Colorado Family Wins Insurance for Autism Services

An arbitrator in a Colorado family's dispute over whether Applied Behavior Analysis (ABA) therapy is covered under a health insurance plan has ruled in favor of the family seeking reimbursement for about $110,000 over two years of therapy.

Autism services advocates are hailing the decision in the case of Jill and Stephen Tappert who appealed several coverage denials for ABA services for their young daughter Abby by Anthem Blue Cross Blue Shield of Denver, as an important victory.

But a spokeswoman for Anthem told Denver ABC TV affiliate KMGH Channel 7 the insurance company believed Tappert case was a single instance and was not precedent-setting: "This decision is not a broad-based declaration that ABA therapy is 'medically necessary' in all cases. To what extent this type of therapy should be covered...should be made by legislators and/or the division of insurance."

It's not surprising for the insurer to assert a narrow reading of the case. However, families around the country could study the arbitrator's decision which clearly states that ABA is a mainstream, research-based approach for early intervention services for young children with an autism spectrum disorder diagnosis—and rejecting the insurer's arguments that it's not an effective medical treatment.

The case also raises questions for other insurance companies and whether they could use this decision to revise their coverage policies or the administrative rules that govern them.

One thing the Anthem spokeswoman hit upon was a legislative trend. The question about health insurance coverage for autism services such as ABA has, in fact, been a theme of legislative debates around the country as the issue makes its way through state-level debates. Reading different bills, some legislators leave the wording vague as to what health insurers should cover; new laws have passed in South Carolina, which calls for coverage of behavioral therapy, and Texas which calls for coverage of ABA. (Insurance industry and business industry lobbyists, meanwhile, have argued against any additional coverage because of the cost, in states like Pennsylvania.)

The Arbitrator's Findings

The arbitrator's decision document (dated Nov. 20 and issued by Judicial Arbiter Group) which Autism Bulletin received from advocates, provides a window into the health insurance company's policy on autism coverage. Anthem rejected coverage on the grounds that ABA services were not provided in a doctor's office, that ABA was not a medically valid treatment.

Some of Anthem's testimony appears to have been undercut by the fact that administrators and doctors with no experience treating autism cases were making decisions about whether ABA should be covered. Even so, the arbitrator's decision rejects Anthem's arguments and cites the testimony of Philip Strain, an early intervention autism expert and professor of educational psychology at University of Colorado at Denver states:

In his criticism of the Anthem policy, Dr. Strain points out that Anthem erroneously equates ABA therapy with Lovaas therapy—an approach which has received considerable justifiable scientific criticism. ABA therapy is based upon incidental teaching and pivotal response training, which Dr. Strain testified is the standard of care when dealing with autistic children.

According to Dr. Strain, instead of being investigational and experimental, ABA therapy reduces problem behaviors 80 to 90 percent and studies have replicated these results repeatedly.

Finally, Dr. Strain testified that the ABA therapy received by Abby was endorsed by the National Academy of Sciences—the recognized authority in the United States for resolving scientific disputes. Dr. Strain's opinions were echoed b Dr. Huckabee, Abby's treater for autism. Both Dr. Strain's and Huckabee's opinions are supported by the National Institute of Mental Health's publication on Autism Spectrum Disorders: "Among the many methods available for treatment and education of people with autism, applied behavior analysis (ABA) has become widely accepted as an effective treatment. Mental Health: A Report of the Surgeon General states: 'Thirty years of research demonstrated the efficiency of applied behavior methods in reducing inappropriate behavior and increasing social behavior.'"

Remember the American Academy of Pediatrics

The arbitrator's decision in this Colorado also case points out the importance of the recently launched autism awareness campaign at the American Academy of Pediatrics. The full-on effort to educate pediatricians about autism and early interventions to address the condition is likely to lead to more medical prescriptions for therapies such as ABA for young children who are diagnosed with autism spectrum disorders. It will also make it more difficult for health insurers to pledge ignorance about the legitimacy of such approaches.

Also see in the Autism Bulletin archives:

American Pediatricians Make Big Push for Autism Diagnosis, Awareness; Kits for Doctors, Checklists for Parents

Questions and Answers About the Florida Autism Center of Excellence in Tampa

The Florida Autism Center of Excellence (FACE), which opened August 20 in Tampa, Florida, to serve children with autism spectrum disorders, represents an interesting model for a new school. There's been a great deal of interest among Autism Bulletin readers in how the school is set up to help kids and their parents, and below I am publishing the transcript of an e-mail question-and-answer session with representatives of the school about the FACE program.

First, a bit of background. About one year ago, FACE received seed money ($700,000) from the state of Florida to cover starting costs. Students at the school are eligible for partial tuition grants from a state government "school choice" program for children with disabilities. The school is pursuing a program based on the principles of Applied Behavior Analysis (ABA), which means staff seek to manage the behaviors of children to help them learn, to encourage positive behaviors that lead to growth and development and to discourage behaviors that are obstacles to learning.

In addition, the for-profit Educational Services of America, based in Nashville, is responsible for managing the nonprofit FACE school. With such a model, with a rising demand nationally for autism services and educational programs, it's no wonder that there has been a great deal of interest among Autism Bulletin readers in the school, and the specifics of how it's set up. What follows below is the full text of questions I had, plus those collected from readers, and the answers which the school administration sent on November 29 through Lovell Communications, Educational Services of America's public relations agency.

1. What kind of training do teachers receive?

Our teachers receive specific, extensive training that begins before they enter the classroom and continues throughout the school year. Topics include Applied Behavior Analysis and specific methodologies for working with students with autism, such as discrete trial, structured teaching, social skill training and other tools to develop individual education and behavior support plans.

Our school calendar requires an additional 150 hours of formal training, which is supplemented by ongoing coaching and support from the clinical program director and from teachers who mentor their colleagues. Teachers are trained to conduct individual assessments, write lesson plans and collect and analyze data so they can make objective determinations about whether a student is advancing academically, behaviorally and socially. In addition, teachers are required to obtain an Autism Endorsement from an accredited university.

2. What kind of training do one-on-one aides receive?

We staff classrooms to provide the greatest amount of support to promote students’ independence, enhance generalization and encourage relationships with their peers and, therefore, we do not provide one-on-one aides. However, all aides receive the same extensive, specific training the teachers receive.

3. What direct supervision do teachers and aides receive -- how often, how much time per week and from whom?

Teachers and aides receive a high degree of support and supervision. Several teachers serve as mentors to their colleagues and the mentors hold weekly supervision meetings with classroom teachers to provide ongoing training, support and guidance. The clinical program director meets with each mentor teacher weekly. And the clinical director/behavior specialist and school director review each teacher’s weekly lesson plan. Assistants receive formal supervision from the classroom teachers once a week and on-the-job coaching, support and training all day every day.

4. What kind of certification of education and training do you require of staff?

Our teachers are required to meet all state standards plus the standards of the Florida Autism Center of Excellence. Our school calendar requires an additional 150 hours of formal training, which is supplemented by ongoing coaching and support every day. In addition, teachers are required to obtain an Autism Endorsement from an accredited university.

5. How many staff members have advanced training in applied behavior analysis (ABA)?

Educational Services of America, the company FACE hired to manage the school, has seven qualified board certified behavior analysts, including two who provide support and supervision to FACE and conduct on-site training for FACE teachers. The FACE clinical program director earned her master's degree in Applied Behavior Analysis from the University of South Florida and sat for the certification exam in November. The principles of ABA are the very foundation of what we do. For example, our lesson plans include ABA components such as the instruction (discriminative stimulus), the prompt level, the correction and reinforcement plan.

6. Who is responsible for individual behavior plans for students? If an aide has a problem, where does she go for help?

The teacher, the mentor teacher and the clinical program director work collaboratively to develop students’ individual positive behavior intervention plans. If an aide has a problem, he or she goes first to the classroom teacher, then to the mentor teacher, then to the program director.

7. How often does your staff visit with students at home to generalize lessons from school, and work on home-based skills?

Our mission is to educate students in a school environment. Therefore, our staff does not go to students’ homes – rather, we communicate with every parent every day and we invite parents to schedule visits to FACE. In addition, we will soon offer parents additional support they can use at home. Our plan called for us to open FACE in Fall 2007 and offer parent and family initiatives such as training, support groups and a parent-teacher association in Spring 2008 – and we’re on track to do that.

8. What kind of training and education do supervisors have?

One supervisor has a bachelor’s degree in special education, a master’s degree in ABA and sat for the certification exam in November. Another has a bachelor’s degree in business management, a master’s in education and is working toward a doctoral degree in educational leadership. Our lead teachers each have bachelor’s degrees in psychology and seven years of experience working with children with autism. One of our lead teachers has a certification in Exceptional Student Education for students in grades K-12. The executive director of FACE has a bachelor’s degree in social science, a master’s in mental health counseling and is completing a doctoral program in adolescent counseling. He is a board-certified professional counselor and a licensed mental health counselor whose specialty is children and adolescents.

9. How many board certified behavior analysts does FACE employ on site?

ESA has three board-certified behavior analysts, including two who provide direct, ongoing support to FACE and are frequently on campus. The clinical program director, whose office is on campus, has a master’s degree in ABA and sat for the certification exam this month.

10. What is the student-teacher ratio?

We individualize our curriculum and behavior intervention plans for each student, so our student-teacher ratio is based on students’ needs. There is one teacher and one aide for every eight children at the FACE Dale Mabry campus, whose students require more intensive interventions. There is one teacher and one aide for every 15 students at the FACE Chelsea campus, whose students require less intensive interventions.

11. How many students have a one-on-one aide, compared to the total enrollment?

We staff classrooms to provide the greatest amount of support to promote independence, enhance generalization and encourage relationships with peers and, therefore, we do not have one-on-one aides.

12. The autism spectrum can present as a broad array of needs, from severe communications challenges, to highly verbal children who have a diagnosis of Asperger's Syndrome. Do you serve them all? How?

Our mission is to provide a continuum of education and behavioral services to students anywhere on the spectrum. We do this by providing individualized curriculum and behavior intervention plans to meet the specific needs of each student. Students at our Dale Mabry campus require more intensive interventions; students at our Chelsea campus require less intensive interventions. Class sizes are small and students are grouped by according to their age and then by their level of ability. Our small class size, low student-teacher ratio, highly individualized instruction and two campuses enable us to serve students no matter where they are on the spectrum.

13. What kind of parent training do you offer? What do you do to help parents learn about ABA?

We will begin offering parents structured training and support soon. Since FACE opened in the Fall of 2007, we have worked closely with our parents and shared our methodologies and philosophies with them. Our plan called for us to open FACE in Fall 2007 and offer parent and family initiatives such as training, and network and support groups in Spring 2008 – and we’re on track to do that. We can help parents learn about many aspects of ABA, such as positive behavior management, that will help parents and students in their daily lives at home.

14. What other services are available for families from the school?

FACE has partnered with the Boys and Girls Club of Tampa, in part due to a federal grant to establish after school programs for children with special needs. The goal is to provide a comprehensive after school program integrating children at all levels of functioning with a comprehensive academic, social and physical program model. As part of the program, FACE students are teamed with typically developing students from other schools who serve as mentors one day a week. This provides FACE students an opportunity to interact and develop friendships with students who attend other schools.

15. Do you offer any social worker support from the school?

Through our partnership with the Hillsborough County School District, every student and family has access to social work support.

16. What do you say to those who are skeptical that a for-profit parent company can run an effective non-profit organization like FACE? How do you balance the need to maximize revenues, minimize costs and still provide a quality program?

Our mission is to help students with special needs develop academic, behavioral and social skills that will enable them to lead more independent lives. Being a for-profit organization allows us to do this effectively, efficiently and with a high level of quality. Organizations, whether they are non-profit or for-profit, have many of the same fiscal realities – they have income and they have expenses. But there are some important differences. Because we do not have to raise money through charitable donations, we have the resources to focus strictly on helping children. We also feel tremendous accountability. We remain in business because our programs are successful and our families are happy with the results their children achieve.

Editor's Note

As always, you are welcome to leave comments about this exchange with the FACE school. No doubt the FACE administration will see them. In addition, I want to publicly thank the school's administrators for participating in this Q&A.

For more background, also see from Autism Bulletin's archives:

New Florida Autism Charter School Opens in Tampa

Florida Awards $700,000 Grant to Start Tampa Autism Center

Autism Schools Map Project

Advocates, Parents Among Those Appointed to Autism Committee at National Institutes of Health

One theme of the Combating Autism Act of 2006 was to do more to coordinate federal government efforts on autism research and diagnostic screening along with autism services and education programs. Following this directive, Mike Leavitt, the Bush Administration's secretary of Health and Human Services, on Nov. 27 announced 19 appointments to the government's Interagency Autism Coordinating Committee.

The committee's goal is to make sure government agencies are sharing information so they can coordinate their respective efforts on various autism-related programs. You can read Leavitt's full announcement by clicking here.

While the law calls for the director of the Centers for Disease Control to be appointed to this panel, Leavitt instead appointed another CDC official to represent the agency head, Julie Gerberding. (You can read the text of the Combating Autism Act here in a PDF file. For those of you interested in the specific section of the law pertaining to this committee, read to the end of this post.)

The committee chair is Thomas R. Insel, M.D., director of National Institutes for Mental Health. "The committee's first priority will be to develop a strategic plan for autism research that can guide public and private investments to make the greatest difference for families struggling with autism," Dr. Insel said in a statement.

Four Parents, One Autistic Adult Appointed to the Committee

The law calls for the committee to have one-third of its members come from the public at large, and at least one person with autism, one parent and one member of the autism advocacy organization. Levitt's six choices to fill these roles are below, with notes from the government's press release and some associated website links:

Stephen Shore, Ed.D., the executive director of Autism Spectrum Disorder Consulting. See his website at www.autismasperger.net. Shore has an autism spectrum disorder diagnosis. He is an education consultant who is an expert "on adult issues pertinent to education, relationships, employment, advocacy, and disclosure." Shore serves on the board of the Autism Society of America, as board president of the Asperger's Association of New England, and is on the board of directors for Unlocking Autism, the Autism Services Association of Massachusetts, MAAP Services, The College Internship Program, and the KEEN Foundation.

Parent Lee Grossman, the president and CEO of Autism Society of America (ASA), a leading advocacy organization based near Washington D.C. He is the parent of a young adult son with autism. Mr. Grossman is also the chair of the ASA Foundation and a member of the ASA Environmental Health Advisory Board.

Parent Christine McKee is a lawyer who has developed and manages an in-home therapy for her autistic child. She participates in monthly consultations with a Board Certified Behavior Analyst/Speech Pathologist. She applies the therapeutic measures in her daily parenting and childcare routines.

Parent Lyn Redwood is co-founder and president of the advocacy group Coalition for Safe Minds. The coalition is a private nonprofit organization "founded to investigate and raise awareness of the risks to infants and children of exposure to mercury from medical products, including thimerosal in vaccines." She is a nurse practitioner who has 25 years of experience, and began her advocacy efforts for autism research after her son was diagnosed with pervasive development disorder in 1999."

Parent and sibling Alison Tepper Singer is executive vice president of Autism Speaks and is a member of the board of directors. Prior to joining Autism Speaks, Ms. Singer spent 14 years at CNBC and NBC where she served in several positions. She has both a daughter and an older brother with autism, giving her long-term, personal experience with the disorder.

Yvette Janvier, M.D., is the medical director for Children's Specialized Hospital in New Jersey. Dr. Janvier is also a clinical assistant professor in the Department of Pediatrics, Robert Wood Johnson Medical School. Her specialties are autism and developmental and behavioral
pediatrics. Dr. Janvier is a fellow of the American Academy of Pediatrics.

Government Officials on Committee

Secretary Leavitt appointed 13 government officials and researchers to this committee. They are:

Duane Alexander, M.D., director of the National Institute of Child Health and Human Development at NIH. The Institute supports research on all stages of human development, from preconception to adulthood, to better understand the health of children, adults, families, and communities.

James Battey, M.D., is director of the National Institute on Deafness and Other Communications Disorders at NIH. The Institute supports biomedical and behavioral research and research training in the normal and disordered processes of hearing, balance, smell, taste, voice, speech, and language.

Ellen Blackwell is a social worker and health insurance specialist of the Division of Community and Institutional Services, Disabled and Elderly Health Programs Group, Center for Medicaid and State Operations, Centers for Medicare and Medicaid Services where she serves as an expert on policies that affect individuals with autism spectrum disorders.

Margaret Giannini, M.D., is director of the HHS Office on Disability. Dr. Giannini serves as advisor to the Secretary on HHS activities relating to disabilities. She is also a member of the Institute of Medicine of the National Academy of Sciences and fellow of the American Academy of Pediatrics.

Gail Houle, is associate division director of the Research-to-Practice Division, Early Childhood Programs, Office of Special Education Programs, Department of Education where she oversees programs for children with disabilities and their families funded through the Individual with Disabilities Education Act. Her expertise focuses on services for children with autism spectrum disorders.

Larke Huang is senior advisor on children and a licensed clinical-community psychologist who provides leadership on federal national policy pertaining to mental health and substance use issues for children, adolescents and families for the Substance Abuse and Mental Health Services Administration.

Thomas Insel, M.D., is director of the National Institute of Mental Health at NIH. The Institute's mission is to reduce the burden of mental illness and behavioral disorders through research on mind, brain, and behavior.

Story Landis is director of the National Institute of Neurological Disorders and Stroke at NIH. The Institute's focus is directed toward reducing the burden of neurological disease through research on the normal and diseased nervous system.

Cindy Lawler is scientific program director of the Cellular, Organs, and Systems Pathobiology Branch, Division of Extramural Research and Training, National Institute of Environmental Health Sciences at NIH. The Branch plans, directs, and evaluates the Institute's grant program that supports research and research training in environmental health.

Patricia Morrissey is commissioner of the Administration on Developmental Disabilities at the Administration for Children and Families, which seeks to improve services to and assure that individuals with developmental disabilities have opportunities to make their own choices, contribute to society, have supports to live independently, and are free of abuse, neglect, financial and sexual exploitation, and violations of their legal and human rights.

Edwin Trevathan, M.D., is director of the National Center on Birth Defects and Developmental Disabilities (NCBDDD) at CDC. NCBDDD is focused on identifying the causes of and preventing birth defects and developmental disabilities, helping children to develop and reach their full potential, and promoting health and well-being among people of all ages with disabilities. Dr. Trevathan is representing Julie Gerberding, M.D., M.P.H., director of the CDC, on the committee.

Peter van Dyck, M.D., M.P.H., is associate administrator of Maternal and Child Health at the Health Resources and Services Administration (HRSA). Dr. van Dyck oversees HRSA's Maternal and Child Health Bureau, which seeks to improve the health of mothers, children, and families, particularly those who are poor or lack access to care.

Elias Zerhouni, M.D., is director of the National Institutes of Health. A world renowned leader in the field of radiology and medicine, Dr. Zerhouni has spent his career providing clinical, scientific, and administrative leadership. He leads the nation's medical research agency and oversees the NIH's 27 Institutes and Centers with more than 18,000 employees.

Notes on This Panel from the Combating Autism Act

The law calls for the committee to meet at least twice a year, in public. Here's what the law says about its goals:

In carrying out its duties under this section, the Committee shall—

(1) develop and annually update a summary of advances in autism spectrum disorder research related to causes, prevention, treatment, early screening, diagnosis or rule out, intervention, and access to services and supports for individuals with autism spectrum disorder;

(2) monitor Federal activities with respect to autism spectrum disorder;

(3) make recommendations to the Secretary regarding any appropriate changes to such activities, including recommendations to the Director of NIH with respect to the strategic plan developed under paragraph (5);

(4) make recommendations to the Secretary regarding public participation in decisions relating to autism spectrum disorder;

(5) develop and annually update a strategic plan for the conduct of, and support for, autism spectrum disorder research, including proposed budgetary requirements; and

(6) submit to the Congress such strategic plan and any updates to such plan.

Related Stories on Autism Bulletin:

CDC Director Cites Autism as Urgent Concern

Bush Signs Combating Autism Act

National Institutes of Health Reorganizes Autism Research Program

Federal Research Grants Shows Intensified Effort to Find Autism Clues, Treatments, NIH Says

Autism Issue Makes Ripple in Presidential Race As Clinton Promises to Spend $700 Million Per Year

Sen. Hillary Clinton of New York, a front-runner in the race for the Democratic presidential nomination, last week issued a plan to help children and families affected by autism. The plan calls for spending $700 million per year to expand research, identify treatments, expand access to services for children and adults with autism spectrum disorders and provide autism-specific training for teachers.

While some other candidates do address autism in their campaign literature and remarks (read on below), Clinton's proposal is the most detailed of any of the major presidential candidates I could find, and follows her filing a bill in March 2007 with Republican Senator Wayne Allard of Colorado to increase access to support services for Americans with autism. (See "Senators Clinton and Allard Unveil Proposal to Expand Autism Services," in the Autism Bulletin archives.)

You can read a press release about Clinton's plan here. Both the Clinton-Allard bill and this plan—issued during this white-hot period leading up to the Iowa causes and New Hampshire primary in early January—include similar ideas around the same broad themes: expanding access to autism services for people who need them, from children to adults; spending more to understand what happens when someone has autism and why diagnoses are on the rise; generating more consensus around evidence-based effective treatments for autism.

Notably, Clinton calls for providing grants to states to increase programs and services for adults.

What Other Candidates Are Saying About Autism

A number of candidates who serve in Congress have records on autism that relate to the landmark 2006 passage of the Combating Autism Act, which received broad support. In fact, Sen. Christopher Dodd, a Connecticut Democrat, was the co-sponsor of the Senate version of the bill. You can read more about his work on that law here and see more coverage of that landmark law here.

Dodd and other Democratic candidates including John Edwards, the former North Carolina Senator and vice presidential candidate; Sen. Barack Obama, Democrat of Illinois, and New Mexico Gov. Bill Richardson, include their ideas about helping people with autism in their health care reform plans. Some quotes follow:

From the John Edwards campaign blog, Nov. 26:

We need to find the causes so we can help protect our children. The National Institutes of Health have concluded that childhood vaccines are not the cause, but many families are not convinced. As president, I will double funding for autism research, issue an all-hands-on deck challenge and follow the results wherever the science takes us.

We also need to take better care of children affected today. My plan for universal health care, guaranteed coverage of autism care in Medicaid and private insurance, and better investments in special education and home health workers will assist families to support and treat children with autism and help children, and adults, reach their full potential.

We should also invest more in recruiting, training and paying sufficiently teachers, therapists, psychologists and others working in the special education field. It's time to finally get on a path to fully funding special education.

From the Barack Obama campaign's health care plan:

Support Americans with Autism. More than one million Americans have autism, a complex neurobiological condition that has a range of impacts on thinking, feeling, language, and the ability to relate to others. As diagnostic criteria broaden and awareness increases, more cases of autism have been recognized across the country. Barack Obama believes that we can do more to help autistic Americans and their families understand and live with autism. He has been a strong supporter of more than $1 billion in federal funding for autism research on the root causes and treatments, and he believes that we should increase funding for the Individuals with Disabilities Education Act to truly ensure that no child is left behind.

More than anything, autism remains a profound mystery with a broad spectrum of effects on autistic individuals, their families, loved ones, the community, and education and health care systems. Obama believes that the government and our communities should work together to provide a helping hand to autistic individuals and their families.

From Bill Richardson's health care proposal:

First of all I am for strongly increased research on autism. The number of children in this country affected by autism is just staggering. [1 in every 150 children] Comprehensive and universal access to health care is part of the solution. I fought for increased funding in New Mexico for outreach, education, treatment and awareness. This is something that I have been talking about on the campaign trail everyday and it will be a priority in my administration.

From Christopher Dodd's health care plan:

Under the Dodd Plan, every child in America will have guaranteed health insurance equivalent to the health coverage Members of Congress have for their children. All children will have access to preventive health screenings including vision, hearing, autism, and other neurological disorders.

Where Are The Republicans?

I researched the online campaign literature and recent press coverage for Mike Huckabee, the former Arkansas governor; Sen. John McCain of Arizona, Rep. Ron Paul of Texas, and former Massachusetts Gov. Mitt Romney. With the exception of a haircut fundraiser that Huckabee attended for autism in New Hampshire, and a Romney campaign volunteer in Colorado who has done some charity work for autism, I couldn't find a mention of autism anywhere.

That doesn't mean it's not there, so if you know of someone in any of these campaigns, write to me or submit a comment at the end of this post. It could just mean that autism hasn't risen to any level of importance in the Republican race. Health care is present, though. Mitt Romney is running on his bringing health coverage to all in Massachusetts. Ron Paul is a doctor. In the past, Mike Huckabee has been on a mission to make citizens lose weight.

Noted: I couldn't find anything on the websites of two other Democrats, Sen. Joe Biden of Delaware and Rep. Dennis Kucinich of Ohio.

Haircut Footnote

Four candidates have taken up a "$400 haircut challenge" for charity, from the father of an autistic child in New Hampshire. Here's an item from the Autism Society of America's website:

Representative Dennis Kucinich made a campaign stop for autism on November 20. The presidential candidate, a democrat from Ohio, was the third politician to take up New Hampshire hair stylist David Holden on his challenge to get a $400 haircut with all proceeds going to ASA.

Though the challenge was inspired by candidate John Edwards’ high-end haircuts that appeared on campaign statements in April, Holden said the challenge isn’t meant as a dig just an opportunity to help a good cause. Holden is the owner of Hair Biz salon in Concord, and the father of a 12-year-old with autism.

Kucinich is the third to take up the challenge. Representative Tom Tancredo of Colorado and former Arkansas governor Mike Huckabee have also participated.

Also see:

Bush Vetoes Domestic Spending Bill That Includes Autism Research, Education Funds

Film Review: Three Reasons to See "Autism: The Musical"

Written by Carol Gerwin

If you have a chance to see "Autism: The Musical," the documentary directed by Tricia Regan that chronicles the debut of a Los Angeles theater group for children with autism, you should grab it. Even if it means going by yourself (as I did on Thanksgiving night) because your spouse has to stay home with the kids. Here are three reasons I'm glad I did:

1) The film is a moving and nuanced depiction of the huge range of kids who fall onto the autism spectrum and the challenging reality of their daily lives.

Among the participants who write, plan and produce a full-length musical in five months are Lexi, a 14-year-old with a beautifully sweet singing voice who constantly repeats questions people ask her but has trouble coming up with answers; Henry, an extremely talkative 10-year-old with encyclopedic recall of reptile facts whose awkward behavior puts off peers; and Neal, a nonverbal 12-year-old who sometimes acts out aggressively when feeling anxious.

The movie shows the kids at school, at home, and in chaotic rehearsals that eventually lead to a well-orchestrated and emotional opening night. In one remarkable moment, an often ebullient boy named Wyatt describes his frustration with theater group friends who withdraw from others and then suddenly realizes that he sometimes does the same thing, asking, "Why do I go into my own world?"

2) The movie demonstrates the life-changing impact that having a child with autism has on parents—for better and for worse.

Neal's mother, Elaine, started the theater group she named "The Miracle Project" after discovering that music and movement were effective ways to engage her son. Divorced after several years of Neal's sleepless nights and frequent tantrums, Elaine later finds a new love who embraces her son. During the filming, one couple bickers, one separates and another despairs that they can't afford an expensive legal battle to get appropriate educational services for their child. They all struggle to understand their kids and help them lead fulfilling lives—and they worry intensely about what will happen to them after they themselves die. As Lexi's mother, who has suffered from depression but beams through her tears on opening night, says: "Living with her has had a profound effect on who I've become."

3) The film illustrates both the tremendous potential of kids with autism and the relentless nature of the disorder.

In the end, The Miracle Project's musical really was no miracle at all. No one was cured; no one's life was transformed. (Be sure to stay for the biographical end notes, which drive home the point that the ongoing challenges these kids face certainly will continue.) But the experience had value for everyone involved. These kids showed themselves and their community how much they can accomplish when people take the time to accept them for who they are, celebrate their strengths and devote resources to help them overcome (or at least compensate for) their weaknesses. As the kids sing in the musical's opening song, "Take a chance. Get to know the real me." The real miracle would be for this to happen all the time.

Background notes: "Autism: The Musical" has been showing at film festivals across North America and has picked up two audience awards so far. HBO will show the movie in April and it will be out on DVD after that. (For Autism Bulletin's Boston-area readers, the documentary is playing through Nov. 29 at the Coolidge Corner Theatre in Brookline, Mass. Then it's on to Anchorage, Alaska for a film festival screening December 3. Check the film's website for more updates.)

Carol Gerwin is a Boston-based editor and writer who is married to Autism Bulletin blogger Michael Goldberg.