Thread Drift

[OakLeaf]

The other thing is that in some states, insurance coverage is much more favorable for certain diagnoses than others. Depending on where you are, a therapist might tailor a diagnosis to allow the client the maximum insurance coverage, and choosing a mood disorder over a personality disorder is a prime example of that.

[malkin]

The other thing is that in some states, insurance coverage is much more favorable for certain diagnoses than others. Depending on where you are, a therapist might tailor a diagnosis to allow the client the maximum insurance coverage, and choosing a mood disorder over a personality disorder is a prime example of that.

Right now, the center where I work is in the process of 'diagnosing' every one of our clients with a dx in addition to autism for this reason. So now in addition to 'autistic disorder' every client will have ADD or OCD or anxiety or mood disorder or some other more reimbursable diagnosis.

[Crankin]

That's because of the changes in the new DSM. I have a couple of clients with a PDD-NOS dx, but fortunately, they also have another dx. There is no more PDD dx, just Autism spectrum disorder. However, since all of my clients have one of 3 behavioral health providers that work with Mass Health and the special in home therapy program I work in, they rarely question a dx. In fact, this program has been so successful, that anyone in the state can now access it, through the behavioral health partnership, even if the parents have regular insurance. They can't use it for physical health care, but I now have a couple of clients who are in this category. It's nice that the state realized the benefit of intensive treatment, that it avoids future issues, and not just low income people could benefit.
Of course, it took a lawsuit to get this program.

[Owlie]

Right now, the center where I work is in the process of 'diagnosing' every one of our clients with a dx in addition to autism for this reason. So now in addition to 'autistic disorder' every client will have ADD or OCD or anxiety or mood disorder or some other more reimbursable diagnosis.

That makes me feel all sorts of dirty and I don't know why.

[malkin]

I think it is because of a change in Medicaid rules for our state rather than the DSM change. I know it has generated some controversy, but I think I like the new DSM Autism Spectrum diagnosis because it does away with a perceived (and incorrect) hierarchy of severity.

Anyway, our current online medical record system has this stupid thing where the dx for PDD-NOS shows up as the entire category, so that printed reports state that the child has PDD-NOS, Rhetts Syndrome, and Aspergers.

Owlie- Coding, billing and reimbursement almost never fails to give me a sick feeling. Fortunately I don't have much to do with it at work.

[Dogmama]

((INDY))
I've been estranged from my mother for over twenty years. She was actively alcoholic & abusive which resulted in many adjustment problems for me. I made some major life changes that threatened her. She cut me out of her will - literally - sent me a Fed Ex that I had to sign for where I was deleted & her step son was inserted. Just like a word processing program for her but not so much for me.

It totally sucked, I fell into a deep depression and crawled back out. I am not angry at her because that expends energy and keeps the arrows flying. I do not have any contact nor do I wish to have any. It is self preservation. I had to refocus my life and move on. It wasn't as easy as it sounds now but I'm at peace. When I realize that our estrangement is not against her - but it is for my own basic well being - it feels better. Hope that helps.

Oh and riding my bike really helped move energy that I may have directed towards myself (bad daughter, etc. - the usual crap.) I seem to get a lot of clarity on my bike when it's just me, my bike and nature.

[redrhodie]

I don't know if this is a new thing around here or not, but I just noticed that a lot of kids in my city ride their bikes to school! Little kids, elementary school age. I find that really hopeful for some reason. Do they ride to school where you live?

[Crankin]

I have actually seen kids riding to school, when I was running in Concord center last year. It's flat and there are sidewalks. These kids knew what they were doing, too.
My neighborhood is on the other side of the highway from the schools the elementary and middle school kids go to. I can't figure this out, as the school I saw the kids riding to is closer.
I remember having to sign all kinds of releases when my younger son was in 6th grade and he wanted to ride to field day, which was about 3/4 a mile from our house (different town). When he got his first nice bike, at the end of 7th grade, I let him ride to school, which was about 5 miles away, and with sidewalks on the busy roads. I remember my neighbors being shocked, and probably another example of what a bad mom I was . About a year later, he was racing.

[katherine]

I ride with my kindergartner and 1st grader every day. And if the first grader gets his way we take the long way via the trails