peer review or following up and making sure That if there is an issue today that we can fix it going forward. That's the best thing. To cut it off completely is the worst thing they can do. And that's really where that's really the problem lies. Everyone everyone might have a bad day. You may react harshly in a certain circumstance. But to re on another behavior and say, you know, on another day, we can't I can't give exact examples, but if you go and say if you have a peer review and then that peer review is nothing more than a formality Okay, you're having a peer review, but we're still gonna deny you. What they've gone into that peer review. They're not even they're not no it's will not even have it at that point because they're saying we are in control matter that's the worst thing that can happen. speaker-1: their behavior would p potentially be setting up for a legal dispute just based on their behavior. Because on our side, we're all doing and following protocol. And we recently had an evaluation bec for the this appeal process that had has gone very well. so far and we have done everything they've asked and we are we we will be submitting everything they've asked in order to overturn their decision. And again, I would expect nothing less than approval. if not, again, based on their behavior, from the beginning, they would be setting themselves up for illegal dispute. Yeah, there his his or her approach should not have been one that was defensive. It should have been one that would have been inclusive, which would have been, okay, I made a decision. Please speak on behalf of the student and let me understand where you're coming from so that we can make the right decision for the student. Right. That Hopefully it doesn't get to that though and we just get the approval through all the things they've asked us for. speaker-0: No, I think I think once you get a you know, get it to get past a certain point, you've moved past the person or persons who were involved in that immediately. And that okay, we moved to a place and now you're working with somebody that's more rational, that's detached from the original horse in the race. They have a horse in the race only in the fact that they're still part of the organization. But you know, was that review done by a third party and the third party is so rigid, you know? Yeah, but speaker-1: A lot speaker-0: Lotta a lot of work a lot of a lot of lines of business. Work gets farmed it's not just insurance, but a lot of lines of business. Do you need to evaluate this third party based on this on this interaction and the negative it's not just the denial, it's just the it's the circumstance, everything that went around it. You know, it's it's it's just wrapped up in a nice neat box. speaker-1: Psychologists. Yeah. Yeah. Who pr whose practice does not even take the insurance company that he's representing If that tells you anything about this process. Anything. So this is wrap your mind around speaker-0: Yeah. You can't get in somebody else's mind to think, what was their what's the rationale? But they have to provide that. They have to provide that information. And then but that's really review. So it won't it's meant to be done during a peer review, so that it won't get to this point. You know, but that's what the peer review is about. You know, to to s to discuss among peers where where if there's something else is needed, if there's something lacking. and that's communication. There's nothing more important in this world. you know, and and on this topic, I mean, we're not just talking about, you know, changing a spare tire or having, you know, we're not talking about a car. We're not talking about a being about a human, being about a child. We're talking about a human being. you know, we're not talking about, you know, calling somebody because my computer doesn't work. we're not talking about some foreign object. we're talking about a human being, a child, a seven year old child. and it's this you know, it it just it just it bothers me the whole The whole piece of even though, you know, we haven't we we've speaker-1: Yeah. It's alarming for sure. speaker-0: But I mean it's important that people realize that this happens, that you guys aren't alone, but you guys are handling it the best speaker-1: We have a great support system. We have a great people at the school that he attends to that have gone above and beyond, like yourself who's just having this podcast. everybody that's attached to this, that is communicating with us on a daily and weekly basis has given us their overwhelming support, given us great advice. And absolutely. speaker-0: It's gotta help even just to have speaker-1: yeah. speaker-0: year. I mean 'cause Yeah. I mean the weight that you guys have on you just without any of that, you know. and raising an autistic child and the the concerns that you know that that you have each and every day are enough without any of this other stuff. It does. and I I've I've seen it I've seen it play out in other ways, you know. It's just Yeah. But I mean what I mean, you know, I mean these days technology has come a long way. So I mean the power of that, being able to share that with somebody doing an evaluation, an external evaluation. again, somebody that ha that's not that's doing something independent, you know, they're they're because that's outside of a school setting, that is most of the time is every couple of years they have to have an evaluation like that done by a psychologist or another professional. for them to be able to base that on something other than just words on a on a you know, you can only derive so much. I mean most treatment plans are maybe pages fifteen, sixteen pages. Depends on the behaviors, it depends on how complex they are and how much information is in there. but again you can only derive so much from a piece of paper. speaker-1: that the system is as antiquated as it is and the paperwork is as antiquated as as it is There's just no, you know, the the the requirements of the insurance are asking for how this information is being perceived is because we're we're in a place in the past. We're not in the present. And and and the fact that they don't require video editing to see how a child is is is you know, progressing is absolutely insane. Because otherwise it does leave it to subjective opinions. And technology may have been the very thing that flagged the treatment plan to begin with. But yet on the other side of things, they're asking for these, you know, forms to be filled out that are have questions that really don't they're not even applicable to anyone's child because they throw everybody in some sort of box or category. And and there's of course there's naturally labels that are attached to each one of those. We all know that human beings are complex individuals that are unique and and have, you know, different strengths and different weaknesses and have good days and bad days. And they're just not speaker-0: you never know where that road's gonna lead to with your child. And that for me was always one of the most frustrating parts. You do your best day in and day out, but you have there's no guarantee of results. I think you've and I have talked about it. We sometimes we project on our children. We want to think that they're capable of more and that's maybe because we think that we think they are, but at the end of the day they're they're the master of their own destiny. we don't i it's hard to know what their real what's their ceiling. You don't know what their ceiling is. we want to try to push them as much as you can. even my own son as an adult now, I continue to try to push him on a daily basis, to to make him think about things 'cause his brain, even though we're both autistic, our minds still work very differently. he and I grew up in different times. you know he he went through and even though he wasn't ABA, he before he w even went to kindergarten he was diagnosed with with autism. I wasn't diagnosed until I was in my forties. so he had all that understanding which I'm happy I'm glad he had but is a it's a little bit of a double edged sword he didn't develop some of the skills that I developed over the years of having to go through some of the things Because of a lack of understanding. I was for you know, people like myself that get diagnosed later in life, you're you're forced to develop your own skill set to to navigate daily life. if you're fortunate enough to to have the faculty to do that. Not everybody, depending on where you are, can do that. For some of us, we try to mask, we try to hide, we're in a world what we think to we're showing a world what we think the world wants to see. but there's always something behind there. It's there's always challenges. there there's no such thing as being a little autistic Part of me wishes sometimes that he had experienced a little bit, you know, but it's it sounds harsh to say, but some of the some of the things that kind of make you kinda develop certain skills, I I think it's a far better path than having to go through life not understanding. at least now we know what we're dealing with and you can you can kind of formulate a plan with that. that's that is always the comforting side of knowing your child has autis autism. But again, you don't know at age seven, where is where is that child gonna be at at age ten, fifteen, twenty, twenty-five. you know, you just gotta do your best every day. But that goes for all children. you guys are are obviously great parents. I mean that goes without saying. So he's he's got that going for him and that's there's no there's never no better tool that he can have, than than good parents, trust me. so anything you guys wanted to touch on before we wrap up today? speaker-1: We'll just sit waiting and see what happens. as far as our situation goes with the the appeal process. The appeal process and hope for the best. And hope for the best. speaker-0: it's important for our audience to know. I mean, because there's people that go through this. You're not the first ones, obviously. but you know, one of things that we like to show on the podcast is different situations of people going through is so people don't feel alone and they know you know, that other people are going through it and that shared experience, there's like I said, there's strength and understanding people and always feels like you are and always feels like the hardest because it's happening to you. speaker-1: If there's anything I would say, and I know Jocelyn feels the same way I do, is is don't give up and fight. Yeah. And and you're not alone. And you're not alone. Exactly. And your child is always gonna be worth fighting for and you is you are you know Absolutely there's support around you. Yeah. You know, go find it. speaker-0: Yeah. Well you've got our support. You got my support. You know, I'm if nothing, I'm always a so a good sounding board. So that you can't understate the the value of having somebody to be able to the to talk to that understands it. When you're talking to somebody that actually understands it or has been through it, there's that shared experience. I always found comfort in that. I was when I when I talked to somebody I know had experience with it, I thought it was always easier 'cause I didn't have to go into certain details. It you it was 'cause there was something speaker-1: start from the beginning, it's like they already know when where you're going and what you're talking about because they they have that shared experience. And that does make it a lot easier. And thank you so much for having us. Yeah. Thank you very much. speaker-0: No, no. I mean you guys again consider you guys friends. I mean it's we're glad to be able to have you guys on because this is these are the kind of things that we want to share with people. and we'll keep our audience up to date, 'cause we wanna this is not a this is the first in a recurring series that we're gonna go through. try to bring more attention to this because I see this in heading in a certain direction and we wanna try to do what we can to try to see if we can head it off and do what we can to bring attention to it. You know, you're doing that as parents by following the appeal process. by spreading the word and and having the the podcast as our foundation, we can try to get that information to more people and try to change a perception, hopefully change the process for the better. I mean, if we're not able to do that, then it's hopefully hopefully won't come to that. It's it's not widespread, but we wan wanna make sure it's not widespread. you know, it's the world becomes more complex each day. It's just like I said, I feel there's a lot of pressure on the system, a lot of pressure on the individual companies, the people working there. It's people, you know, everybody feels it. Parents feel it. the school and clinic feel it. The people at the insurance company feel it. But we all have to get through it together. We'll we'll keep track and we look forward to having you back again, That's gonna do it for us today on the Autistic Mile. I appreciate Lou and Jocelyn joining us. and we'll see you next time on the Autistic Mile. Thanks everyone.