NC Passes Autism Insurance: What It Means for Families


This article was contributed by Jennifer Mahan, Director of Advocacy and Public Policy at ASNC.

On Tuesday, the North Carolina General Assembly passed SB676, “Autism Health Insurance Coverage.” The bill now goes to the governor’s desk for his signature, which would make North Carolina the 43rd state to enact autism insurance legislation. This is a historic day for North Carolina and the 65,000 plus families affected by autism in our state. Senator Apodaca and Representative McGrady’s leadership in the passage of SB676 was invaluable, as was the bipartisan support across the NC Senate and NC House for this issue.

The Autism Society of North Carolina, numerous families, and many partners have worked for more than seven years to make autism insurance a reality in North Carolina. Over that time, many versions of the legislation have been introduced. Every bill is a compromise between what you know is best and what is politically possible. Most legislation is a starting point. For today, we are celebrating that what we have worked so hard to achieve has come to fruition, though we always know we have much to do.

With any new legislation there are questions. Here are some quick highlights of the bill:

  • Health plans subject to the bill include large group plans (employers with 50+ employees- updated 10/2); grandfathered plans; and transitional plans.
  • Defines treatment for autism under the term “Adaptive Behavioral Treatment.” Adaptive Behavioral Treatment is not limited to one type of therapy, but includes Applied Behavioral Analysis as well as other evidence-based interventions, including ones that were developed here in North Carolina by TEACCH.
  • Covers medically necessary treatments such as occupational therapy, speech therapy and physical therapy. It also covers psychiatric, psychological, and pharmacy care.
  • Coverage will be available through age 18, with an annual benefit for Adaptive Behavior Treatment of up to $40,000. (Co-payments and deductibles apply).

When will this take effect?
Because the bill passed on the last day of the session, the implementation date has been moved from January 1, 2016, to July 1, 2016, to allow for the state and federal regulatory, legal, and implementation requirements for a new insurance benefit to take place. Group insurance plans renew on a quarterly basis, so the new benefit will be added to plans when they renew over the next year starting July 1, 2016. Plans that renew on July 1, 2016, will start then, and plans that renew after July 1 will offer the benefit starting with the renewal date: Oct 1, 2016, January 2017, and April 1 2017.

When will the governor sign the bill into law?
At this writing, we do not have a date. Governor McCrory has committed to signing the bill into law, making North Carolina the 43rd state to enact autism insurance legislation. The signing will be within 30 days and does not affect implementation.

How will I know whether my employer benefits will include autism coverage? 

  • Heath-care coverage varies depending on the type of employer and type of plan. We strongly suggest contacting your employer’s Human Resources department directly to discuss the new legislation and its effect on your health-care coverage. ASNC has written about health insurance coverage in this policy paper.
  • SB 676 will cover group health plans of larger employers (those with more than 50 employees), which are based in and operate only in North Carolina. It’s possible because of a law pending in Congress that large employers will be defined in 2016 as those with 50+ employees, but this has not been decided as of this writing. We are monitoring the outcome of that policy debate. Update – On October 2, 2015 the U.S. Congress passed legislation defining large group employers as those with 50+ employees.

Who is covered and who is not covered?

  • Large employers that operate in more than one state or internationally are not required to follow state law, but operate under federal ERISA (Employee Retirement Income Security Act) laws. Those employers will be more likely to offer coverage to employees living in North Carolina now that the bill has passed, but are not required to do so.
  • Individual plans sold under the Affordable Care Act on the health-care marketplace are not covered by this bill. Nor are insurance plans for federal employees and retirees, the military, railway, Medicaid, Medicare, and private companies that self-insure. There are many reasons for this fragmented system, which we explain in more detail in our Health Insurance Policy Paper.
  • The Autism Society of North Carolina continues to advocate with the NC Department of Health and Human Services to ensure that it follows recent federal guidelines directing states to offer autism behavioral services under Medicaid. We hope to have an announcement about those changes soon.
  • The State Health Plan sets its own benefit package and has already voluntarily adopted an autism treatment benefit, which began on January 1, 2015, so state employees’ benefits might differ from other plans covered under any new law.

Even though state laws cannot require every plan to cover autism treatments, once a law like this has passed, many companies that are not covered will voluntarily adopt coverage for their employees who live and work in that particular state.

This new law will not cover every person with autism, but ASNC is dedicated to continuing public-policy advocacy to ensure that individuals on the autism spectrum have health care across the private and public insurance systems. Thank you for all of your hard work to make this possible.

If you have questions about this or other public policy issues, please contact Jennifer Mahan, Director of Advocacy and Public Policy at ASNC, at or 919-865-5068.

Priming 101: Help Your Loved One with ASD Succeed in New Situations


This article was contributed by Leica Anzaldo and Louise Southern of ASNC’s Clinical Services Department.

How many of you have experienced the challenge of introducing something new or unknown to your loved one with autism? Having an effective plan is a critical component to the person with autism succeeding and reduces the likelihood that they will respond negatively or incorrectly. For some individuals with autism, priming should be a key part of that plan. Priming is an evidence-based antecedent strategy in which the learner is exposed to materials or activities that are likely to present difficulties later, when he encounters those materials or activities in an actual performance situation. The general objective of priming is to increase the likelihood that the student will exhibit the primed behavior in subsequent, naturally occurring situations.

Priming can be used in a variety of areas: social, academic, functional skills, transition, etc. An example is a kindergarten student who will experience an assembly for the first time. What can you do to prime for this? Priming for this out-of-the-ordinary event includes teaching the expected behaviors prior to the actual event and providing an opportunity for limited exposure to the event using a means that does not evoke stress and anxiety in the child. This may mean that you first allow the child to watch a video of an assembly and identify and list the expected behaviors they are observing. Then perhaps a social story is developed about an assembly that again includes those expected behaviors. This should be followed by modeling the expected behaviors and having the student imitate and practice them, as you give feedback and reinforce appropriate performance of skills.

Visual supports, including scripts, schedules, and organizational systems, are also evidence-based practices for children and adolescents with autism. Priming that features a visual component may be especially helpful to individuals with autism. A visual schedule is meant to clarify expectations, reduce maladaptive behavior during transitions, and, ultimately, increase independence. This priming tool prepares the student for transitions and allows the opportunity for others to visually display new or non-routine events in a platform with which the student is comfortable and familiar. A visual script is another great priming tool that displays written phrases that identify what to say and often how to say it. These may be accompanied by images that clarify or serve as shorthand for the phrases and are especially helpful for those who have difficulty initiating and/or delivering a message in an effective way. A social narrative is a written description of what the expected or appropriate behavior is for a specific situation. It not only explains what to do, but also promotes social understanding by explaining the reason behind an expected behavior. Social narratives often include images that support comprehension and promote interest and motivation. These include social stories, power cards, and cartoon or comic book conversations. Visual rule-and-reminder cues are words and/or images that signal which behaviors should be performed in a given situation, or sometimes, which behaviors should not be performed. These most often should be portable and used as a reminder of what is expected just prior to the individual being exposed to a situation that may evoke negative/maladaptive behaviors. They may also replace the need for verbal reminders, which often overwhelm individuals with autism.

Like all strategies, priming tools must be taught in a systematic way, presenting the tool within a structured instructional activity that delivers high levels of reinforcement for performing the appropriate behavior. Priming does not need to be overly complicated, but it must address the specific needs of the learner. It is a proactive, simple procedure that can be used by many to prepare for upcoming events or activities.


Learn more

Here are some recommended books on these topics from the ASNC Bookstore:

Activity Schedules for Children with Autism

How to Develop and Implement Visual Supports

How to Write and Implement Social Scripts

Visual Strategies for Improving Communication: Practical Supports for School and Home


For more information on strategies like these, please contact ASNC’s Clinical Services Department at or 919-865-5070 or 919-743-0204, ext. 1118. Louise Southern, M.Ed., BCBA, Associate Clinical Director, can be reached at or 919-743-0204. Leica Anzaldo, MPA, BSW, BCBA, Lead BCBA/Trainer, can be contacted at 704-894-9678, ext. 1603, or

ASNC’s Clinical Services Department staff is composed of PhD and master’s-level licensed psychologists, Board Certified Behavior Analysts, and former special education teachers. We provide individualized intensive consultation using evidence-based practices to support children and adults across the spectrum in home, school, employment, residential and other community-based contexts. We also deliver workshops to parents and professionals on a wide range of topics including but not limited to, strategies to prevent and respond to challenging behaviors, best practices in early intervention, functional communication training, and enhancing social understanding in individuals with autism.

Nominate Your Direct Support Professional for Roman Award


This article was contributed by Kerri Erb, Chief Program Officer.

This week, Direct Support Professional Recognition Week, we are taking time to honor our staff members who provide critical support for individuals with autism. Every day, they work one-to-one with individuals with autism, teaching skill acquisition and supporting them in reaching their life goals. In addition to staff, many become trusted friends, natural supports, and honorary members of families.

Each year in September, ASNC accepts nominations for the John and Claudia Roman Direct Service Award. The annual award was endowed by Lori and Gregg Ireland to honor Christine Roman, the direct service professional who worked with their son, Vinnie. It was named for her parents, John and Claudia Roman. Families who are served by the Autism Society of North Carolina for this award may obtain a nomination from by emailing Kathy Cockrell. Nominations will be accepted through Sept. 30.

The Autism Society of North Carolina employs hundreds of direct support professionals; without their dedication and continued efforts, many individuals on the autism spectrum and their families would not have needed support services. Some come to work for ASNC for a few months, others stay for a lifetime.

DSPs are the largest percentage of ASNC’s employees, and we learn how to improve what we do as an organization and as a system from them. Many full-time ASNC employees and managers got their start in the field through direct support work. Because of this understanding throughout the organization of the importance of DSPs, our ultimate hope is that an individual with autism’s life is improved in some way through their work.

Last year’s winner of the Roman Award was Melissa Mulcahey of Asheville, a community skills instructor who had worked with ASNC for five years. Jillian Martin, one of the mothers who nominated Mulcahey, said that when Mulcahey came to work with Martin’s son Jace four years ago, she immediately learned the Applied Behavior Analysis program that the family was using with him.

“Jace’s skills flourished soon after she joined what we call Team Jace,” Martin wrote. “His vast improvement in language, reading, and completion of tasks were a direct reflection of her countless hours and tireless efforts to make Jace successful.

“It’s because of people like her that our kids are loved and accepted, our families are comforted, and we can all attempt to have the most ‘neurotypical’ life possible,” Martin wrote.

We invite you to give your DSP a pat on the back, or make a donation in his or her honor, for a job well done this week (or any week).

Kerri Erb can be reached via email at or by phone at 919-865-5053 or 800-442-2762, ext. 1102.

Documenting Your Concerns in Your Child’s IEP

IEP meeting

This article was contributed by Teresa Mebane, an Autism Resource Specialist in the Wilmington region and an autism mom.

Now that school is back in session, it’s time to think about your child’s IEP. Do you ever feel your concerns are not being heard? Have you left an IEP meeting with unanswered questions? Here are a few tips that might be useful.

Prepare for the IEP meeting

First, always ask for a draft IEP a few days in advance of the meeting. This way you have information about how the school perceives your child’s “Present Level of Educational Performance.”

Then write a list of what you consider to be important to be included in the IEP. You will also want to write down any questions that you may have about your child’s special educational programming. This will also help you come up with what to put into the “Parent Concerns” section of the IEP. This section is not only for concerns but for documentation of things that may not be documented elsewhere in the IEP, for instance, other diagnoses, outside therapies, or how your child is doing at home. You will want to make sure that all of your major concerns are listed in this section, but do not let it become too cumbersome.

Your proposals must be documented

As a full participating member of the IEP team, you have a right to make any proposals that you feel are important. For example, if you want a social skills goal added, then you may make that proposal. This doesn’t mean the team has to adopt your idea, but they do have to consider it. There is a section in the IEP that is part of “Procedural Safeguards/Prior Notice of Proposal (DEC 5)” where there has to be documentation of options proposed or refused. This section should include a summary of all decisions made as part of the IEP meeting. There must also be a rationale for why those decisions are made. So again, let’s say you asked for the social skills goal and the team rejected the idea; it must be documented as to WHY they decided not to include this goal. This is powerful information should a parent choose to dispute that decision through mediation or due process.

It is a good idea to have someone read aloud the “Parent Concerns” and “Procedural Safeguards/Prior Notice of Proposal” sections at the end of the meeting. This will help ensure that all of your concerns and proposals have been adequately captured.

Signing the IEP

Keep in mind that unless this is an initial IEP, your permission is not required. Signing the IEP only indicates that you participated. It is the school’s responsibility to make a FAPE (free and appropriate public education) proposal even when there is parental disagreement. If the “Parent Concerns” and “Procedural Safeguards” sections have been adequately filled out, then those areas will indicate when you are not in agreement. If you strongly disagree with the decisions made, then it is your right to pursue some type of dispute resolution. But I hope that with a little bit of knowledge under your belt, you and everyone else will leave the meeting feeling satisfied.

Happy IEPing!

Teresa Mebane can be reached at or 910-332-0261.


Learn more

For more information on IEPs, browse the ASNC Bookstore, in the category “Classroom Management, Inclusion, IEPs.” We also recommend these expert picks:

Wrightslaw: Special Education Law, 2nd Edition: This updated resource breaks down the Individuals with Disabilities Education Improvement Act (IDEA) into terms that a parent can understand.

Wrightslaw: From Emotions to Advocacy: This guide will help parents and caregivers become better advocates for their children. Parents will learn how to communicate more effectively during IEP meetings by focusing on what children need based on present levels of performance and evaluation results.

Wrightslaw: All About Tests & Assessments: In this easy-to-read book, you will find clear, concise answers to frequently asked questions about assessments, evaluations, and tests.

The IEP from A to Z: This step-by-step guide on creating meaningful and measurable goals and objectives provides a helpful overview of the IEP process.

Triangle Run/Walk for Autism: ‘One of our Favorite Days of the Year’

Wizards of Auz at the 2015 Triangle Run/Walk for Autism

Wizards of Auz at the 2015 Triangle Run/Walk for Autism

The second Saturday in October is a special day to 9-year-old Seamus Millet. On his family’s calendar, it is marked with a puzzle piece, and he counts down the days.

Seamus, who was diagnosed with high-functioning autism just before his fifth birthday, is a veteran of the Triangle Run/Walk for Autism, the biggest fundraiser of the year for the Autism Society of North Carolina. Every day, he asks his parents: “How much money have we raised? How many people are walking? How many people have signed up?” said his mom, Katie Millet. “He takes it very, very seriously.”

He and his family have participated in the downtown Raleigh event every year since 2010, raising almost $30,000. They know the money will help dozens of individuals and families affected by autism, but what is most important to Seamus is the actual event.

“This day is huge for our family. It’s one of our favorite days of the year, honestly,” Millet said. “It is a special day for Seamus to understand how big his support network is and how many people there are supporting him and behind him and behind our family. When you see that, that goes a long way.”

Seamus, second from left, with his brother, Beckett, and friends

Seamus, second from left, with his brother, Beckett, and friends

Seamus’s team is called the Wizards of Auz, a play on the word “autism” and his favorite movie when the family first created the team. Their T-shirt, which Seamus helped design, features the yellow-brick road and ruby slippers. “Everything has to get approved by Seamus, according to him,” his mom said, laughing. “He takes a lot of pride in his team.”

The team has a core group of family members who walk every year, but they also are joined by friends and friends of friends, some of whom even fly in. They usually have 20-25 team members; the bigger the team, the happier Seamus is, his mom said. After the Run/Walk for Autism in downtown Raleigh, they all go back to the Millets’ Durham home for a big party to celebrate their success and what Seamus has been able to do to help others.

They certainly deserve to celebrate; $30,000 is an incredible amount for a Run/Walk team. Millet said she and her husband, Dan, each send out letters by email and on Facebook, to share their family’s story, Seamus’s milestones that year, how the Autism Society of North Carolina (ASNC) has helped them, and where the money will go. “We are just very big into appreciating the help that we got early, and ASNC is great about advocating and getting information out there,” Millet said. “It’s a way for us to help support that cause.”

She said making the cause personal helps people understand the challenges some families face. Even asking for small amounts often results in bigger donations, she said. “I’m always surprised by people who give. …You never know who’s affected, and who it means something to. Go for it!”

Millet’s letter this year shares a lot of positive news about Seamus. He started a new school last year, but took that in stride, making plenty of friends.

“He is doing amazing. This past year he has really come into his own,” Millet said. “For a child on the spectrum, I think most of us would agree he’s a social butterfly.”

Seamus and Beckett

Seamus and Beckett

Seamus has come a long way from the 3-year-old who was so frightened and anxious around groups of people that he wouldn’t get out of the car for his first day of soccer, or on the field later in the season. “When there was a group of kids, Seamus would cling for dear life to us. He would not look at anybody; he would not talk to anybody. He was terrified.”

Now, Seamus has close friends and is excited about joining chorus. He has been in Cub Scouts, and the other day, he shook the Cubmaster’s hand for the first time.

“Seamus is to the point now where there’s a lot of cool things that he can do and that he is good at, that are very closely related to the autism,” Millet said. “And we really see it as a strength for him, and we talk about how cool it is that he has autism. He understands that he is one of the lucky ones.”

Step out to improve lives in the Triangle Run/Walk for Autism on Saturday, Oct. 10! The event in downtown Raleigh will include a USATF-certified 5K race, which is part of the Second Empire Grand-Prix Series; a 5K noncompetitive run; a recreational 1-mile run/walk; and a kids’ dash. Celebrate autism awareness and acceptance with a kids’ play area, music, refreshments, and vendor space that will showcase local businesses, service providers, support resources, and sponsors. Proceeds will fund local programs of the Autism Society of North Carolina.

Register today:

HPU Lacrosse Team Steps Out to Improve Lives in Greensboro Run/Walk for Autism


The High Point University men’s lacrosse team has quickly established a winning tradition in the first four years of its existence, but for Triad families with autism, some of the team’s off-the-field stats are what make the players outstanding:

4 years of participating in the Greensboro Run/Walk for Autism as a team
56 lacrosse players ran last year
$7,291 raised since 2011

The team has become a familiar sight at the annual fundraiser for the Autism Society of North Carolina. The players come straight from practice and “basically show up as the gun is going off for the race,” said Associate Head Coach Pat Tracy.

They might arrive at the last minute, but that doesn’t reflect their dedication. Each year, every player on the roster registers for the Run/Walk and takes the time to seek donations from family and friends beforehand. “We have really great kids who care a lot,” Tracy said. “They’re definitely not hesitant to go outside of their comfort zone to help.”

Tracy has a stepbrother with autism and had participated in fundraisers for the cause in Baltimore before coming to High Point. It was his idea to make the Greensboro Run/Walk for Autism one of the team’s many community service projects. The first year, their team had just 19 players; last year, they were up to 56. “The guys have been unbelievable in being supportive of it,” Tracy said.

15358636360_cf335862b8_zNick Bittner, a fifth-year senior, has been part of the lacrosse team since the beginning. Participating in the Run/Walk for Autism meant a lot more to him last year, though, after he spent the summer working with children with autism during an internship with the Kennedy Krieger Institute in Baltimore. Bittner was part of a team led by a clinical psychologist that was teaching social behaviors.

“It really opened my eyes to see what autism is, and to see the effort it takes for families who have children that have autism,” he said. Last fall, Bittner shared his experiences with his teammates. “I had seen firsthand what donating to the Autism Society could do to help people with autism.”

Bittner, who is a biology major and hopes to attend medical school, is now considering the autism field specifically. “I definitely found a certain passion for it,” he said.

In the meantime, he’ll join his teammates one last time for the Greensboro Run/Walk for Autism on Sept. 26. Coach Tracy said they wouldn’t miss it.

“We’re excited. Our guys look forward to it every year,” he said. “Our guys really do enjoy being out there. They enjoy supporting the cause and supporting the community and the families.”

Step out to improve lives in the Greensboro Run/Walk for Autism on Saturday, Sept. 26! The event at UNC-Greensboro will include a 5K race and a recreational 1K run/walk. Celebrate autism awareness and acceptance with music, refreshments, and vendor space that will showcase local businesses, service providers, support resources, and sponsors. Proceeds will fund local programs of the Autism Society of North Carolina.

Register today:

Bringing Art into the Lives of Adults with Autism


The Autism Society of North Carolina’s day program in Raleigh, Creative Living, focuses on clients’ individual strengths and interests to help them lead meaningful lives. Art is a large part of this individually tailored approach. Creative Living clients express themselves through many media, including painting and pottery.“Through art, there’s no right or wrong way to do something,” said Katherine Gardocki, Director of Creative Living. “For a lot of clients, it’s a really big stress relief because they don’t have to be verbally engaged or necessarily extremely focused on another person, they can focus on the work.”

Through art, the clients can grow as they have a chance to try something new in a safe environment.

Eric Lionheart Wolf, who has attended Creative Living for three years, enjoys drawing and painting items with meaning or symbolism. “Being able to use different colors and techniques gives me control in my life, and my artwork. I like being creative.”

101024_ASNC_0907B_5x7Clients’ art can also help others get to know them and how they are feeling that day, Gardocki said. Creative Living has about 20 clients who are paired one-on-one with staff, which allows them to build a relationship. “I think that you can learn a lot about somebody through their art – the colors that they select, the styles that they use,” she said.

Artists choose whether to display and sell their work; they keep some of the proceeds, and some goes back into the program. But the program still requires a lot of funding to continue, as art supplies are used up on a regular basis.

That’s where White Memorial Presbyterian Church in Raleigh has stepped in.

Since 2004, White Memorial has given more than $11,000 in donations and grants to ASNC and Creative Living. The grants have helped provide supplies for the art program and specifically the pottery program. With White Memorial’s generous support, Creative Living was able to purchase a kiln.

Rev. Gloria Johnson, Associate Pastor for Community Ministry at White Memorial, said the church was inspired to support ASNC by members who have relatives with special needs. “We want to support them and let them know how much we care about their families,” she said.

Church member Marie Horne is the mother of Rob Horne, who is 51 and has attended Creative Living since it started in 1997. Rob thrives at Creative Living, she said, because he is able to get out into the community with his staff member to do volunteer work at the church, the SPCA, a thrift store, and an assisted living facility. “He has to have something that lets him move around.”

Horne brought up Creative Living to the church’s grant committee after seeing the positive influence it had on her son, whose main challenge is expressive language. “He’s gotten a lot better about greeting people because the Creative Living staff really understand him and people with autism,” she said.

Rev. Johnson is the coordinator of the church’s community grant program. “We want to help people that are doing a good job continue to do the job that they know how to do best. We’re not equipped to work with people at the caliber and the depth that other organizations are able to do, but we are certainly committed to our community and helping the community be the best that it can be.”

Church members are happy to support the art program at Creative Living’s request. “They do some wonderful things to allow that kind of creative spirit that we all have to flourish,” Rev. Johnson said.

Gardocki said it is the church’s donations that have allowed the art program to expand based upon clients’ interests, and through the art program, they have also built relationships. For example, they recently held an art show at Roundabout Art Collective in Raleigh. “It just continues to allow us to form those relationships, and in turn, I think it really helps educate the community about adults with autism and what they’re capable of,” Gardocki said.

The Autism Society of North Carolina is thankful to White Memorial Presbyterian Church for its support in bringing art and all of its benefits to the adults at Creative Living. We hope the partnership will continue for years to come.


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