Really good news!
Early on a recent Monday morning, I had the surreal experience of opening my email alerting me that at last, at last, Governor Gavin Newsom signed our bill! California SB 805 requires insurance funding for all evidence-based autism therapies so that doctors and families will finally have a choice of therapeutic method that is right for the patient.. As the current President of the bill sponsor, the DIR/Floortime Coalition of California, I have been working with brilliant parents and colleagues for 10 years for this!!
The empirical outcome research for the efficacy of developmental, relational approaches, such as DIR/Floortime, has greatly expanded over the past 10 years. Published studies and meta-analyses demonstrate effectiveness of relational approaches for improving the social communication and core capacities of autistic children and youth. The American Academy of Pediatrics and the American Medical Association have both changed their guidance for healthcare providers, pointing now to the variety of evidence-based approaches to therapeutic supports for autistic people, and no longer recommending just the one widest-known approach, ABA (Applied Behavior Analysis). ABA is based in the behavioral learning theory of operant conditioning. Myths still abound and parents routinely still get told by their pediatricians or funding sources that “ABA is the only way” to help their child, or the only evidence-based approach. This means we still have more advocacy work to do to get the word out to all prescribers and families that there are options and choices of method.
DIR/Floortime is a wonderful developmental, relationship-based approach to embracing and supporting neurodivergent clients in their sequence of social-emotional growth stages. DIR and other developmental, relational approaches utilize finely attuned family and professional relationships to foster growth in social-emotional, motor, and cognitive skills and capacities through play, conversation, and shared joy or emotionally meaningful experiences. See a full description, our handbook of strategies, and also research support.
Learning about legislative advocacy -
As if my life as a group practice founder and clinical psychologist wasn’t busy enough, I still needed to add on legislative advocacy because of the urgent need to fix the glitch in California’s 2011 autism insurance mandate, SB 946. Despite the original intentions of the CA legislature to require coverage for all evidence-based approaches, the important law ended up mandating insurance coverage only for patients whose providers practice the ABA approach. Parents whose doctor recommended a developmental approach for their child such as DIR/Floortime would routinely get insurance denials. This was incredibly inequitable: only wealthy families could afford to pay out of pocket for comprehensive service teams to come out to work with their child or youth in the home environment across years of need. Some lucky families had their particular Regional Center cover DIR/Floortime services, but most Regional Centers did not cover developmental approaches, only behavioral approaches, and therefore most families in the state were unable to access developmental, relational approaches to care.
Over these ten years, I learned a lot about how to patiently develop momentum and work to make a law from our experienced lobbyist, Jim Lantry. We gathered thousands of petition signatures and letters of support from individuals and organizations. We flew to Sacramento with parents to testify. We worked with Senator Anthony Portantino and his devoted staff to pass 3 prior versions of this bill unanimously all the way through the California Senate and Assembly and on to the Governor’s desk. Sadly, these 3 bipartisan-supported bills got vetoed - once by Jerry Brown and twice by Gavin Newsom. Our devoted co-founder, Josh Feder, M.D., compared the ups and downs to a game of “Chutes and Ladders”!
Nevertheless, in January 2023, we worked again with Senator Portatino to present a completely novel approach under the brilliant legislative leadership of our founding President, Diane Cullinane, M.D. We were greatly heartened by large state or national organizations such as the Board of Psychology, the California Psychological Association, California Academy of Child and Adolescent Psychiatry, Disability Voices United, Adult Self-Advocacy Network, and so many others submitting letters of support for the bill.
You can imagine our joy on the morning of October 9, 2023 when we awoke to learn that the Governor signed this year’s version of the bill, SB 805, into law! Newsom even texted a photo of his hand signing the bill with the caption “At last”! Now we hope to support government agency implementation of the bill with the legislative deadline for finalization unfortunately not until mid 2026.
I was grateful to be interviewed about this big legislative win by the online autism family resource hub, Undivided.io. You can see their excellent article with video snippets of our discussion. Watch the full Undivided.io YouTube channel interview of me here.