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Diagnosis for a Disorder

States step in to provide services for children with autism.

Federal money devoted to autism is directed mainly toward research and finding an answer to the puzzle of why incidence of this particular disorder has expanded exponentially in recent years. States and schools, meanwhile, are stepping up their efforts to expand services to this growing population.

In Massachusetts, where the incidence rate is higher than the national average, state lawmakers have established a separate Division of Autism, which this year was funded with its own line item. "It's groundbreaking that we got it in the budget," says state Representative Barbara L'Italien, "but reaching everyone obviously hasn't happened." Massachusetts is also seeking a federal waiver to leverage Medicaid dollars for autism, which about half a dozen states have succeeded in getting.

The estimated number of children on the "autism spectrum" has risen from fewer than 1 in 2,000 during the 1980s to 1 in 150. It's not clear whether there is an environmental cause or simply better diagnosis. Much of the burden of coping with the growing need has fallen on schools, but states are starting to recognize the need to offer services to adults, since the first big wave of childhood cases began about 20 years ago.

New Jersey now has a statewide program through which parents with autistic children can register them with the police, to expedite tracking of frequent runaways. And the Pennsylvania House this year passed legislation to require insurance companies to provide up to $3,000 a month for care of autistic patients. "The earlier we get to these children and offer more fundamental programs, the less costly they're going to be," says Speaker Dennis O'Brien who, like L'Italien, has an autistic child.

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