Autistic Spectrum Disorder (ASD) is a multi-factorial disorder. There is no one cause of ASD. The most prominent risk factor is genetics. Studies by the All India Institute of Medical Sciences (AIIMS) reveal that one in 89 children aged between two and nine years have been diagnosed with autism in India.

Studies have shown that if one of an identical twin has ASD, then the other would be affected 36-95% of the time. In case of non-identical twins, if one child has ASD, the other is likely to be affected 31% of the time. Parents who already have a child with ASD risk a 2-18% chance of having a second child afflicted with the disorder.

Research has shown that early detection and therapy can resolve and, in certain cases, even restore the emotional, behavioral and academic development of autistic children. But this is possible only if parents spot the warning signs early on.

For instance, parents need to observe the child’s behavior and look for symptoms such as delay in speech development or difficulty in interaction with others. A late diagnosis of autism requires prolonged therapy and support services to help the child develop various capabilities, including social and communication skills.

Health insurance for children diagnosed with ASD

ASD can take a serious toll on the emotional and physical health of the affected people and pose a serious financial challenge for their families. Medical treatment and special therapies/education can cost Rs 2-4 lakh a year. A monthly expenditure of Rs 25,000-30,000 on speech and vocational therapy is not unusual, as just one session of speech therapy can cost up to Rs 500.

Loss of wages can raise treatment costs even more. Parents of autistic children are often forced to reduce their working hours or even quit their jobs to stay at home and look after their child. Therefore, it is essential to have special health insurance for children diagnosed with ASD.

Fortunately, financial help is at hand. Special insurance policies catering to autistic children are now available and cover all inpatient and outpatient treatments, including therapies such as behavioral, physio, occupational and speech therapies.

Parents can customize their policies depending on the specific requirements of their children and their own financial strength. In some cases, the insurance policy may cover the treatment if it is recommended by a doctor.

An ideal health insurance for children with the diagnosis of ASD should cover the cost of treatment for seizures, soft tissue and bony injuries, surgical procedures for alleviating the spasm of the muscles, and infectious diseases.

Although Government of India has a Rs 1-lakh special health insurance scheme, Niramaya, which caters to the welfare of children with disabilities such as autism and cerebral palsy, there is an urgent need for the Indian insurance sector to offer dedicated polices for ASD.