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When You Suspect Your Child May Have a Disability…

January 19th, 2016

By Felicia Lebewohl Rosen, Esq., Ed.M. (Edited by Marion M. Walsh, Esq., Littman Krooks LLP)

Take a deep breath … It can be emotionally difficult to accept and deal with the fact that your child has a disability. If you want your child with a disability to receive appropriate services to make his or her life (and yours) easier and more productive, you should acknowledge the possibility and consider seeking services.   First, you need a good diagnosis, to which interventions can be geared. This diagnosis can occur at any point during a child’s development, most commonly during infancy or early childhood. However, some parents only realize that their child has a disability in adolescence, when work and social demands become more difficult. If your doctor or psychologist makes a diagnosis, keep in mind that you need to share this information with your school district or preschool and determine whether your child is eligible for services.

The Law Protects Students with Disabilities and Requires Evaluations and Services

The Individuals with Disabilities Education Improvement Act of 2004 (“IDEA”), protects children with disabilities ages birth to 21 or until a student graduates with a regular high school diploma. The IDEA requires each state and school district to identify and evaluate all children who need special education and/or related services. Related services include physical, occupational and speech and language therapy and more depending on need.

Early Intervention (EI) is a system of services, free of charge to parents, that help children with disabilities or at risk for a disability, ages birth – 3 years old, and their families. For a child to receive EI services pediatricians, other service providers and parents may refer a child for EI. The Center for Disease Control and Prevention recommends that children be screened for developmental delays and disabilities during regular well-child doctor visits at 9, 18 and 24 or 30 months and additional screening may be warranted if a child is at high risk.

Once your child is school age and you suspect a disability or receive a diagnosis, parents may contact their school district and request that their child be evaluated for eligibility for special education and related services. School districts are responsible to provide educational and related services, free of charge to parents, for children with disabilities ages 3 – 21 or until a student receives a high school diploma. The law requires that school districts receive informed consent from parents before the child is evaluated by the school district to determine if the child has a disability under the IDEA. The individual evaluation must include a variety of assessment tools and strategies. A school district must conduct the evaluation within 60 days from the date that the parent consents to testing. At a minimum, an evaluation must include: a psychological evaluation, a classroom evaluation, a social history, a physical examination and other appropriate assessments or evaluations.

An evaluation is intended to address the following three questions:

  1.  Does the child have a disability that requires special education and related services?
  2. What are the child’s specific needs? and
  3. What special education and related services are appropriate for addressing those needs?

If parents disagree with the school district’s evaluations, they have a right to an Independent Educational Evaluation (IEE) and request that the school system pay for the IEE. A diagnosis from a doctor or psychologist of a disability does not guarantee that a child will be eligible for special education or related services. The law requires that the disability impacts the child academically.

Littman Krooks Special NeedsIn New York, a Committee on Special Education (CSE) for students in grades K-12, and a Committee on Preschool Special Education (CPSE) for students ages 3-5, are multi-disciplinary teams that include, at the very minimum, the parent, a general and special educator, a school psychologist or another professional who is qualified to interpret evaluations, and a district representative. The CSE and CPSE will convene to review the evaluations and determine if the child is a “student with a disability”, as defined by the IDEA. If the parents do not agree with the evaluation decision, they may ask for an impartial hearing to challenge the decision. Some neurological conditions, such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder/Attention Deficit Disorder (ADHD/ADD) and a Learning Disabilities (LD) are often difficult to diagnose because there is no medical test, like a blood test or an MRI, to diagnose these disorders. Further, many other conditions have symptoms that are similar to those of ADHD/ADD and there is a great deal of comorbidity with other conditions. For example, anxiety can mask as ADHD.

At the CPSE and CSE meetings, if a child is deemed eligible, the team will draft an Individualized Education Program (IEP). The IEP is a legal document which discusses the child’s strengths and areas of need. It specifies the special education and related services that the child will receive free of charge to the parents. If the parents disagree with the IEP or the placement recommended by the CSE, the parent may request a Due Process Hearing. In some cases, filing a complaint with the New York State Education Department may be appropriate. Parents may proceed pro se (without a lawyer) or be represented by counsel.

Personal Advice on Keeping it all in Perspective

If your child has a disability, try not to waste your emotional energy on self-blame. Disorders such as autism, ADHD, and emotional and learning disabilities can be disorders in certain regions in the brain. They are not caused by bad parenting, chaotic home environments, ineffective teachers, too much sugar in the child’s diet or the child himself. Your child is still the same child you had before the diagnosis. Love, play, engage, have fun, enjoy, hug and laugh with your child. If your child is an adolescent, give your child support along with the space he or she needs to grow at their own pace.

Take care of yourself or you will not be able to take care of your child. We are all familiar with the stewardess’ message on airplanes to put your oxygen mask on before you place one on your child. So take care of yourself so you can better take care of your child. Put on your oxygen mask by joining support groups, finding solace in supportive family and friends or religion, joining support groups, exercising and eating well and remembering to enjoy and laugh. It can be a long journey.

For more detailed information about disability laws, see


Felicia Rosen is a legal intern with Littman Krooks LLP and is an attorney. She graduated from New England School of Law and Columbia University Teachers College. 


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Community Based Service Network To Serve Medicaid Beneficiaries in Westchester County

March 5th, 2015

The Neighborhood Network of New York (NNNY) is set to develop an innovative, community based service network for adults with autism, thanks to a grant from the New York State Office for People with Developmental Disabilities (OPWDD). The program will provide individualized services to clients, including remote support technology and community activities.

NNNY will launch a prototype of the program to serve Medicaid beneficiaries in Westchester County. In time, the organization will develop protocols to launch similar networks throughout the state.

The NNNY program is intended to provide greater independence and empowerment for adults with autism through supports within the community, including remote support in private apartments. The program will be more affordable than traditional models, while also providing services which are appropriate to the individual’s needs and more fully integrated into the larger community.

With a record 1 in 68 children diagnosed with Autism Spectrum Disorder, as of 2010, services like these will be essential in serving an unprecedented number of children with autism reaching adulthood. This transition often represents a challenge for people with autism and their families, as they leave the support of parents and the school system and struggle to identify appropriate supports within the adult service system. Traditional full service options, like group homes and day services, are expensive, and for many individuals with autism who do not need such a high level of staffing, unnecessarily restrictive. These traditional, segregated models may represent a stark contrast to the integration into the school community that the individual with autism previously experienced in school, where they were mandated by law to be educated in the Least Restrictive Environment, together with students without disabilities to the maximum extent appropriate.

The NNNY program will take a three-pronged approach. Individualized Living Services for All Levels of Need allows clients to live alone or with a roommate in apartment complexes where both clients and non-clients reside. Clients who need more support may live with a professional family. All NNNY homes will include Proprietary Remote Support Technology that can be used to monitor residents’ safety and provide real-time coaching. Finally, the Communiversity will provide lifelong learning, teaching job skills and life skills along with community and recreational activities.


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How Respite Care through Medicaid Helps Parents Care for their Children

December 5th, 2013

Our latest guest blogger is Nanette Saturn, Educational Advocate, Westchester Independent Living Center and Putnam Independent Living Services

Clearly, parents of a child with a developmental disability experience stress far beyond what most parents of neuro-typical children experience. In fact, a recent study noted that mothers of children with autism experience as much stress as combat veterans.

I didn’t need to see the data to believe this. I am the mother of a 9 year-old neuro-typical daughter, and a 13 year- old son who is diagnosed on the Autism Spectrum, along with ADHD and anxiety. When my daughter started getting older, I noticed how easy it was to do things with her, compared to my son. This is when I began to realize how different and challenging my life was compared to the average mother.

Since many children with developmental disabilities require a tremendous amount of one-on-one support, it’s difficult to take them on basic errands or to places where a child may have to sit for a period of time. Many parents take for granted the fact that they can bring their typical children to appointments or make a quick run to the store or send their child into the yard to play so they can get things done in their home. Parents of children with disabilities cannot often do this. The most basic of tasks – the supermarket, the pharmacy, a haircut, or a visit to a friends’ home – can be stressful, frustrating or simply avoided.

Respite Care Can Help You Be a Better Parent

Too often, parents are homebound and lose patience and time with their other children and relationships with family and friends suffer. I did not want to feel that I had to escape. I wanted to be a better mom, a healthier mom, a happier mom. I wanted to feel rested in order to enjoy the times I would be taking both of my children on an outing and to have some time to myself as well, to build and maintain my own relationships. I required time during the week or weekends to engage in activities without the stress automatically attached to each venture. I needed someone to engage my son and keep him properly occupied so I could have some time for whatever I needed to do.

Help is Available!

The good news is help is available for parents in this situation. If you are married or a single parent, respite care can help you maintain or build a relationship. It also benefits the siblings and allows them to access your time and attention. It allows for down time to re-group and re-energize yourself. Many parents feel that our needs are not as important as our children’s needs. They are! The stress, anxiety, frustration, anger and solitude aren’t healthy and do not help make you a stronger parent.

The goal of respite care is to provide relief to parents so they can find free time to take care of needed tasks or simply to maintain balance. The Office of People with Developmental Disabilities (OPWDD) Home and Community Based Medicaid Waiver may be an option to assist you in accessing this service through Medicaid, despite parental income level. There are limitations to the hours you are approved for, but even a few hours a week can make a significant difference in your family’s quality of life.

Don’t Give Up

I had always known respite care was available but had a difficult time finding a provider and, quite frankly, the thought of looking for someone on my own was daunting. I am so happy that I didn’t give up because since hiring my respite worker almost a year ago, I have never looked back. In fact, it has prompted me to make additional changes in my life that have benefited not only myself, but more importantly my children. I’m able to run out of the house at the last minute for something at the market, give my daughter some well-deserved attention, enjoy a bath or work on my personal relationships. My respite worker helps with homework and interacts with my son by playing games or doing some outdoor activities. This time not only allows me to have some freedom but provides the necessary one-on-one interaction my son requires. It also provides him with healthy alternatives to play. He’s no longer sitting in front of video games or movies, which in all fairness, may be the only respite I was getting. I challenge anyone to try to perform the daily tasks parents have to accomplish while simultaneously providing the constant attention required for their child. It’s impossible!

I cannot imagine how I was able to do it for so many years without this help. It’s important for every parent to know about the Medicaid waiver and the many services it provides. The initial set up or application process may seem daunting but the reward is tremendous.

Contact OPWDD Office

There are eligibility requirements through the Office of People with Developmental Disabilities (OPWDD). You must contact your local OPWDD office and explain that you have a child with a developmental disability and would like to apply for eligibility for OPWDD services. You can get information at

Once your child is found eligible for OPWDD, you will be directed to attend a Front Door Session for individuals and families of people with Developmental Disabilities. Here, you will learn about the different services OPWDD offers and how you can obtain respite services through the Medicaid waiver or through the many different Family Support programs offered throughout New York State.

Nanette Saturn is an educational advocate with Putnam Independent Living Services, a satellite office of Westchester Independent Living Center. She is a mother of two children, one of whom has autism.


ADHD Awareness: What Hurts and What Helps

October 1st, 2013

by Dr. Virginia Hurley, Professional ADHD Coach, TimeSavor Coaching.

People with ADHD are people with special needs. They are people with a neuro behavioral disorder that improves or deteriorates based on circumstances. It is linked to many neurological factors that have only become evident in the last two decades with the advent of advances in technology and multidisciplinary, integrated studies. Yet, in the classroom, the workplace, home and social settings, there are still many incredulous and uninformed people who perpetuate the suffering of those with ADHD.

To inform the public, to support those with ADHD, and to provide a more hopeful picture for those in the ADHD community: those are some of the reasons to promote ADHD Awareness

When the ADHD Awareness Campaign first really got off the ground, there were three major ideas the coalition of ADHD communities wanted people to know:

· ADHD is Real

· There is Hope

· Where’s the Help?

The ADHD Awareness Campaign has changed and expanded its impact over the past eight years, although the message that ADHD is real, there is hope, and there are avenues of help, remains the same. The importance of awareness got some traction with the US Congress’ declaration of a single DAY, Sept. 17, 2005.

Five years later, the ADHD Awareness Campaign was sponsored by a coalition of groups serving the ADHD community. The Campaign was not just for one day. Rather, the first ADHD Awareness WEEK was celebrated in the US in 2010. And beginning in October of 2013, the Global ADHD Awareness MONTH Campaign will take place. This year, the ADHD Awareness Month theme is The Many Faces of ADHD.

What else should we know? ADHD can affect anyone of any age (not just children), in any family, of any gender (not just boys), race, ethnicity, occupation or status.

My ADHD coaching clients share their voices to help show you the many faces of ADHD, in honor of the Awareness Month theme:

1. ADHD is Real

  • “Neurotypicals” are the majority on this planet, and get to make nearly all the rules. It’s very tough getting ahead in a system that’s optimized for people not like you. Keep that in mind when you come up with your rules and procedures, when you decide who deserves promotion or a raise, when you decide who’s “the best man for the job.” – From J.G., software engineer
  • “I wish people would recognize ADHD symptoms for what they are, and see the genius and the hard work that those children put in their day to day activities. Instead people still judge children with ADHD as being wild, unmannered, lazy, stupid, disruptive and more.” –  From Y.E., nurse midwife
  • “We’re human beings with feelings and intelligence. Having ADHD doesn’t make us incompetent, irresponsible, or lazy. We work extra hard to keep pace to make deadlines that people with intact executive functioning have no problems meeting.” – From G. K., school psychologist

2. There is Hope

  • “Having a friend or a coach or a secretary (or two!) Who is non-judgmental but persistent is very helpful.” – From G.K., school psychologist
  • “I prefer to invest my efforts into instilling my child with confidence, and shower her with love, and give her all the support and help that she needs to succeed” – From Y.E., nurse midwife
  • “My own experience of ADHD is that it’s like juggling.  The best thing you can do for someone with ADHD is to let them know that it’s OK to drop the balls, even on purpose. It’s OK to leave some of the balls on the floor. It’s also OK to ask for help before you drop the balls. Even better, it’s OK to say “no thanks” when someone tries to toss another ball at them.” From S.H., “Fortune 500” corporate executive

3. Where’s the Help?

  • What helps? Oddly enough, structured assignments but with some flexibility (if assignments have beginning, middle and end components spelled out or expectations clearly provided, that helps). It also helps to have tasks broken down into parts, small goals, not just one big global goal. Allow for creative approaches … If that doesn’t make sense, please ask for clarification.

What else helps?

  • Day planners
  • Personal Organizers
  • Life Coaches!(dead serious) –  From P.M, licensed occupational therapist

More Help for ADHD Accommodations

Help also comes through the many faces of ADHD Awareness Month 2013 Coalition Members. These include:

You can find help through other affiliate groups, and the medical and healthcare partners of the Awareness Campaign. For more detailed information, please visit

Many students with ADHD may also qualify for accommodations or special education and related services – through a Section 504 plan or an Individualized Educational Program. Parents who are concerned about their child’s educational performance should contact their school’s district’s Director of Special Education and refer their child to the Section 504 Committee or the Committee on Special Education, for evaluations and consideration of services. If your child simply needs accommodations, a Section 504 plan may be appropriate. But if the ADHD is impacting educational performance, the child may qualify for services under an IEP as a child with an “Other Health Impairment.”

To learn more about Dr. Virginia Hurley, click here. For more information about our legal services, visit


How to Help Children Who Have Difficulty with Executive Functions

August 30th, 2013

Children with special needs often struggle with executive functions. For parents whose children face these challenges, it is important to understand what executive functions are, the common warning signs of problems with them, and how learning specialists can help children who face this difficulty.

Executive functions are cognitive processes that control other cognitive processes, connecting past experience with present action. Executive functions are crucial to children’s daily activities like dressing themselves or doing chores, and difficulty with executive functions will especially impact a child’s schoolwork. We all use executive functions for such actions as making plans, keeping track of time, making corrections while thinking, reading or writing, and engaging in group discussions. Executive functioning is what permits us to keep track of more than one thing at a time, holding on to information until it is appropriate or useful for it to be applied.

Children who struggle with executive functions will often seem to be disorganized. Thy may have trouble planning projects and have little understanding of how long they may take. These children may have trouble memorizing information, and when telling a story may have trouble keeping events in sequential order. In addition, a child may have problems with working memory, for instance being unable to remember a phone number while dialing it. There is no one test to identify problems with executive functioning. Educators, psychologists and others may use a variety of methods to identify such problems, including careful observation, tests and trial teaching.

If a difficulty with executive functions has been identified, there are many learning tools that educators and parents can share with children to help them with organizational skills.

Four Learning Tools Available:

  • Checklists: One tool that helps with executive functions is using a checklist. If a child has trouble conceiving of or keeping track of the steps necessary to accomplish a complex task, then a checklist can be a tremendous help. Instead of struggling to understand what step should be done next, a child can simply move through the list. Checklists can be useful at school or with the tasks of daily living, such as getting ready for school in the morning. It can be especially helpful to set time limits for each task on a checklist, as children with executive dysfunction will often not be able to judge how much time each step should take.
  • Calendars and Plans: Because struggling with executive functions make planning difficult, it is all the more essential for children to be introduced to the importance of writing down a plan. Frequent use of a calendar and writing down homework assignments are habits that should be encouraged, and that will take time and energy.
  • Encouragement: Children who find organization challenging often do not understand why being organized is important and may become frustrated with planning. However, encouragement and repetition can help children develop these skills, and establishing a reward system can help them see the benefits.
  • Routines: Developing a routine is also important for children with executive function problems. Doing homework at the same time every day is an especially useful routine, especially with older children who may prefer to do homework when they feel like it. This leads to procrastination and problems with the work. A child who has trouble planning and getting organized may not see that putting off a task will have bad results, and encouraging a routine is one way to help.

Difficulty with executive functions is a common problem for children with special needs, but if the challenge is identified and addressed, then there is a lot that parents and teachers can do to help. If you believe your child’s executive functioning difficulty is becoming debilitating, be sure to discuss this with his or her teacher or section 504 or IEP team and document concerns in writing.

For more information about our legal services for families with special needs, visit


New Online Campaign Seeks to Help High School Students with Autism Find Employment

June 27th, 2013

This summer, New York Collaborates for Autism (NYCA) is launching an online campaign to raise awareness and support for Project SEARCH Collaborates for Autism, a nonprofit organization founded in 2003 to address the needs of families and individuals living with autism spectrum disorders (ASD).

The campaign will last 30 days and aim to help more high school students with autism find a job.

Here’s how to help:

  • When someone joins (within the next 30 days), $25 will be donated to Project SEARCH Collaborates for autism in their name—no charge to you.
  • The campaign goal is to have 600 new supporters in 30 days

To learn more about this campaign, follow NYCA on Twitter (@NYC4A) or Facebook.


Study Finds Respite Care Important for Parents of Children with Autism

May 14th, 2013

Parents of children with autism spectrum disorders often experience high levels of stress and marital problems when compared with other parents. Much of this stress is the result of the greater amount of caregiving needed when raising a child with autism. A recent study shows that being able to take a break from caregiving, even just for an hour per week, decreases stress and improves the quality of a marriage.

The study was published in the Journal of Autism and Developmental Disorders. Researchers surveyed the parents of 118 children with autism spectrum disorders and found that the number of hours of respite care per week was directly related to better marital quality. There was also an association between respite care and a reduction in stress.

About 64 percent of the children in the study spent time with a respite care provider, such as grandparents, other family members, babysitters and community agencies. The study found that for every hour per week of respite care, there was less stress and better marital quality. The researchers said that it is important for supports for respite care to be developed for families raising children with autism.

The study adds to what is already known about the importance of respite care for parents of kids with autism. A study last year found that children with autism had a reduced risk of psychiatric hospitalization when their parents were able to take advantage of respite care.

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Proposed Changes for Autism Spectrum Disorders in the Diagnostic and Statistical Manual (DSM) can have a Profound Impact

September 20th, 2012

Our guest blog this week is written by Lisa B. Rudley, Vice President of Private Client Services for Clark Dodge Asset Management. Lisa is responsible for Client Advisory Services and Business Development and brings over 15 years of financial investment services expertise.

By Lisa Rudley

A coalition of groups within the autism community is extremely concerned about potential impacts of the proposed criteria for Autism Spectrum Disorders (ASD) in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) – 5th Edition. The new criteria are supposed to be finalized by December 2012 for May 2013 publication. The ramifications of a new autism definition are far reaching and could be devastating. Among other changes, the new autism criteria will eliminate Asperger Syndrome and PDD-NOS, although children with these conditions could still be diagnosed with autism if they meet the DSM-5 criteria. A child who does not present with restricted or repetitive behaviors would not meet the criteria for autism. Everything from epidemiology to services could be affected for individuals with autism. Those dealing with autism need more answers and support, not more hurdles.

Since February 2012, five studies have been published indicating the proposed DSM-5 ASD criteria will significantly reduce the number of people diagnosed with ASD compared to the current DSM-IVTR criteria:

McPartland and Volkmar – 39.4% decrease
Worley and Matson – 32.2% decrease
Matson et al. – 47.8% decrease
Gibbs et al. – 23.4% decrease
Taheri and Perry – 37% decrease

In addition, Field Trials which identified 83 children with ASD, were reported by Dr. Swedo, chair of the APA’s Workgroup on Neurodevelopmental Disorders (NDD). These trials indicated that the decrease in the number of identified ASD cases using the proposed criteria would be in the single digits, but this would be counter-balanced by the inclusion of some cases that had been missed by the DSM-IVTR. The NDD Workgroup is concerned primarily with the new criteria accurately diagnosing new cases of ASD as they present in the community and does not think that the decreases in the published studies are accurate. Currently, there is no data on adult patients using the new criteria.

Online Survey to Collect Data on New ASD Cases Using the Proposed Criteria

SafeMinds and the Holland Center want to collect and analyze much more data on the proposed criteria through an online survey to assess its impact on autism diagnosis in the community.

This survey can be used by any clinician who speaks English anywhere in the world. The data will be made available to the NDD Workgroup directly. Cases are needed urgently given the tight time frame for publication of the proposed criteria!

Please spread this information and link to any clinician who diagnoses people with autism:

New York State Legislation to Protect People with Autism

Last legislative session, Assemblyman Thomas Abinanti from the 92nd District (D-Greenburgh) sponsored legislation, A9983 that will define “autism” under New York State law as the currently used criteria set out in the Diagnostic and Statistical Manual (DSM-IVTR), a definition that has been in use since 1994. Assemblyman Abinanti along with many of his assembly and senate colleagues believe that the proposed changes would significantly impact people with the diagnosis of autism today and in the future.  Also, the cost to the New York State to re-diagnose people with autism would be extremely costly when these precious resources could be used help people with autism.  The bill was very close to going to the floor of both houses for a vote and Assemblyman Abinanti is expected to reintroduce in the upcoming session starting in January, 2013.

(Some of this information was reprinted with permission from SafeMinds and the Holland Center)

Lisa B. Rudley is Vice President of Private Client Services for Clark Dodge Asset Management   Lisa is responsible for Client Advisory Services and Business Development and brings over 15 years of financial investment services expertise.  She earned her BA from Richard Stockton College of NJ in 1988 and received an MBA in finance with a designation in international business from Fordham University in 1995. Lisa lives in Briarcliff Manor, NY with her husband and three children. As a parent of a child diagnosed with an autism spectrum disorder, Lisa has a comprehensive understanding of the “Special Needs” community. Currently, Lisa serves on the boards of the Elizabeth Birt Center for Autism Law and Advocacy (EBCALA) and Autism Action Network (AAN)  She is the President of the Ossining Special Education Parents Teachers Organization (SEPTO) and is the co-founder of the NAA NY Metro Westchester sub-chapter support group servicing over 600 families in the Westchester area.
Contact:  Lisa Rudley:


New Center for Autism Research to Open in Westchester County

June 15th, 2012

A new treatment and research facility for autism is under construction in White Plains, New York.  The Center for Autism and the Developing Brain will be part of New York-Presbyterian Hospital.  The center broke ground on April 4 and will open in 2013.

The new facility will provide a wide range of clinical services to people living with autism spectrum disorders (ASD) and other developmental disorders.  The center is a collaboration between the hospital, Weill Cornell Medical College, and Columbia University, along with the New York Center for Autism.  It will be located at New York-Presbyterian’s 214-acre White Plains campus.

Until the center opens, the hospital provides limited clinical services at a temporary location on the hospital grounds and offers ASD assessments through participation in their research studies.  When the permanent center opens, insurance will be accepted, including Medicaid in some situations.

According to the Centers for Disease Control (CDC), the prevalence of autism is continuing to increase.  The CDC found that, in the communities they studied, the prevalence of autism had increased from one in 88, from one in 110.  Autism continues to be more prevalent in boys than in girls, with one in 54 boys and one in 252 girls in the research group being diagnosed with ASD.  It remains unknown whether the increase is due to more careful diagnoses or another factor.

For assistance with questions regarding your child’s special needs visit our website at

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