Pathway to care
In the United States, roughly one in 68 children have Autism Spectrum Disorder (ASD). There is no cure and care can lead to both a social and financial burden. The impact becomes even greater if the condition is not diagnosed or treated. Early identification and intervention are the best ways to lessen the impact of ASD. Once treatment begins, symptom management can improve the quality of life for the individual and their families.
Identification
ASD is a lifelong neurodevelopmental condition that hinders or limits how people behave, communicate and interact with others. ASD often appears in early childhood. ASD affects people differently, and no two experiences are the same.
Anyone can be diagnosed with ASD, at any age. The core ASD symptoms are typically present in early childhood, but sometimes symptoms are not visible and can be hard to identify. Knowing what to look for can help. The core symptoms of ASD are problems communicating and relating to others and limited and/or repetitive behaviors, interests or activities.
Screening and assessment
There is no medical test to detect ASD. Doctors rely on screenings and comprehensive evaluations to diagnose ASD. These assessments also help to identify if other medical conditions are present.
A Primary Care Manager (PCM) will refer the beneficiary to a specialist to diagnose the condition, if the screening indicates ASD may be a possibility. However, they may refer patients for immediate treatment before a confirmed diagnosis*. A non-clinical outreach coordinator can be assigned for up to 180 days to beneficiaries interested in participating in the Autism Care Demonstration (ACD), but who require assistance in meeting the eligibility requirements.
*A diagnosis is required to receive services under the ACD.
Comprehensive evaluations are used to identify a beneficiary’s strengths and needs, find the cause of symptoms, and determine an ASD diagnosis. The assessments often included are:
- A physical exam
- Hearing and vision testing
- Genetic and neurological testing
- Review of family's medical history
- Interviews with parents, family members, caregivers, teachers, etc.
- Measurements to assess abilities and overall functioning
Once all assessments are complete, the specialist(s) reviews the results of the evaluation and, together with the beneficiary and their family, treatment plans and goals are decided. For additional information about the process of diagnosing ASD, screenings and comprehensive evaluations refer to the resources below:
Treatment
After receiving an ASD diagnosis, begin following treatment plans right away to help stop symptoms from getting worse.
Because each diagnosis is different, we do not endorse any one treatment or program. We encourage beneficiaries and their families to learn about all options and work with qualified professionals to choose the appropriate form of care.
Behavior and communication approaches
Behavior and communication treatments offer structure, direction and organization, while encouraging family participation. These approaches for ASD include Applied Behavior Analysis (ABA), occupational therapy and speech therapy.
ABA focuses on behavior modification and uses principles such as positive reinforcement to increase good or useful behaviors (e.g., functional, communication, and social skills) and reduce negative behaviors (e.g., self-injury). ABA may be used to develop basic skills (e.g., looking, listening) in addition to more-complex skills (e.g., reading, communicating).
Occupational therapy teaches people skills to support independent living such as dressing, eating, bathing and relating to people. Learn more about occupational therapy.
Speech therapy focuses on improving how individuals communicate. Some people are able to learn verbal communication skills, while others may learn how to use gestures or picture boards.
Dietary approaches
Though not always supported by scientific research or the medical community, therapists may develop a dietary treatment to help individuals with ASD. It is important to discuss any dietary changes with a qualified professional first to ensure the plan includes all the essential vitamins and minerals the individual needs.
Early intervention and special education
Intervention services help infants and toddlers less than three years old learn physical, thinking, communication, social and emotional skills.
Special education and school-based services are provided for school-aged children and youth (three through 21). Educating individuals with autism often includes a combination of different environments and must be designed to meet the child's specific needs.
NOTE: The Individuals with Disabilities Education Act (IDEA) governs how states and public agencies provide early intervention, special education and related services to infants, toddlers, children and youth with disabilities. Each state may administer these services differently. Services through IDEA may be in addition to what it is already provided through TRICARE. It is important to sign up through your states program(s) as soon as you are aware of the ASD diagnosis. To enroll in services, visit the Office of special needs.
Medication
No medication will cure ASD or treat all of the main symptoms. Qualified providers can prescribe medication for symptoms to help manage irritability, inattention, inability to focus, depression, seizures, aggression and to reduce self-injury. Medication is most effective when used in combination with behavioral therapies.
Complementary and Alternative Medicine (CAM)*
Parents and providers may consider methods outside of what is recommended by healthcare professionals or evidence-based medicine, known as Complementary and Alternative Medicine (CAM). CAM approaches may include special diets, chelation (a treatment to remove heavy metals from the body), biologicals (e.g., secretin), or body-based systems (like deep pressure), vitamins or supplements, yoga, or massage. It is important to consult qualified professionals and seek a second opinion before starting such treatments.