Autism Speaks urges Department of Defense to expand, not restrict, services for military children with autism

Burdensome changes to Operations Manual and flawed research review pose barriers for military families

May 6, 2021

Autism Speaks urges the Department of Defense to reconsider recently announced changes that would make it harder for children with autism to access needed care. These changes would make applied behavior analysis (ABA), an evidence-based treatment that helps reduce challenges with social communication and repetitive behaviors, less available in school and community settings.  

The changes would also impose new burdens on families and otherwise create more barriers to services. The changes are memorialized in the TRICARE Operations Manual, which sets guidelines for the healthcare program for military families.

Children with autism benefit from an array of intervention, including occupational therapy, speech therapy, physical therapy and behavioral interventions like ABA. ABA is a routinely covered benefit for the children of federal civilian employees. But for the children of military families in TRICARE, ABA is considered an "experimental treatment" available only through a demonstration program.

"TRICARE should listen to the voices of the military families affected by the Manuel changes and reverse course. TRICARE is making it more difficult for these families to care for their children," said Stuart Spielman, Esq., senior vice president for advocacy at Autism Speaks. "The thousands of autistic children of military service members who rely on TRICARE deserve to have the services they need to reach their full potential. We strongly urge TRICARE to turn its focus to how it can maximize, not restrict, the benefits it offers to its beneficiaries and follow the science when it comes to ABA.” 

The Manual changes follow Department of Defense reports to Congress on the Autism Care Demonstration program that cast doubt on the effectiveness of ABA.   

“More than 20 studies have established the benefits of ABA therapy,” said Thomas W. Frazier, Ph.D., chief science officer at Autism Speaks. “While we support continued high-quality studies of interventions that use blinded assessments or other objective measures, the evidence that the Department cites does not meet that standard and is not appropriate to justify the finding that ABA lacks effectiveness. TRICARE stands alone in its assessment of ABA as 'experimental.' The flawed methodology it has used to evaluate ABA's effectiveness appears as if it is designed specifically to show a lack of evidence of its efficacy. We hope TRICARE will reconsider this approach, meet with experts and families, and transparently revisit their findings.” 

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