REFERENCE SHEET for TRICARE Services in DC

REFERENCE SHEET for TRICARE Services to Individuals with Autism Spectrum Disorders in Military District of Washington (MDW) Area I am an active duty Army officer currently located in the MDW/DC-area, North Region and receive services through National Naval Medical Center (NNMC) at Bethesda and Walter Reed Army Medical Center (WRAMC) for our son with autism. The web sites for these hospitals are http://www.bethesda.med.navy.mil and http://www.wramc.amedd.army.mil. This sheet explains what medical services we’ve managed to get for him from TRICARE and how we got them. I know that services vary from region to region, even though they should not. I also understand from personal experience that it is very difficult to move into a new area every two to three years and quickly identify which services are available and how to secure them. If you have any questions or would like me to include additional information that might be helpful to new families in the area, please feel free to email or phone. My contact information is Scott Campbell at campbellsservices@gmail.com. Home phone number is (703) 241-2640.

Recommended WRAMC and NNMC doctors: Dr. Ed. Coll, Developmental Pediatrician from NNMC at ed.coll@na.amedd.army.mil. Office phone number is (301) 319-4095.

Dr. Lowry Shropshire, Neurodevelopmental Pediatrician from NNMC at lcshropshire@bethesda.med.navy.mil. Office phone number is (301) 295-4917.

Another helpful person has been Betty Thomas at betty.thomas@na.amedd.army.mil from Dewitt Hospital at Fort Belvoir. She is the chief of utilization management and can be very useful in finding TRICARE or MTF services for your kids. Her office phone number is (703) 805-0764. Three more helpful folks have been Marcia O’Connor, the Fort Myer Exceptional Family Member Program (EFMP) Manager at o’connorm@fmmc.army.mil. She has been around the area for many years and has a great network for advice and contacts. Her office phone number is (703) 696-8467/3510 or marcia.a.oconnor@us.army.mil. The Fort Belvoir EFMP office can be reached at (703) 805-5435.

A social skills group for individuals with High Functioning Autism at the National Naval Medical Center in Bethesda, MD. Phone Barbara Eckman, LCSW at (301) 295-0576 for more information.

ACQUIRING SERVICES IN TRICARE’S NORTH REGION The first step in acquiring services in the North Region is to enroll your child in the Exceptional Family Member Program (EFMP) at one of the local offices. Once that is done, you can enroll in the Extended Health Care Option (ECHO) program (used to be the Program for Persons with Disabilities (PFPWD) by contacting Health Net at https://www.hnfs.net/content/hnfs/home/tn/common/care/echo/registering_in_echo.html/pp/content/hnfs/h ome/tn/bene/error_pages/404.html. You will need to make appointments with your military PCM or physician for a referral to a developmental pediatrician (Dr. Coll’s and Dr. Shropshire’s contact information is listed above). The program switch happened on 1 SEP 05. FAQ info from Health Net is at https://www.hnfs.net/content/hnfs/home/tn/common/care/echo/echo_faq.html/pp/content/hnfs/home/tn/be ne/error_pages/404.html. Registration phone numbers are at https://www.hnfs.net/content/hnfs/home/tn/common/care/echo/echo_contact_information.html/pp/content/ hnfs/home/tn/bene/error_pages/404.html. TRICARE ECHO Program info is at http://www.tricare.mil/mybenefit/ProfileFilter.do;jsessionid=KWrQxbCGVzp87h7MphngLYP5CxPLkdG7qd 6DhqSNpsZs6tR2n39Q!1869056764?puri=%2Fhome%2Foverview%2FSpecialPrograms%2FECHO. I suggest signing up for the TRICARE ECHO email newsletters subscription at http://www.tricare.osd.mil/tricaresubscriptions.

For all the interventions listed below, it helps to have a provider already picked and listed on the request for all TRICARE requests. Get a copy of referral ASAP after it is submitted to cut down on problems with utilization personnel filling it. If any services are not sufficient or adequate at school, request additional

services for “behavioral” or “medical” and not “educational” purposes from TRICARE. Congress created the ECHO program to make services accessible to active duty service members in one state that are not accessible in another state because they are required to move frequently and are normally not in one area long enough to wait to become eligible for services through Medicaid waivers in most states. From Section 1.1 of Chapter 9 for “Special Education”, “Extended Health Care Option (ECHO) is a supplemental program to the TRICARE Basic Program and provides eligible active duty family members with an additional financial resource for an integrated set of services and supplies designed to assist in the reduction of the disabling effects of the beneficiary’s qualifying condition.” Some services are only accessible through TRICARE's ECHO program and not through regular TRICARE. Most notably is Applied Behavior Analysis (ABA) therapy. However, most services (such as OT, PT and S&L) are only available through the regular, basic program, even though some TRICARE folks may state the opposite.

There is monthly co-pay depending on the sponsor’s rank. The program initially provided up to $2500 of services per month for each family member enrolled in ECHO, when it started in September, 2005. That figure went to $36,000 a year (or on average $3000 a month) retroactively from when the FY09 NDAA budget was signed on 14 October 2008, but the TMA did not get implementing instructions to the contractors until 1 April 2009. However, Respite care, assistive services and durable equipment limited to only $2,500 per month and the $36,000 per fiscal year limit, but the cost of durable equipment can be spread out over multiple months. Unused portions can be rolled over from month to month until the end of the fiscal year on 30 September of each year. This program is currently not available to families of retirees.

Applied Behavior Analysis (ABA) therapy is a structured one-on-one program to identify and address problem areas unique to each individual and is currently approved through the ECHO Program. The initial request stated: “ECHO Program enrollment and Applied Behavior Analysis (ABA) Therapy for 15 hours/ week x 12 months and 2 hours/ month for evaluations, training, or team meetings by … from … through …” Our son was authorized 15 hours per week during the school year and 30 hours a week during the summer months, along with a two-hour evaluation once a month. However, it was reduced by the case manager to only 15 hours a month based on the monthly funding limit and not his medical needs. When this program changed from the PFPWD to ECHO, the criteria to get ABA changed. They are currently listed in sections 2.2 through 2.4 of chapter 9 of the TRICARE Policy Manual at http://manuals.tricare.osd.mil. Most individuals qualify for services under the "Significant Physical Disabilities" at section 2.3 by having problems with “unaided performance” of at least one of the following major life activities is an ECHO qualifying condition: breathing, cognition, hearing, seeing, and age appropriate ability essential to bathing, dressing, eating, grooming, speaking, stair use, toilet use, transferring, and walking.” State all that apply in your request for a referral. Some TRICARE personnel may insist that the individual must also have a mental retardation (MR) diagnosis too or a specific autism label to get into the ECHO Program, but that is ABSOLUTELY NOT correct. If you run into this problem, please contact me immediately. TRICARE will NOT approve ABA therapy for what is viewed as only educational issues, but only for behavioral or medical problems, which is why you also have to have your school system or county health agency complete the Public Use Certification Form (Section 5.1 of Chapter 9), which should be provided by your case manager. Again, a home ABA program is possible, if the local school system states that they "only provide ABA for educational purposes", if they do that at all.

You will probably also have to provide a copy of your child’s current Individualized Education Program.

The CPT code to be used for ABA therapy has been 99199 for TRICARE ECHO Program. For more information about what ABA at http://www.poac-nova.org/base.cgim?template=aba_vb and http://www.feat.org. A list of certified providers is on the certificant registry and other info at http://www.bacb.com/index.php?page=58.

Info on 2008 Autism Demonstration Project: Details in Section 9 of Chapter 18 of the TRICARE Operations Manual at http://manuals.tricare.osd.mil, dated 15 March 2008 with changes on 20 March, 22 April, & 17 September 2008 and 18 March 2011. It only covers ABA; no other types of behavioral interventions reimbursable.

You must enroll in EFMP, then in the ECHO Program and then in the Demo.

–

Eligibility (Paragraph 6.0):

– –

Diagnoses of only AD, PDDNOS, AS, and CDD. Over age of 18 months and receiving special education under an IEP or IFSP.

–

Providers (Paragraph 5.2):

– – – –

–

Must be a pediatrics MD, clinical psychologist PhD, BCBA, or BCABA. Must sign participation agreement and undergo a criminal history review.

Tutors employed by or contracted with TRICARE provider.

Certify tutor education, training, experience, competency requirements and that have successfully completed a criminal background check.

Complete Behavior Plan (BP) and EIA Progress Report (EPR) for each child every six months.

(Paragraphs 7 and 9.1.4). Pay up to $47.65 using CPT 99080.

Carry liability insurance of $1M per claim and $3M aggregate.

“Shall organize and direct required quarterly family treatment progress meetings”. (Paragraph 9.1.5). Pay up to $65.08 using CPT 90887.

Provider rates: Up to $125/ hour for BCBAs, up to $50/ hour for tutors.

–

Tutors (Paragraph 5.3): (Requirements prior to billing TRICARE)

–

Education- Minimum of 12 semester hours of college coursework in psychology, education, social work, behavioral sciences, human development or related field) -orminimum of 48 hours of any college course -or- H.S. diploma or GED and 500 hours of ABA services employment.

Classroom training- 40 hours required.

Experience and Competency- no specific, quantified requirement.

Ongoing Supervision- 2 hours of direct supervision a month.

– – –

– – – –

Parent/ Caregivers training (Paragraph 7.1.4): Now only provided during billable ABA therapy. But, detailed training plan must be included on the semi-annual Behavior Plan.

–

TRICARE will not cost share (Paragraph 12.0):

– –

Training for tutors to meet training requirements, or tutor supervision.

Program development or administrative services and assessment required for developing the EIA Progress Report (EPR) and updating the Behavior Plan (BP).

The following are TRICARE-authorized ABA providers in the MDW area listed in no particular order: http://www.autismoutreach.org for Autism Outreach, Inc. (AOI). Their office phone number is (703) 689-0019, or email her at MichelleHurstAO@AOL.com. Michelle Hurst, M.Ed, BCBA and her folks are providers to a number of autistic kids of military parents and are very familiar with working with TRICARE on your behalf. Their office phone number is (703) 689-0019, and their office is in Reston, VA. Her cell phone is (571) 236-1110. http://www.alternativebehaviors.com for Alternative Behaviors in Falls Church, VA. Their office phone number is (703) 237-2219, or email them at info@achievebeyondusa.com. http://autismlearningcenter.net for Paul Glass with Autism Learning Center (ALC). Their office phone number is (703) 506-1930, or email them at autismlc@aol.com. Their office is in Falls Church, VA. They usually do not provide the hands-on therapists. http://www.autismservicesnorth.com for Paul Eschbach at Autism Services North. Their office phone number is (800) 306-8602, or email them at info@autismservicesnorth.com. http://www.basicsabatherapy.com for Saundra Bishop at B.A.S.I.C.S. ABA Therapy. Their office phone

number is (202) 650-2083, or email her at SaundraBishop@basicsabatherapy.com. http://www.behaviorsforlife.com for Allison Clark, M.Ed., BCBA with Behaviors for Life. Their office phone number is (703) 400-3035, or email her at allison@behaviorsforlife.com. http://cap-autism.com for Toni Haman with Comprehensive Autism Partnership in Fredericksburg. Their office phone numbers are (954) 829-0790, or email her at toni@cap-autism.com. She has 8 years of training at the Lovaas replication site in Wisconsin and 2-1/2 years with her company in Florida until she moved here. http://www.centerforautism.com for Center for Autism and Related Disorders (CARD). Their office phone number is (703) 750-0633, or email Mary Ann Cassell at M.Cassell@centerforautism.com. Their office is in Alexandria, VA. http://www.eakinbehaviorconsultva.org for Kelly Eakin, MS, BCBA with Behavioral Therapy & Consultation. Their office phone number is (703) 537-0700, or email her at kellyeakin@familypriority.net. http://leapahead.org for Talisha Herring, BCABA with Leap Ahead. Their office phone number is (703) 392-6166, or email them at leapahead2002@aol.com. http://www.matthewscenter.org for Matthew’s Center, a TRICARE-authorized ABA provider. For more info, contact Laurie Heilman, Executive Director at (703) 369-2976, extension 101, or email them at lheilman@matthewscenter.org. http://www.pbdynamics.com for Benjamin C. Mauro with Positive Behavioral Dynamics, Falls Church, VA. Their office phone number is (703) 533-3856, or email them at bmauro@pbdynamics.com. http://www.prioritiesaba.com for Adam Spencer with Priorities ABA from a DC office, who only services TRICARE ABA clients using Lovass ABA techniques. He works through a North Carolina company, Priorities ABA at (252) 341-4192. They may even bill TRICARE directly on our behalf. http://www.reachingpotentials.org for Reaching Potentials in Fredericksburg is an approved ECHO Program and Autism Demonstration Project provider. Their office phone number is (540) 368-8087, or email them at RPforAutism@aol.com.

Dee Payne with DKB Therapy Services in Fredericksburg, VA. Their office phone number is (571) 330 8120 or (888) 511-1091, or email them at dkbtherapyservices@yahoo.com.

Trish Schnabel, M.Ed, BCBA. Her office phone number is (703) 786-835, or email her at trishschnabel@aol.com.

For another perspective, http://rsaffran.tripod.com/schools.html#VA lists schools claiming to use ABA as a primary intervention in the US, Canada and also in other countries.

When in doubt, submit a claim to TRICARE for anything that you think might qualify. If denied, appeal right away using the info from their denial letter and the justification from the TRICARE Policy Manual at http://manuals.tricare.osd.mil. That is true for all the interventions listed below.

Other Benefits Under the ECHO Program: From Section 11.1 of Chapter 9, “Transportation of an institutionalized ECHO beneficiary to or from a facility or institution to receive otherwise allowable services or items through the ECHO may be cost shared.” No longer available for ABA therapy as of 3 December 2009.

From Section 14.1 of Chapter 9, “Durable Equipment (DE) is a device or apparatus which does not qualify as Durable Medical Equipment under the TRICARE Basic Program but which is essential to the

efficient arrest or reduction of functional loss from, or the disabling effects of a qualifying condition.”

Examples are adapted car seats, beds and other safety equipment. This is different from Durable Medical Equipment (DME) explained in Section 2.1 of Chapter 8 and is allowable since it: 1. Can improve, restore, or maintain the function of a malformed, diseased, or injured body part, or can otherwise minimize or prevent the deterioration of the patient’s function or condition; 2. Can maximize the patient’s function consistent with the patient’s physiological or medical needs; 3. Provides the medically appropriate level of performance and quality for the medical condition present.

Examples are wheelchairs and other mobility devices.

From Section 12.1 of Chapter 9, “ECHO registered beneficiaries are eligible to receive a maximum of 16 hours of respite care in any calendar month in which they also receive any other ECHO-authorized benefit.” Health Net has stated that you will need to have a new request from a MD for this "non-skilled nursing" entitlement, so contact your PCM with your choice of local TRICARE-authorized providers to put in your request. The request should state “Respite care through the ECHO Program by "provider's name and address" for up to 16 hours/ month X 12 months … from … through …” The request can and should be for 12 months at a time, even though Health Net can only do the authorizations for 6 months at a time. Once you are enrolled in ECHO for any service, get list of possible providers from ECHO case manager for non-skilled nursing providers (usually certified nursing assistants). The respite care provider MUST be a TRICARE-authorized "home health care agency" provider, so you CANNOT use a neighbor, family member, or anyone like that. To find the nearest one to you, go to https://www.hnfs.net/content/hnfs/home/tn/common/app_help_pages/provider_directory.html/pp/content/h nfs/home/tn/bene. Under "specialty" go to "home health care agency". Hit search and go to the provider tab to see who is a TRICARE-authorized "home health care agency" provider in your area.

Then, call whoever comes up to verify that they do accept and bill TRICARE and have non-skilled nursing providers (certified nursing assistants usually) before determining which provider would be the best fit for your family. Call possible providers to verify that they do accept and bill TRICARE, and have non-skilled nursing providers to determine which provider would be the best. However, this is only for your disabled child, and they may not also watch any of your other children, unless you can work out something with the actual respite care provider on the side. The Current Procedural Terminology (CPT) code to use is 99600 for respite care.

Respite Care: In addition to possible respite care through the ECHO Program, some services also offer it through the Exceptional Family Member Program (EFMP) respite care available as of June 2007 for active-Army and AGR families enrolled in EFMP. Marine Corps started a similar program in August, 2007. The Navy started with five locations for only CAT4 or CAT5 families in March 2009 through the National Association of Child Care & Resource Referral Agency (http://www.naccrra.org/MilitaryPrograms/NavyEFMP). However, the funding source for EFMP respite care went from using Global War On Terrorism (GWOT) dollars to budgeted, appropriated funding starting with this fiscal year as of October 2008. That should have been a good thing, since it better ensures consistent funding for the future. However, those funds are allocated at the discretion of each garrison commander, so he can fund respite care fully, a little, or none at all. If lack of funding is an issue, see the garrison commander or CSM to explain why this service is so vital for your family. A little education can sometimes yield big results. Funding stuff aside; there will be a reduction for many families getting respite care in the past, since the same amount of money will probably be spread across more families. Qualifying families may be eligible to receive up to 40 hours of EFMP respite care monthly for each certified EFM. It is “consumer-directed”, and the pay and number of hours varies according to the medical needs of the individual, using a matrix that the EFMP folks have to determine that need. EFMP certification, respite care qualification and administration of the entitlement are through the local EFMP manager. For Army Community Service (ACS) EFMP enrollment and more details, contact Marcia O’Connor at (703) 696-8467/3510 or marcia.a.oconnor@us.army.mil at Fort Myer or the fine folks at Fort Belvoir at (703) 805-5435. Sources of potential respite care providers are at the bottom of the POAC-NoVA web link at http://www.poac-nova.org/base.cgim?template=new_pare_resource_suggestions. I do NOT recommend Jesse Kuschner and Professional Education and Respite Service at (888) 664-9886 or

www.vacationrespite.com for ABA therapy or respite. If possible, additional respite care can be possible through your state Medicaid waiver services.

Medical Autism Specialist (Formerly Defeat Autism Now! (DAN!) Doctor: I have gotten a number of referrals through our military pediatrician to see a medical specialist, so we can get some more recent, specific medical second opinions. We requested a "developmental pediatrician who is an autism medical specialist to evaluate and treat autism" under section 3.10 on treatment of mental disorders, chapter 7 of the TRICARE Policy Manual at http://manuals.tricare.osd.mil. However, request a medical autism specialist and specifically not a DAN! MD, since many military pediatricians seem to have some sort of bias against these MDs due to their apparent ignorance of what a DAN! MD is. You can try to find a DAN! Doctor in your area by using the Autism Research Institute web site of http://www.autismwebsite.com/practitioners/us_lc.htm or http://autism.com/dan/danusdis.html for within the U.S. and http://autism.com/dan/danforeigndis.htm for outside the U.S. However, this part of the website will be taken down at the end of 2011. It is good to have the specific MD listed on the referral, since that makes the authorization process go a lot faster. Subsequent referrals to “have our son continue to see … for additional developmental pediatrics services as part of an ongoing treatment plan.”

We have ordered another round of tests each year and began heavy metal chelation (authorized under TRICARE section 2.7 of chapter 7) through them. Finding a medical specialist who specializes in autism has been very, very helpful in determining the best and some overlooked treatment options for our son.

We now have him on him on a 5-Hydroxytryptophan (5-HTP), EnZym-Complete with DPP-IV (multi-spectrum digestive enzyme), Nu-Thera with P5P (multi-vitamin and mineral), Theanine, Trimethylglycine (TMG), a Vitamin C and D3, Magnesium Sulfate cream, Yeast Aid digestive, and a liquid zinc from Kirkman Labs as a result of these visits. We added MinerAll/ WP Minerals, when we were doing chelation. He is on a few other supplements not from Kirkman, such as: a liquid Glutathione, Lipase digestive, Ther-Biotic Complete (lactobacillus acidophilus) probiotic, and Taurine (for more solid poops). One final note is that the person must be a MD, not a dietician for you to be reimbursed. After getting an authorization up-front from TRICARE, we have been reimbursed for about half of the costs for these visits. Our regular DAN! doctor is Dr. Pamela Compart with Heartlight Healing Arts in Columbia, MD. Her office phone number is (877) 641-8472 or (410) 880-4215 or visit their website at http://www.heartlighthealingarts.com. We very highly recommend her as one of (if not the best) DAN! doctor in the area. Our DAN! doctor for chelation was Dr. Richard Layton with Allergy Connections in Towson, MD from July 2006 through September 2010, when we stopped chelation. His office phone number is (888) 337-2707 or (410) 337-2707, or visit his website at http://www.allergyconnection.com. If you need an excellent psychologist, I recommend Dr. Jane Barbin with Behavioral Directions, 626 Grant Street, Suite I, Herndon, VA. She is also a Board Certified Behavior Analyst. Her phone number is (703) 855-4032, email her at info@behavioraldirections.com, or visit her website at http://www.behavioraldirections.com. If you are TRICARE Prime and did not get a prior authorization for a medical specialist visit, you can still request reimbursement of 80% of the allowable by putting in a claim for the Point-Of-Service option. Yearly deductible and additional co-pays or cost-shares, but option to see any TRICARE-authorized provider without a primary care manager’s referral or a regional contractor authorization. More info at http://www.tricare.mil/Factsheets/viewfactsheet.cfm?id=183.

Nutritional Supplements: Our son is currently on 16 nutritional supplements listed above and 3 prescribed supplements listed below, based on the advice of his DAN! doctors and deficiencies from testing. On 25 June 2003, I received a letter from the TRICARE Management Activity (TMA) about my seeking reimbursement for products ordered from Kirkman Labs, where we get most of them. TMA is the government agency that oversees all the military medical HMO contractors. Their letter implies that Kirkman products are not covered as nutritional supplements unless they are fed only by tube, are ordered by an MD, can be gotten only from a pharmacy and are the child's primary source of nutrition.

Their web site is at http://www.kirkmanlabs.com, and their office phone number is (800) 245-8282. As of June 2008, Kirkman is offering a 25% military discount on its nutritional product line. To get it, call and speak to someone in customer service. Depending how much you order at a time, also ask for free shipping and handling. With ARI’s help, we are pushing for a bigger discount, but this is what we have so far. This is ONLY for military families. Ther-Biotic Complete is from Klaire Labs at http://www.klaire.com or (888) 488-2488. 5HTP is from Lucky Vitamin at https://www.luckyvitamin.com or (888) 635-0474 or at Whole Foods stores, which is where we get the Theanine. LipoCeutical

Glutathione is from The Way Up at http://www.thewayup.com or (800) 289-8487. Lipase is from the Village Green Apothecary at http://www.myvillagegreen.com or (800) 869-9159. Vitamin D3 drops are from Xymogen at https://store.xymogen.com or (800) 647-6100. Prescribed DMPS (DiMercaptoPropaneSulfonate), then EDTA (EthyleneDiamineTetraAcetic Acid) suppositories and Methyl B-12 supplement injections by Dr. Layton are ordered through Hopewell Pharmacy and Compounding Center in New Jersey at (800-792-6670) or http://www.hopewellrx.com from July 2006 through September 2010, when we stopped chelation. We give him the chelation suppositories once a week and the Methyl B-12 supplement injections twice a week after he is sound asleep.

Nystatin, Lactobacillus Acidophilus, Laxatives and Toileting: Dr. Coll at Walter Reed wrote a prescription for Nystatin and lactobacillus acidophilus to counter our son's gastrointestinal yeast overgrowth problem, which has helped some in 2002. We have also had him on a gluten-free and casein-free (GFCF) diet for over seven years so far, which has been the most significant thing that they have done for him until Miralax/ Glycolax. As such, we very highly recommend that diet or one like it, if you can provide the proper amount of intake in vitamins and minerals through other foods or supplements. However, the lactobacillus acidophilus available from the military pharmacy has a low concentration (about 30 million) of live cells, and it probably does not do much good. You may need to order a higher concentration product from Kirkman Labs (information is above). We currently use the 75 billion unit Super Pro-Bio from Kirkman Labs. You can get more info on GFCF food alternatives from any one of a number of web sites by putting GFCF or CFGF in any web search engine. Another good source of info on diets and potential immune deficiency complications is at http://www.neuroimmunedr.com. It has some very good articles in it. Their office phone number is (818) 343-1010, and their email address is office@neuroimmunedr.com. After Nystatin, we had him on Milk of Magnesia for three years, which helped but did not totally fix the problem of alternating constipation and/ or diarrhea. In 2005, we saw Dr. Carolyn Sullivan from Walter Reed who prescribed Miralax/ Glycolax to clean out his chronic constipation at that point, which required x-rays since he was so backed up. That further cleaned out his gut and everything after it, which must be done first using a regular and consistent schedule. He is now back to as normal as he will probably get, is partially potty-trained and gained 20 pounds in the process. Potty training involved using a reinforcer initially to get him to the potty, and then when only he has success on the potty. He started to go there just to get his reinforcer of long balloons and would sit there for hours if we would let him. We had to get a padded seat, because he wanted to sit there so long. He is a much happier kid now that he is not in constant gut pain. In June 2010, we also added Lipase and Ultimate Omega essential fatty acids supplements once a day at dinnertime to help him stay regular.

Diet: Our son has been on a gluten (whole grains)-free and casein (dairy)-free diet since March 2002, when we deduced that he had a problem before the food panel was done. These problems were confirmed with a comprehensive food panel done in March 2003 by Great Plains Labs, showing sensitivity to most nuts, whole grains (gluten), and dairy (casein) products. The normal reaction if he eats a dairy or whole grains food is increased hyperactivity for a short time after he digests that food. An increase in bad behaviors could occur for a short time, if there is a period of yeast die-off in the gut. It takes at least a month for the toxins to get out of the body. The only liquid that he usually drinks is vanilla-flavored rice drink, but he is now also drinking fruit juices. After five years on this diet, he now has a greatly improved food variety and may soon be slowly taken off of the GF/CF diet. Local Whole foods and Trader Joe's stores are the source for his rice drink, gluten-free pasta, cereal, waffles, and soy yogurt. They also have a list of all gluten-free foods in their stores at the service counter. Locations and more info are at http://www.wholefoodsmarket.com. Additional diet information is available at: http://www.autismndi.com for the Autism Network for Dietary Intervention http://www.bookofyum.com/blog for the Gluten-Free Book of Yum blog http://www.gfcfdiet.com for the Gluten-Free, Casein-Free Diet Intervention Diet http://pecanbread.com for info on the Specific Carbohydrate Diet Testing: Any doctor can order tests for kids with autism for outside labs, but the military lab will probably insist that they can do tests like them for free and just as well. This is not quite true; we recommend Great Plains Lab (GPL) or Doctors Data (DD) that do tests specifically for autistic kids and are

TRICARE-authorized. However, only GPL will bill TRICARE for you. I have had the same test done by a military lab and GPL, with very different results. The one from the military lab was totally useless, while we got very useful results from the GPL one. Their office phone number is (800) 288-0383 or (913) 341-8949, or their web site is http://www.greatplainslaboratory.com, or send an email to CustomerService@GPL4U.com. The Doctors Data web site is http://www.doctorsdata.com, or their office phone number is (800) 323-2784. I believe that Genova Diagnostics is also TRICARE-authorized.

Quest and Lab Corp are also TRICARE-authorized, and tests should be able to be ordered electronically through TRICARE. Metametrix Lab is NOT. Ultimately, I was reimbursed by TRICARE for all the test costs by GPL when we were stationed overseas.

However, you can get these tests done without any payment from you at all. First, you or your doctor order the appropriate test kits from the lab at no cost to you using their web site or by phone. Have your doctor sign off on the test request form, and then you send the sample to the lab using the express package service that they provide. The doctor will need to put the lab request into TRICARE through the military referral system electronically and list the specific test and non-network lab to be used, only if it is for Quest or Lab Corp. A military lab will take and process a blood sample if that is necessary, if you have a valid test request form. You should verify with TRICARE claims that they will pay for these tests BEFORE you take the samples and send it to the lab, just to be sure. Then, complete the form for a direct payment from you (which will be cheaper) or an insurance payment through TRICARE, which will have to be backed up by a credit card entry by you in case TRICARE does not pay. However, you usually get more fully reimbursed if you pay first and then get reimbursed by TRICARE. Do not worry about that, since TRICARE has paid for all testing for us in the past five years. TRICARE has paid for a comprehensive food allergy test, four microbial organic acid tests, three comprehensive stool with yeast sensitivity tests, and a hair analysis test for our son. Due to chelation, we intend to do CBC (done by military lab), metabolic profile (Quest or Lab Corp), fecal metals (DD), RBC trace minerals (DD) and fractionated urinary porphyrin (Quest or Lab Corp) tests on a regular basis.

Auditory Integration Therapy (AIT), is a twice a day for ten days method of helping kids who have difficulty handling noises. This was surprisingly approved as a regular TRICARE Prime OT request in NOV 02, but I have been told that other families have not been too successful at getting this sort of request to go through lately. The justification on the doctor's clinical order was "He is very adverse to certain sounds and needs a formal program to help with sound sensitivities and aversive behavior responses." It helps to have a provider already picked and listed on the clinical order. This Berard therapy has helped our son with noises, and he rarely now sticks his fingers in his ears. We saw Susan Glaub at McLean Speech and Language. Her office phone number is (703) 734-0211. They are providers to a number of autistic kids of military parents and are very familiar with working with TRICARE on your behalf.

Speech and Language therapy: In addition, our son received S&L PROMPT therapy three to two times a week until early 2009, when we stopped it. It took a while to get the provider TRICARE-authorized for this specific type of S&L, but he has responded to a point to this specific type of S&L. This service is covered through a regular TRICARE Prime request from our military pediatrician, but our regular DAN! MD originally suggested it. The continuation referral has read “Continued PROMPT speech and language therapy from … at three times per week from … through …” More info about PROMPT therapy is at http://promptinstitute.com/index.php?page=parent-resources, including a way to find possible PROMPT therapists. However, it has recently been brought to my attention that some Health Net case managers have been not approving S&L therapy authorizations if PROMPT is listed in the referral. They claim that PROMPT is not proven. Of course, my counter to that is no S&L therapy has ever been “proven” to work with kids with autism. Regardless, I would recommend initially putting in the referral without specifically listing PROMPT, and then add it if it helps in the appeal process. Please CALL me if you have any questions about this.

Augmentative Communication Devices (ACDs) and Speech Generation Devices (SGDs): Our son has an ACD from our public school system, and it has been very successful for him in and out of school. nd However, that goes away when he ages out of the public school system on his 22 birthday. At that point, we plan to get a replacement one from TRICARE. The TRICARE policy on ACDs and SGDs is at

Section 23.1 of Chapter 7 of the TRICARE Policy Manual at http://manuals.tricare.osd.mil. Equipment of this type and purpose are also listed in Section 2.1 of Chapter 8 about Durable Medical Equipment used to improve, restore, or maintain a medical function or prevent further deterioration. It states ACDs (also referred to as speech generating devices (SGDs) and medically necessary services and supplies that provide an individual who has a severe speech impairment with the ability to meet functional speaking needs are covered. ACDs/SGDs are characterized by: – Being a dedicated speech device, used solely by the individual who has severe speech impairment; – May have digitized speech output; – May have synthesized speech output, which requires message formulation by spelling and device access by physical contact with the device-direct selection techniques; – May have synthesized speech output, which permits multiple methods of message formulation and multiple methods of device access; or – May be software that allows a laptop computer, desktop computer or personal digital assistant (PDA) to function as a speech generating device.

ACDs and SGDs are considered voice prostheses. The prosthesis provisions also found at Chapter 8, Section 4.1 apply. So, this policy should allow for an ACD or SGD for a non-verbal or limited-verbal individual with autism to “improve, restore, or maintain a medical function or prevent further deterioration.”

Pediatric OT and PT: Our son used to receive both pediatric OT and PT at Walter Reed a couple times a month. However, we stopped getting these services there in December 2004, due to their understandably busy schedule with higher priority casualties from the Mideast. We then got an increase in OT to an hour a week and started getting PT consultations in school through the IEP process to make up for this shortfall. Hippotherapy (horseback riding) also possible as an OT request HyperBaric Oxygen Therapy (HBOT): We have not done it, since we are doing other biomedical interventions first. The TRICARE policy on this is at Section 20.1 of Chapter 7 of the TRICARE Policy Manual at http://manuals.tricare.osd.mil. That particular section has not been updated since October 7, 1982, so it is very out of date. It states that “HBO is covered when provided by an approved institutional provider, such as a hospital or specialized treatment facility and only when provided as treatment for approved indications listed by the Hyperbaric Oxygen Therapy Committee of the Undersea Medical Society (http://www.uhms.org). NOTE: The Hyperbaric Oxygen Therapy Committee is the one national body that regularly reviews all applications.” So, if it is not on the UHMS approved list, TRICARE will not cover it. That limited list includes only the conditions shown in the "Indications" pull down menu in their Resource Library of their website. There are no autism or other behavioral or neurological conditions on that list, so I doubt that TRICARE will ever cover HBOT. Sleeping Help at Night: See web site at myvitanet.com for more information on Noctium Syrup. We found this all-natural, homeopathic product while living in France, and it definitely worked for our son. It is not a drug, so no prescription is needed. NOCTIUM Sp Fl/125ml is sold online by Ferrier Laboratoire at http://www.pharmaxie.com/Ferrier-Laboratoire-num-522.html for about 5 to 6 euros a bottle, plus shipping. If they stop carrying it, do a search on Goggle or another web search engine for “Noctium Syrup” or “Noctium Sirop”, which is the product in French for this good-tasting, flavored liquid. I found this all-natural, homeopathic product while living in France, and it definitely worked for our son. He was sleeping through the night after getting a whole and then a half-teaspoon of this natural syrup about a half-hour before bedtime for about a month. This was done in conjunction with the GFCF diet and a very regular and consistent bedtime routine. Milk given at bedtime would cause him to wake up a few hours later and then laugh out loud for half an hour or more. We think that the combination of all three things is what got him into an excellent sleep pattern. Eventually, he would fall asleep at exactly 2130 (9:30pm) wherever he was, and then we stopped the syrup a short time later. Now, we tell him that it is time to go to sleep at around that time, he goes to bed, pulls the covers over his head and promptly falls soundly asleep within a few minutes with no fuss at all. Of course every child is different, but this was a resounding success with our kid.

Dental Services: The National Defense Authorization Act of 2007 legislated a change to the TRICARE dental benefit to cover anesthesia services and institutional costs for dental treatment for beneficiaries with developmental, mental or physical disabilities, and children age 5 or under. For TRICARE to reimburse claims, beneficiaries must save their bills for medical care occurring after Oct. 17, 2006. The change does not include the actual dental care services coverage through the TRICARE Dental Program and the TRICARE Retiree Dental Program. Once program officers finalize implementation requirements, TRICARE will announce when beneficiaries may submit their bills for reimbursement. This announcement is at http://www.military.com/military-report/tricare-expands-childrens-dental-coverage.

Before this entitlement, the anesthesia costs were not covered by United Concordia or TRICARE, so families would have to cover that expense themselves. For our son, dental services other than attempts at routine checkups were not possible without sedation. We have taken our son to the National Naval Medical Center (NNMC) in Bethesda, MD for all of his dental needs, including routine checkups and sedation dental services when they are needed for the past five years. Call the dental clinic to get a “second-opinion” to see if they can see your child at no cost to you. Phone number for the NNMC pediatric dental clinic is (301) 295-1364, and for the main NNMC dental clinic is (301) 295-4339/40.

Having all dental services done at NNMC means no invoices or claims to deal with for us and that has turned out to be the easiest services to access for our son.

Supplemental Security Income (SSI) and Medicaid benefits: Beginning on 1 April 2003; 2003 BAH, Combat Zone pay, hostile fire pay, imminent danger pay, hazardous duty pay and separation pay will be exempt for SSI calculations to qualify a special needs child for SSI benefits. More info is at http://www.socialsecurity.gov/pressoffice/pr/troops03-pr.htm. This will make an incredible difference for those military families who have a dependent family member with a disability. In the past, the types of income noted above are what typically what cause a military family to be denied SSI benefits. Those who are already receiving SSI are expected to receive an increase within the next 60 days. Those who do not should contact the SSI office at (800) 772-1213. Individuals who have been turned down for SSI benefits in the past or whose SSI benefits have been cut off will not be notified by the Social Security Administration of this change. I highly recommend that any military family who has been denied SSI benefits --and even families who just never applied because they thought their income was too high to qualify-- complete a new application immediately. Do not wait. Local Army Community Service (ACS) offices should be able to direct these families to the local Department of Family Services (or other appropriate health department agency-- each state has a different name for their agency that handles this). Individuals should begin the process as soon as possible, because payments are retroactive from the day you apply, not the day you are deemed qualified. If the individual's family income is below a certain threshold, the individual will receive monthly SSI payments. These payments defray the costs associated with caring and providing supplies for a person with a disability. In addition, if an individual qualifies for SSI, he or she will also receive Medicaid benefits. Medicaid is a form of public health "insurance", and it will, in almost all instances, pay any portion of medical services and supplies not covered by the individual's other insurance. In the case of military families, Medicaid will cover in almost all instances, the costs not paid by TRICARE. Additionally, Supplemental Security Income Special Rules for Children of Military Personnel Living Overseas are at http://www.ssa.gov/ssi/spotlights/spot-military-overseas.htm.

Other Financial Assistance Sources: Autism Research Institute offers a military family web page at http://www.autism.com/fam_military.asp with the following benefits.

FREE "Recovering Autistic Children” book, a 468 page paperback book, which normally costs $24.00.

To order- print, complete and fax or mail in the form at the web link of http://www.autism.com/pdf/families/militarybookrequest.pdf, along with a copy of the front of your military ID card. Please fill out all the blocks, so we can start a database on what services military children with autism may be getting from TRICARE. Fax the form to 619-563-6840 with a copy of your military ID card along with your name and postal address, or mail it to Autism Research Institute, 4182 Adams Avenue, San Diego, CA 92116. There is a strict limit of one copy per family. Recovering Autistic Children, edited

by Stephen M. Edelson, Ph.D. and Bernard Rimland, Ph.D. is the extensively updated and enlarged revision of Treating Autistic Children, which was published in 2003.

25% discount on Autism Research Institute's (ARI) Defeat Autism Now! (DAN!) conferences, including this one. To request a military discount for a DAN! conferences, please email Tanya from ARI at Tanya@DANconference.com. She will then provide simple instructions as to how to register online and receive the 25% discount. You will need to show your military ID when picking up your materials at the on-site registration booth at the conference. More info on this offer is at www.defeatautismnow.com..

Possible Funding Resources: Advantages Online Private Schools at http://www.advantagesschool.com/tuition.php offers 15% off private school tuition for military families.

Aid for Autistic Children Foundation at http://www.aacfinc.org.

Air Warrior Courage Foundation at http://www.airwarriorcourage.org.

Angel Flight at http://www.angelflightmidatlantic.org or Mercy Medical at http://www.mercymedical.org, and Patient Travel at http://www.patienttravel.org offer free air travel for special needs families.

Autism Care and Treatment (ACT) Today at http://act-today.org provides grant money for families that cannot afford or access the treatments their autistic children need.

Autism Cares at http://www.autismcares.org helps families to cover costs associated with critical living expenses.

Autism One offers a $49 conference fee for the entire week to military families at http://www.autismone.org.

Believe In Tomorrow Children's Foundation offers adventure programs, respite housing and vacations at http://www.believeintomorrow.org/housing_military.html.

Easter Seals Champions for Children at http://www.championsforchildrenga.org.

Generation Rescue family grants at http://www.generationrescue.org/rescue-family-grant.html.

Houston Enzymes at http://www.houston-enzymes.com offers a military discount of 30% off retail price of enzyme products. This offer is for enzyme products only, and not in combination with other offers or discounts.

Kirkman Labs at http://www.kirkmanlabs.com provides a 25% discount on all of their own products.

Laurel Springs School at http://www.laurelsprings.com/home offers 15% off private school tuition for military families.

Lee Silsby Compounding Pharmacy at http://www.leesilsby.com is offering a $20 savings for first time military customers (active and retired) and they accept TRICARE. More info is at http://www.autismsalutes.com/2008/11/autism-salutes-lee-silsbycompounding.html.

Kš² Schools at http://www.k12.com/who-we-help/military-families offers 15% off private school tuition for military families.

Lend4Health facilitates community-based, interest-free "micro-loans" as a creative funding option for individuals seeking optimal health at http://lend4health.blogspot.com.

Master Supplements provides a $10 discount per bottle of their Theralac High Potency Probiotic Supplement by calling in an order to (800) 926-2961, extension 3. More info is at http://theralac.com.

National Autism Association at http://www.nationalautismassociation.org/military.php has a list of helpful websites and grants through the Helping Hand Project at http://www.nationalautismassociation.org/helpinghand.php and the Family First Project at http://www.nationalautismassociation.org/familyfirst.php for marriage counseling grants.

National Parks and Federal Recreational Lands Pass - FREE Access Pass at http://www.nps.gov/fees_passes.htm.

Project Devin (a partner of Abilities Network Project ACT) at http://www.elevationweb-development.org/abnetwork/index.php?option=com_content&view=article&id=18 &Itemid=21.

Talk About Curing Autism (TACA) has a Family Scholarship program. Scholarships are available for DAN! Conferences, a DAN! doctor initial visit and the holiday Adopt a Family program. See www.tacanow.org for details and applications.

United Healthcare Children's Foundation at http://www.uhccf.org/apply_applicant.html.

Educational Resources: Visit these web sites for special education information: US DoE website for IDEA 2004 Implementation called "Building the Legacy: IDEA 2004" is at http://idea.ed.gov.

Virginia Department of Education (VDOE) Special Education and Student Services website especially for parents at http://www.doe.virginia.gov/special_ed/index.shtml.

“Regulations Governing Special Education Programs for Children with Disabilities in Virginia” (January 25, 2010) at http://www.doe.virginia.gov/special_ed/regulations/state/regs_speced_disability_va.pdf.

“Extended School Year Services Technical Assistance Resource Document” (December 2007) at http://www.doe.virginia.gov/special_ed/regulations/federal/extended_schoolyear_services.pdf.

“A Parent's Guide to Special Education” (2010) at http://www.doe.virginia.gov/special_ed/parents/parents_guide.pdf.

I.E.P. Pop-Up Tool Chart from the National Center for Learning Disabilities and National Center on Low-Incidence Disabilities at http://www.handsandvoices.org/articles/education/popup/pop_index.html.

The Department of Defense Special Needs Parent Tool Kit at http://www.militaryhomefront.dod.mil/pls/psgprod/f?p=MHF:DETAIL1:0::::SID,COHE:20.40.500.565.0.0.0.

0.0,218947 has many pages of comprehensive information and tools geared towards helping military families with special needs children navigate the maze of medical and special education services, community support and benefits and entitlements. Each module contains valuable resources and important facts; record keeping tools and sample letters have also been incorporated. The Tool Kit is divided into six colorful modules that can be easily downloaded and printed or saved on to a CD.

Other helpful web sites for assistance within Virginia, Maryland and DC include: The first place to go for Virginia is to the Virginia Department of Medical Assistance Services web site at http://www.dmas.virginia.gov. They have a very good Road Map to Services, a resource guide for people with disabilities, long term illnesses and the elderly. The guide can be found at http://www.dmas.virginia.gov/downloads/pdfs/Road_Map_to_Va_services.pdf or you can order a free copy by phoning (804) 780-0076 and request a copy of the Road Map to Services. http://www.AbilityUnleashed.com for info on the Virginia's Developmental Delay (DD) Waiver Program, which can provide additional services while you’re stationed in Virginia. The services are provided through Medicaid, but approval is NOT income based. Apply as soon as possible; the waiting list is extremely long. Their email address is at JJacobs@AbilityUnleashed.com. The application and associated information can be found under “DD Waiver” on Northern Virginia’s Autism Society of America

main web page listed below. Phone (703) 497-1580 or email them at info@abilityunleashed.com for more info. http://www.thearcofnova.org for The Arc of Northern Virginia, which offers a great “Family Resource Guide� at no cost, if you call them at (703) 532-3214 or under the Info/Referral menu on their web site. http://www.asnv.org for the Autism Society of Northern Virginia. Call Kymberly DeLoatche at (703) 495-8444, (703) 532-3214, x117, or email her at executivedirector@asnv.org for more info. Their resource directory is at http://support.autism-society.org/site/Clubs?club_id=1200&pg=docs. http://www.autismva.org for the Commonwealth Autism Service, formerly known as The Autism Program of Virginia (TAP-VA), which is a statewide program providing services to families, consumers, agencies/ organizations, and professionals through the following: information and referral; technical assistance in the form of consultation, as well as training, workshops and in-services (training for school personnel); networking; follow-along; collaboration and leadership. Phone (800) 649-8481 or email them at information@autismva.org. http://www.csaac.org for the Community Services for Autistic Adults and Children, with services including an Intensive Early Intervention program, Individual and Family Support Services, several residential and day school sites, adult/child residential houses, vocational, and recreational programs in Maryland. Phone (800) 735-2258 or email them at csaac@csaac.org for more info. http://dcautismparents.org for DC Autism Parents (DCAP), a parents group in DC. Phone (202) 271-9262 or email them at info@dcautismparents.org for more info. http://www.cildrc.org for the disAbility Resource Center in Fredericksburg, VA. This is a great resource center for this part of the state. Phone (540) 373-2559 or (800) 648-6324 for more info. http://www.dsanv.org for the Down Syndrome Association of Northern Virginia which have many of the same issues as families with children with autism. Phone (703) 569-5547 for more info. http://www.ecnv.org for the ENDependence Center of Northern Virginia which is a community-based resource and advocacy center managed by and for people with disabilities. ECNV promotes the independent living philosophy and equal access for all people with disabilities. Phone (703) 525-ECNV (3268) or email them at info@ecnv.org for more info. http://www.fairfaxcounty.gov/csb for the Fairfax-Falls Church Community Services Board. Also, http://www.fairfaxcounty.gov/csb/itc for their Infant & Toddler Connection which provides evaluations and early intervention services to eligible infants and toddlers who have a developmental delay and who are younger than three years old. Families concerned about their child's development are encouraged to phone (703) 246-7121 or send an email to FFCCSB-ITCIntake@fairfaxcounty.gov for more info. http://www.fairfaxcounty.gov/dfs/dspd for the Fairfax Area Disability Services Board. Phone (703) 324-5421 or email them at disabilityservices@fairfaxcounty.gov for more info. http://www.fairfaxcounty.gov/dfs for the Fairfax Area Department of Family Services. Phone (703) 324-7500 for more info. http://www.fcps.edu/index.shtml for the Fairfax County Public Schools. I have been very successful in getting appropriate services through the public school system for our son. If you live in Fairfax County, the Department of Special Services in FCPS has developed a wonderful web site at their Parent Resource Center, which is full of a variety of excellent information at http://www.fcps.edu/cco/prc/index.htm. Information on their ABA/ VB autism programs for pre-K through the elementary grades can be found at http://www.fcps.edu/dss/sei/ABA/index.htm. The Special Education Leadership Team meets quarterly with a parent team from POAC-NoVA to continue improvements in the quality and quantity of public education for students with autism in Fairfax County.

http://www.howard-autism.org for the Howard County Autism Society, who are very active in the area for autism issues. Phone (410) 290-3466 or email them at info@howard-autism.org for more info. http://www.mcie.org/index.asp for the Maryland Coalition for Inclusive Education has some very good publications on inclusion at http://www.mcie.org/pubs.asp for more info. http://www.marylandpublicschools.org/msde for the Maryland State Department of Education. http://www.yellowpagesforkids.com/help/md.htm for the Maryland Yellow Pages for Kids. An excellent resource! http://www.researchautism.org for the Organization for Autism Research is an independent source of grants for autism research in the area and organizer of an excellent conference each October on the results of that research. Phone (703) 243-9710 or email them at OAR@researchautism.org for more info. http://www.peatc.org for the Parent Educational Advocacy Training Center who believes children with disabilities reach their full potential when families and professionals enjoy an equal, respectful partnership. Phone (703) 923-0010 or (800) 869-6782 or email them at partners@peatc.org for more info. http://pathfindersforautism.org for Pathfinders for Autism which is a parent sponsored non-profit organization incorporated to generate funding for research, services and education directed toward improving the lives of individuals with autism and their families, operating from Towson, MD. Phone (866) 806-8400 or (443) 330-5341 or email them at info@pathfindersforautism.org for more info. http://www.poac-nova.org offers ABA and other training workshops throughout the year. We have monthly parent support group and information meetings with speakers on the third Saturday of each month from 1 to 4pm. The web site has a number of useful resources, including one on ABA, one with links to over 100 other education web sites, one for new parents to autism at http://www.poac-nova.org/base.cgim?template=new_parent_resource_suggestions and one on autism safety issues for parents at http://www.poac-nova.org/base.cgim?template=autism_awareness. Phone (703) 391-2251 or email them at Concerns@POAC-NoVA.org for more info. http://www.snap4kids.org for Special Needs Assistance Program for Children is a new non-profit organization that has been stood down due to health problems by its founder, but check it out once in awhile to see if they come back on line since they had a great program. Phone (757) 440-5254 or email them at pam@snap4kids.org for more info.

Training Fund for Consumers and Families Members (TFCFM) provides funds for individuals with developmental disabilities and/or their families to attend local, state or national conferences, meetings, and workshops. The event MUST be disability related. The TFCFM may only provide some of the funding necessary for you to attend a conference, so you may need to identify other funding to assist you in attending the event. Applications MUST BE submitted before the event (at least 30 Days prior to attending in order to receive funds prior to the conference). The Virginia Board for People with Disabilities funds the TFCFM. Their point of contact is Janet Bixby in Winchester, VA. Phone her at (540) 662-4452 for more info. http://www.specialneedskidsinfo.com for Special Needs Kids Info for the greater DC area. It has a lot of great info! http://www.vcuautismcenter.org for the VCU Autism Center for Excellence, which is to improve outcomes of individuals with ASD by improving the knowledge, skills and understanding of families, educators, and professionals who support someone with a spectrum disorder. Phone (855) 711-6987 or email them at autismcenter@vcu.edu for more info.

http://www.varc.org for the VCU Autism Resource Center, who can help children and adults with autism spectrum disorders find solutions to problems in your home, community or school. Free services include information and referral, including a lending library, individual case consultation, and training and technical assistance. Phone them at (877) 667-7771 or (804) 674-8888 ext. 5161, or email them at info@varc.org for more info. They are also affiliated with the Grafton School, which can provide unique services to children with autism and their families living in Virginia, and their web site is at http://www.grafton.org. http://www.vcu.edu/partnership for the VCU Partnership for People with Disabilities, formerly known as the Virginia Institute for Developmental Disabilities (VIDD), is the Virginia Commonwealth University’s center for excellence in developmental disabilities. Phone (804) 828-3876 or email them at bjpiguet@vcu.edu for more info. http://worksupport.com for the VCU Rehabilitation and Training Center. Phone (804) 828-1851 for more info. http://www.vcuhealth.org/vtcc for the VCU Treatment Center for Children. Phone (804) 828-3129 for more info. http://vairs.org for the Virginia Alliance Information and Referral System, which is a statewide association of organizations, agencies and individuals committed to ensuring that all Virginians have access to quality health and human service information. Phone (800) 230-6977 to reach a center that serves your area. http://virginiaautismproject.net for the Virginia Autism Project, which is a grass roots, state-wide coalition of families with children affected by an autism spectrum disorder. Their current priority of our mission statement is to create positive change for people on the autism spectrum through Autism Insurance Reform. http://www.vaboard.org for the Virginia Board for People with Disabilities which serves as Virginia’s Developmental Disabilities (DD) Planning Council. DD Councils are in every state and territory of the United States. They work for the benefit of individuals with DD and their families to identify needs and help develop policies, programs and services that will meet these needs in a manner that respects dignity and independence. Phone (800) 846-4464 or (804) 786-0016, or email them at info@vbpd.virginia.gov for more info. http://www.dbhds.virginia.gov for the Virginia Department of Behavioral Health and Developmental Services (DBHDS). They oversee the Community Services Boards of each county and provide oversight for the Intellectual Disability Medicaid waivers in Virginia. Phone (804) 786-3921 for more info. http://www.doe.virginia.gov/special_ed/index.shtml for the Virginia Department of Education Special Education and Student Services Division. Their resources are listed above under “Educational Resources”. Phone (804) 225-3252 for more info. http://ttaconline.org for the Virginia Department of Education's Training/Technical Assistance Centers (T/TAC) for persons serving children and youth with disabilities. which has regional centers that can offer assistance throughout Virginia. Use their website to reach a center that serves your area. http://www.dmas.virginia.gov for the Virginia Department of Medical Assistance Services (DMAS). They provide oversight for the Individual and Family Developmental Disabilities and the Technology Assisted Medicaid waivers in Virginia. Phone (804) 786-4718 for more info. http://www.dmv.state.va.us/webdoc/citizen/disability/plates_assist.asp to download the form to fill out for a blue handicapped placard for your car. Autism is specifically listed as a permanent disability for a Virginia handicapped placard. The form must be signed by an MD, but you can mail it in with a $5 check to get a placard good for five years. Phone (804) 367-6602 for more info.

http://www.dss.virginia.gov/family/children.html for the Virginia Department of Social Services (DSS).

Phone 800-468-8894 or 804-726-7000, or email them at citizen.services@dss.virginia.gov for more info. http://dls.state.va.us/disability.htm for the Virginia Disability Commission, which has links to many Virginian disability and education websites. http://www.vopa.state.va.us for the Virginia Office for Protection and Advocacy, which helps with disability-related problems like abuse, neglect, and discrimination. We also help people with disabilities obtain services and treatment. All callers receive help with these problems. Individuals with problems, targeted in our program goals, may also receive advocacy services and/or legal representation. Phone (800) 552-3962 or (804) 225-2042. or email them at general.vopa@vopa.virginia.gov for more info. http://www.yellowpagesforkids.com/help/dc.htm has lots of info for autistic kids living in the District Of Columbia. http://www.yellowpagesforkids.com/help/md.htm has lots of info for autistic kids living in Maryland. http://www.yellowpagesforkids.com/help/va.htm has lots of info for autistic kids living in Virginia.

Sports Activities: For BASKETBALL: Arlington Special Olympics Basketball in Arlington, VA with a school-age junior and senior team.

Practices are on Monday and Thursday evenings at Oakridge Elementary School, 1414 24th St S, Arlington, VA. Phone Bernie Woolfley at (202) 973-4543 or (703) 528-0066 or email him at bwoolfley@navigantconsulting.com for more info. http://www.nrhrehab.org/Patient+Care/Sports+Programs/default.aspx for the Blaze Sports Club of Washington, DC, which has Basketball, Tennis and Quad Rugby for individuals with disabilities. Phone Brenda Gilmore at (240) 460-5741, (202) 877-1434, or (202) 877-1819, or email her at brendagilmore@comcast.net; or Joan Joyce at (202) 877-1420, or email her at joan.p.joyce@medstar.net for more info on their teams.

For BASEBALL: http://www.pbsl.org for the Pioneer Baseball/ Softball League in Alexandria, VA. Phone Scott Keith at 703 933-2389 or email him at scott_w_keith@yahoo.com for more info on their league. http://arlingtonlittleleague.org/descript.htm or http://www.eteamz.com/all for the Arlington Little League Challenger Baseball in Arlington, VA for ages 5 to 22. They meet on Sunday afternoons from 2 to 3:30pm at the Barcroft Park in Arlington. Phone Lucia Claster at (703) 276-0748 or email her at AClaster@aol.com or email info@arlingtonlittleleague.org for more info on their league. http://www.chantillyyouth.org/baseball/News%20Minors-A/38635.html for the Chantilly Youth Association Challenger Baseball in Chantilly, VA for ages 5 to 18. Phone Sean Fitzsimmons at (571) 334-7066, or email s.fitzp@verizon.net for more info on their league. http://www.fairfaxll.com the Fairfax Challenger Baseball in Fairfax, VA for ages 4 to 16. Phone Michael Kimlick at (703) 323-1043 or (202) 329-9940, or email him at michael.kimlick@dhs.gov for more info on their league.

http://herndonbaseball.com for Buddy Ball in Herndon, VA for ages 6 to 15. Registration and uniforms are free for their six games each Spring. Phone Jay McMann at (703) 404-0166 or (703) 481-7828, or email janajama@att.net for more info on their league. http://eteamz.active.com/restonlittleleague/index.cfm?subsite=2405663 for the Reston Little League Challenger Baseball in Reston, VA. Phone Jodi King at (703) 713-0036 or phone Linda Washington-Robinson at (703) 318-7414 or email her at Noahsark3@msn.com for more info on their league. http://www.springfieldchallenger.org for the Springfield Challenger Baseball in Springfield, VA for ages 4 to 21 in the Spring and Fall of each year. It only costs $50 per family in the Spring and again in the Fall, which includes the uniform and end-of-the-season picnics. They also offer two free nights in a hotel in the Norfolk area for the annual challenger baseball "tournament" each May. Phone (703) 551-0652 or (703) 304-2330, or email Eddie Garretson at EGarret166@aol.com or eddie@eddiesclub.org; Patti Alf at pattialf@gmail.com for more info on their league. http://www.vll.org for the Vienna Little League Challenger Baseball in Vienna, VA meets at Black Field in Nottoway Park. Phone Bill Levitt at (703) 916-7350 or Katy Levitt at (703) 283-9979 or email her at katylevitt@hotmail.com; or phone Jim Tomasetti at (703) 304-7866 or (703) 408-5488 for more info on their league.

For BIKING: http://www.bikesatvienna.com for bicycles for special needs individuals at Bikes at Vienna, 128A Church St, NW, Vienna, VA. Phone John Brunow at (703) 938-8900 or email him at john@bikesatvienna.com for more info or to reserve your special bike. http://losethetrainingwheels.org for Lose the Training Wheels bike riding training program. Phone John Lord at (703) 734-1118 or email him at john.lord@losethetrainingwheels.org for more info on this program.

For DANCE: www.arlingtondance.org for Arlington County Therapeutic Recreation and Arlington Dance Theatre in Alexandria, VA for children and teens with developmental disabilities. Email Cindy Leiva from Arlington County Therapeutic Recreation at cleiva@arlingtonva.us or call Arlington Dance Theatre at (703) 524-4750 or email ADT@ArlingtonDance.org for more info. http://www.dance2thepointe.com for Dance 2 The Pointe in Alexandria. Phone Cindy Jackson at (703) 750-1160 or email her at contact@dance2thepointe.com for more info. http://www.etm-movements.com/ETM-MOVEMENTS/default.htm for Expressive Therapeutic Movement in Springfield, VA for ages 3 to young adults. They use movement therapy to promote the integration of the "whole" child by providing the tools to understand the language of movement and discover true movement potentials. Phone Lynne Bauer at (703) 218-0751 or email her at etm.movement@gmail.com for more info. http://www.silviacorey.com for the Regan Dance Center. Phone Silvia Beltran or Eileen Greenberg at (703) 354-6000 or email them at silvia@regandancecenter.com for more info.

For FISHING: http://www.castforkids.org for C.A.S.T. for Kids Fishing. Phone Sarah Phillips at (703) 730-8205 or (703) 670-7480, or email her at Sarah.Phillips@dcr.virginia.gov or castforkidsva@aol.com for more info on their

annual fishing event in early September.

For GYMNASTICS: http://www.arlingtonva.us/departments/ParksRecreation/scripts/classes/Classes.aspx for adapted gymnastics classes in Arlington County. Phone Michael Swisher at (703) 228-1809 or email him at mswish@arlingtonva.us, or Jennifer Groner at (703) 228-1809 or email her at jgroner@arlingtonva.us; or Shaeron King at (703) 228-4731 or email at sking@arlingtonva.us; or Carly Meyer at (703) 228-0707 or email at cmeyer@arlingtonva.us for more info. http://www.fairfaxcounty.gov/parks/parktakes.htm or http://www.fairfaxcounty.gov/parks/ada/ada-gym.htm for adapted gymnastics classes for ages 2 to 14 in Fairfax County. It is done at Cardinal Gymnastics in Fairfax, VA. Their phone number is (703) 323-0088. Phone Gary Logue at (703) 324-8727 or email him at gary.logue@fairfaxcounty.gov for more info. http://www.gmskids.com for GMS Institute and their adapted gymnastics programs in Manassas, VA. Phone Dr. Parviz Youssefi or Sara Conlin at (703) 392-5055 or email them at aroushas@aol.com for more info. http://ashburn.jwtumbles.com for JW Tumbles Gym in Ashburn, VA. Phone Michael Lee at (703) 729-3880 or 786-3687, or email him at ashburn@jwtumbles.com for more info. http://nvgagym.com for Northern Virginia Gymnastics Academy in Sterling. Phone Mike Comini at (703) 430-5434 or email him at cnvga@aol.com, or Debbie Giovanis at debbiegiovanis@comcast.net for more info.

For HOCKEY and ICE SKATING: http://www.novacoolcats.org for Cool Cat's Hockey. Special Goals is a new program sponsored by the Potomac Valley Amateur Hockey Association and the Washington Capitals in conjunction with Special Hockey Washington. The Cool Cats "adaptive" ice hockey team is based in Ashburn, VA; but they have received donated ice time at Ashburn, Reston and in Laurel. The program uses "buddies" to allow individuals with disabilities to participate in weekly games or practices, special events, tournaments.

Contact Randy Brawley, Head Coach at madref@verizon.net or Bob Banach, Hockey Director at bbanach@specialhockey.org or at (703) 395-6278 or (703) 536-4131 or Bertra McGann at bbmcgann@aol.com for more info.

Helen Rose also does figure skating and speed skating classes at Skatequest in Reston. Phone her at (202) 431-4797 or email her at henierose@yahoo.com for more info.

For HORSEBACK RIDING: http://www.travinc.org for the Therapeutic Riding Association of Virginia. Phone Mary Jo Beckman at (703) 538-6329 or email her at mjbeckman@gmailcom for more info. http://www.goldendreamsriding.com for the Golden Dreams Riding in Middleburg, VA. Phone Sue Bell at (540) 687-5800 or email her at info@goldendreamsriding.com for more info. http://www.liftmeup.org for Lift Me Up therapeutic riding program in Great Falls, VA began in 1975. Phone (703) 759-3833 or (703) 759-6221 or email info@liftmeup.org for more info. http://www.ltrf.org for Loudoun Therapeutic Riding Foundation in Leesburg, VA. Phone Joanne Hart at (703) 771-2689 or email her at jhart@ltrf.org for more info.

http://www.nvtrp.org for the Northern Virginia Therapeutic Riding Program in Clifton, VA began in 1980.

Phone Brianna Vornhorst at (703) 764-0269 or email info@nvtrp.org for more info. http://www.phxrisingcenter.org for the Phoenix Rising Therapeutic Equestrian Program in Remington, VA. Phone (540) 219-5002 or email phxrisingcntr@yahoo.com for more info. http://www.rainbowriding.org for the Rainbow Center Therapeutic Equestrian Program in Manassas, VA began in 1985. Phone (703) 754-6159 or email rainbow@rainbowriding.org for more info.

One more is Seven Stars Therapeutic Center in Port Republic, VA. Phone Gloria Combs at (540) 234-0661 or email her at lgcombs@shentel.net for more info. http://www.simplechanges.org for Simple Changes in Lorton, VA began in 2004, and we used their program with our son for a couple of months. Phone Corliss Wallingford or Jenny Spain at (703) 402-3613 or email her at info@simplechanges.org for more info. http://www.spiritequestrian.org for Spirit Open Equestrian Program. Phone Davorka Suvak at (703) 600-9667 or email her at dada357@gmail.com for more info.

For MARTIAL ARTS: http://www.jhoonrheetkd.com for the Jhoon Rhee Institute. Phone Chun Rhee at (703) 237-7433 or email them at RheeFC@gmail.com or JRIFC@aol.com for more info. http://www.leadbyexampletaekwondo.com for Lead By Example Tae Kwon Do. Phone Robin Moyher at (703) 391-1754 or (703) 273-1100 or email her at remoyher@cox.net or email Tommy Lightfoot at lbetkdfo@aol.com for more info.

For SKIING: Liberty Mountain Resort Adaptive Skiing at http://www.brasski.org and http://www.skiliberty.com/adaptive.htm is about one and a half hours away near Gettysburg, PA. Phone Leslie or Dick White at (717) 642-8282, extension 3479 or email them at info@brasski.org for more info.

Massanutten Therapeutic Adventures at http://www.therapeuticadventures.com and http://www.taonline.org is about two hours away near Harrisonburg, VA. Phone Mark Andrews at (434) 295-3973 or email him at elitesochoc4@msn.com, or visit adaptive.guide@gmail.com for more info.

Snowshoe Mountain Adaptive Skiing at http://www.snowshoemtn.com/rentals-and-lessons/adaptive/index.htm is in West Virginia. Phone David Begg at (304) 572-6708 or email him at dbegg@snowshoemtn.com, or phone George and Teena Mangano at (703) 242-9487 or email them at tmangano@vacoxmail.com for more info.

Two Top Mountain Adaptive Sports at http://www.twotopadaptive.org is almost two hours away at Whitetail Ski Resort near Mercersburg, PA. Phone Bill Dietrich at (717) 507-7668 or (717) 328-9400, ext.

3582, or email him at bill@twotopadaptive.org for more info.

Wintergreen Adaptive Sports at http://skiwas.org is about two and a half hours away in Wintergreen, VA. Phone (434) 325-2007 or email info@skiwas.org for more info.

For SOCCER: http://alexandria-soccer.com for the Alexandria TOP Soccer Association in Alexandria, VA at TC Williams

High School on Sundays. Phone Bill Dwyer at (703) 549-6535 or email him at julesbill@comcast.net for more info. http://arlingtonsoccer.com/otherasaprograms/topsoccer-2 for the Arlington TOP Soccer Association in Arlington, VA at Woodlawn Park for ages 4 to 19. Phone Joe Lerner at (703) 522-5866 or (703) 395-7379 or email him at topsoccer@arlingtonsoccer.com for more info.

Arlington Special Olympics Soccer in Arlington, VA. Phone Bernie Woolfley at (202) 973-4543 or (703) 528-0066 or email him at bwoolfley@navigantconsulting.com for more info. http://www.burkeathleticclub.org for Burke TOP Soccer with the Burke Athletic Club at White Oaks Elementary on Saturdays for ages 5 to 19. Phone Kathy Skocik at (703) 978-7961 or email her at bactopsoccer@aol.com for more info. http://www.chantillyyouth.org/soccer/topsoccer/index_E.html for Chantilly TOP Soccer with the Chantilly Youth Association. Phone Susan Mulligan at (703) 222-1048 or email her at stmulligan@verizon.net, or Genevieve McManus at (703) 378-8787 or email her at genevieve_mcmanus@yahoo.com for more info. http://www.lysa.net for Loudoun TOP Soccer with the Loudoun Youth Soccer Association. Phone Jayne Hope at (703) 771-3203 or email her at hopefamily4@verizon.net or rich351854@yahoo.com for more info. http://www.novasc.org for Manassas TOP Soccer with the Northern Virginia Soccer Club. Phone Bill Van Wickler at (703) 794-7672 or email info@novasc.org for more info. http://www.mcleansoccer.org for McLean Youth TOP Soccer. Phone Eric Olson at (571) 633-0730 or email him at ericandsusanolson@yahoo.com for more info. http://www.restonsoccer.com/home/default.asp?menu_category=Home&menuid=219 for Reston TOP Soccer Association in Reston, VA for ages 4 to 19. Phone Colleen Hale at (703) 391-1938 or email spcialtchr@aol.com or more info. http://www.vys.com for Vienna TOP Soccer with Vienna Youth Soccer. Phone Dana Miller at vystopsoccer@aol.com, or Richard Montano at (703) 534-0022 or (703) 624-7234, or email him at richard_montano@msn.com or more info.

For SPECIAL OLYMPICS: http://www.arlingtonva.us/departments/ParksRecreation/scripts/classes/Classes.aspx for Arlington County Special Olympics Track and Field. Phone Shaeron King or Therese Smith at (703) 228-4740 or email Shaeron at sking@arlingtonva.us or Trinfo@arlingtonva.us for more info. http://www.nrhrehab.org/Advocacy+and+Outreach/Sports+and+Recreation/default.aspx for Blaze Sports Club of Washington, DC for Basketball, Tennis and Quad Rugby. Email Brenda Gilmore at brendagilmore@comcast.net, or Joan Joyce at joan.p.joyce@medstar.net, or phone them at (240) 460-5741, (202) 877-1434, (202) 877-1819, or (202) 877-1420 for more info. http://www.loudounspecialolympics.org for Loudoun County Special Olympics. Phone Caitlin Marcotte at (703) 777-0438 or email her at caitlin.marcotte@loudoun.gov for more info. http://www.novasova.org for Northern Virginia Special Olympics. Phone (703) 359-4301, 273-6530, or (703) 425-8510, or email chairman@novasova.org or ac@novasova.org for more info. Also, phone T. Patrick Hammeke at (703) 300-5211 or email him at phammeke@finsvcs.com. http://www.pwsova.org/pwso for Prince William Special Olympics. Phone Peggy Van Lowe at (703) 680-6661, or (540) 729-2915, or email her at areacoordinator@pwsova.org for more info.

For SWIMMING or ADAPTED AQUATICS: http://www.arlingtonva.us/departments/ParksRecreation/scripts/classes/Classes.aspx for adaptive swimming classes in Arlington County. For more info, phone Jennifer Groner at (703) 228-1809 or email her at jgroner@arlingtonva.us; or Shaeron King at (703) 228-4731 or email her at sking@arlingtonva.us for more info. http://www.fairfaxcounty.gov/parks/parktakes.htm or http://www.fairfaxcounty.gov/parks/ada/ada-aquatics.htm for adaptive swimming classes in Fairfax County. These are safety and swimming classes in which parents are encouraged to be in the pool with their children. To register, go to and click "Find a Class" then "Adapted Leisure Services." For more info on other aquatics services for individuals with disabilities, phone LeeAnn David at (703) 324-8565 or email her at eeann.david@fairfaxcounty.gov. Another swimming opportunity is the FCPA Paralympic Swim Development Squad, which is a competitive swim team for persons over age 8. Phone Ben Viellieu at (202) 781-3786 or email him at ben.viellieu@navy.mil for more info. http://www.herndon-va.gov/Content/Parks_rec/Programs_and_classes/Aquatics/default.aspx?cnlid=351 for adapted aquatics programs at the Herndon Community Center. Phone (703) 787-7300, extension 2122 for adapted aquatics programs at the Herndon Community Center for more info. http://www.jpmf.org for the Joey Pizzano Memorial Fund “Make a Splash" Program for ages 6 through 22.

Phone (703) 549-4444 or email them at info@jpmf.org for more info. http://www.loudoun.gov/Default.aspx?tabid=804 for adaptive swimming classes in Loudoun County.

Phone Shayle Wigger at (703) 771-5010 or email at shayle.wigger@loudoun.gov for more info. http://www.restoncommunitycenter.com/vsiwebtrac.html for adapted aquatics programs at the Reston Community Center. Phone Joe Leary at (703) 390-6151 or email him at joe.leary@fairfaxcounty.gov for more info. http://www.leadchangestherapy.com for Lead Changes Therapy. Phone Natalie Baker or Jared Conca at (703) 943-0566 or email them at info@leadchangestherapy.com for more info. http://www.swimkids.us for Swim Kids schools in Woodbridge, Lake Ridge, Manassas and Fredericksburg. Phone Angela Baker at (703) 396-SWIM (7946), or (540) 446-KIDS (5437), or email her at learn2swim@swimkids.us for more info.

Also in Arlington County, Jon Wiger, a teacher at the Center for Autism Research and Development (CARD) is also an adaptive swim instructor through Arlington County Parks and Recreation. He offers private and semi-private swim lessons for children of all ages. He has over 10 years of experience. For more information, contact Jon Wiger at (612) 875-3794 or email him at djwiger@yahoo.com.

FOR YOGA: http://www.journeyoga.com for Journey Yoga. Phone Susan at (703) 357-3546 or (703) 822-1638, or email info@JOURNEYoga.net or susan@journeyyoga.com to get more info. http://www.samayoga.net for Sama Yoga. Email Sabrina Huffman at samayoga@mac.com to get more info.

FOR SERVICE and THERAPY DOGS: http://blueridgeassistancedogs.com for Blue Ridge Assistance Dogs. Phone (703) 369-5878 or (703) 591-1185, or email info@blueridgeassistancedogs.org for more info.

http://capitalcci.org/info.htm for Canine Companions for Independence. Phone (703) 248-6655 or email cci_capital_chapter@yahoo.com for more info.

http://www.fidosforfreedom.org for Fidos for Freedom. Phone (410) 880-4178 or (301) 490-4005 or email office@fidosforfreedom.org for more info. http://www.paws4people.org/p4p_home for Paws 4 People. Email info@paws4people.org for more info.

Summit Therapy Animal Services. Phone Michelle Robinson at (703) 793-0181 or email info@summittas.com for more info.

Respite Care and Other Recreation Sources: The Fairfax-Falls Church Community Services Board (CSB) at http://www.fairfaxcounty.gov/csb is a potential source of grant monies, but they currently have very limited funding for their services, and you will likely have to put you on a waiting list. However, you can apply for reimbursed respite care (babysitting) monies with the Hartwood Foundation, once you have completed the intake processing through the CSB. Their office phone number is (703) 383-8500. This foundation can provide about $1000 a year of respite care reimbursements per family, once you register and fill out all necessary, additional forms through this office and go through a separate intake interview in your home. The CSB also accepts grant applications once a year for up to $1000 in reimbursement for direct services, once you are on the MR waiting list. Phone (703) 246-7121 or send an email to FFCCSB-ITCIntake@fairfaxcounty.gov for more info.

Access Ministry at McLean Bible Church also provides respite care through two programs at http://www.mbctysons.org/pages/page.asp?page_id=84564. Breakaway is a respite care program for children with special needs living at home, from infants to young adults (ages 2 to 25). Breakaway is held two Saturdays a month from 10am to 3pm, which allows parents a much needed break. The cost for Breakaway is $20 for the first child and $10 for each additional child of special needs. More info is at http://mbctysons.org/pages/page.asp?page_id=84068. Break Out is a fun respite care program.

Designed for families with children of special needs and their siblings for ages 2 to 16, Break Out allows parents a much needed "break" for personal time. Break Out is held twice a month on designated Friday evenings from 6:30 to 10pm. The cost for the evening is $15 for the first child and $5 for each sibling. More info is at http://mbctysons.org/pages/page.asp?page_id=84067. They started a new day support program called Adults with Disabilities Day Program from 10am to 3pm. More info is at http://mbctysons.org/pages/page.asp?page_id=156780. They also have an Access Parent Support Group that meets monthly and has child care available. Phone Jackie Mills-Fernald at (703) 770-2942 or email her at jackie.millsfernald@mcleanbible.org for more info on their Friendship Club for teens over age 16 and young adults. Phone Aundrea Foster at (703) 770-2942 or email her at aundrea.foster@mcleanbible.org for more info on programs for children. http://www.art-stream.org for ArtStream, an inclusive theatre company. Phone Patricia Woolsey at (703) 975-1008 or (301) 565-4567, or email her at info@art-stream.org for more info. http://www.nrhrehab.org/Patient+Care/Sports+Programs/default.aspx for the Blaze Sports Club of Washington, DC, which has Basketball, Tennis and Quad Rugby for individuals with disabilities. Phone Brenda Gilmore at (240) 460-5741, (202) 877-1434, or (202) 877-1819, or email her at brendagilmore@comcast.net; or Joan Joyce at (202) 877-1420, or email her at joan.p.joyce@medstar.net for more info on their teams. http://www.caringcommunities.org is a non-profit respite care provider in Maryland. Contact Mona Freedman at (410) 549-5707 or (866) CARING-4, or email them at info@caringcommunities.org for more info. http://www.eddiesclub.org for a recreational program for kids and young adults with special needs in Fairfax County. They also sponsor the Springfield Challenger Baseball program in the Spring and Fall of

each year. We very heartily recommend this club. Phone (703) 551-0652 or (703) 304-2330, or email Eddie Garretson at EGarret166@aol.com; or Logan Garretson at (571) 331-1167 or email her at GARRETLL@pwcs.edu for more info. http://www.jccnv.org/specialneeds/special-needs for the Jewish Community Center of Northern Virginia special needs programs for all faiths. Phone Jessica Tischler at (703) 537-3031 or email her at JessicaT@jccnv.org for more info. Specifically, they have Asperger’s support groups for teens, young adults, and older (over 30) adults. http://www.jssa.org for the Jewish Social Service Agency special needs programs for all faiths. Phone Mollie Katz at (301 610-8311 or email her at mkatz@jssa.org, or phone the Fairfax County numbers of (703) 204-9100 or (703) 896-7918 for more info. http://jillshouse.org for overnight respite services at Jill’s House for all faiths, which next to the McLean Bible Church in McLean. You do not have to be a member of the church to participate. It is a fabulous facility and services that we use monthly. Phone (703) 639-5660 or email them at info@jillshouse.org for more info. http://www.katemcclain.org for social skills groups and camps for kids, teens, and young adults in Arlington, VA. Phone (202) 550-7785 or email Kate McClain at kate.mcclain@gmail.com for more info. http://www.keengreaterdc.org for Kids Enjoy Exercise Now (KEEN), which is headquartered in the Washington, DC area. KEEN’s recreational activities, which include basic ball skills, soccer, basketball, swimming, and general fitness -- are provided free one-to-one recreational opportunities for children and young adults with mental and physical disabilities. At each KEEN session, a participating athlete is paired with a volunteer coach for a variety of age-appropriate recreational activities. Phone (301) 770-3200 or email them at Info@keengreaterdc.org for more info. http://www.lifechangingfitness.org for Life Changing Fitness, which is a children’s fitness center focusing on therapeutic exercise, physical therapy, physical education, social skills, adaptive physical education and athletic development. LCF provides services to children of all ages and all developmental levels.

Phone Ricardo Cunningham at (703) 909-7971 or email him at LifeChangingFitness@yahoo.com for more info. http://www.optimalbeginning.com for Optimal Beginnings, which does social skills classes. Phone Jennifer Brown at (703) 798-8446 or (347) 424-5833, or email her at admin@optimalbeginnings.com for more info. http://www.sparcontheweb.org for SPecially Adapted Resource Clubs. Phone Donna Goldbranson at (703) 338-6185 or email her at donna.goldbranson@sparcontheweb.org for more info. http://www.starfishsavers.com for Starfish Savers camp and social programs. Phone Larrie Ellen Randall at (703) 631-9557 or email her at info@starfishsavers.com or Larrie.Ellen@starfishsavers.com for more info. http://alexandriava.gov/Recreation for Alexandria City therapeutic recreation services and fitness programs. Phone Jackie Person at (703) 746-5422 or email her at jackie.person@alexandriava.gov for more info. http://www.arlingtonva.us/departments/ParksRecreation/scripts/classes/Classes.aspx for Arlington County therapeutic recreation services, fitness programs, dance classes, camps, afterschool programs and social clubs. Phone Becky Suttell at (703) 228-4740 or (703) 228-4741, or email her at bsuttell@arlingtonva.us or Trinfo@arlingtonva.us; or phone Michael Swisher at (703) 228-4738 or email him at Mswish@arlingtonva.us for more info. http://www.fairfaxcounty.gov/rec/TRS for general info on Fairfax County’s Therapeutic Recreation

Services. Phone Sandi Dallhoff at (703) 324-5532/5716 or email her at Sandi.Dallhoff@fairfaxcounty.gov for more info. Currently for children that have completed kindergarten, please contact Sandi about the following programs: http://www.fairfaxcounty.gov/rec/trs/ctya.htm#SaturdayLeisureProgram for the Saturday/Sunday Morning Integrated Leisure Experience program for ages 3 to 5. http://www.fairfaxcounty.gov/rec/Trs/adventure.htm for the Summer Adventure Program for ages 5 to 12. http://www.fairfaxcounty.gov/rec/Trs/explorers.htm for the Summer Explorers Program for ages 5 through 22. http://www.co.fairfax.va.us/rec/TRS/satleisr.htm for the Saturday Leisure Program (9am to noon) for ages 6 through 22. http://www.fairfaxcounty.gov/rec/Trs/leisure.htm for the Summer Leisure Program for ages 5 through 22.

For info on their Family Autism Nights or F.A.N.tastic Fridays for ages 3 through 21, phone Katelyn Masterson at (703) 324-5532/5517, or email her at Katelyn.Masterson@fairfaxcounty.gov, or go to http://www.fairfaxcounty.gov/rec/trs/inclusprog.htm.

For info on their Inclusive Recreation Programs, phone Ashley Haddow at (703) 324-5532/5214, or email her at Ashley.Haddow@fairfaxcounty.gov, or go to http://www.fairfaxcounty.gov/rec/trs/inclusprog.htm.

Also contact her for info on their Summer, winter and spring break Rec Quest Inclusion Programs for ages 5 through 12 at http://www.fairfaxcounty.gov/rec/trs/inclusprog.htm.

For info on their Summer RecPac Inclusion Program for ages 5 through 12, phone Gary Logue at (703) 324-5532/8727, or email him at gary.logue@fairfaxcounty.gov, or go to http://www.fairfaxcounty.gov/parks/ada/rec-pac.htm For info on their Project Success inclusive service learning program for ages 13 through 22, phone Robyn Mitchell at (703) 324-5532/5553, or email her at Robyn.Mitchell@fairfaxcounty.gov, or go to http://www.fairfaxcounty.gov/rec/ProjectSuccess.htm.

For info on their Teens and Young Adult Social Club, phone Travis Middleton at (703) 324-5532/5621, or email him at Travis.Middleton@fairfaxcounty.gov, or go to http://www.fairfaxcounty.gov/rec/trs/adults.htm#TeenandYoungAdultSocialClubs.

For more info on their Wheelchair Sports (Fairfax Falcons) for ages 6 through 22, phone their hotline at (703) 324-8371, phone Ashley Haddow at (703) 324-5532/5214, or email her at Ashley.Haddow@fairfaxcounty.gov, or go to http://www.co.fairfax.va.us/rec/TRS/whlchr.htm.

Fairfax County also offers help in finding child care through the Child Care Resource System. Phone (703) 449-9555 or go to http://www.co.fairfax.va.us/childcare for more info. http://www.loudoun.gov/Default.aspx?tabid=804 for Loudoun County adaptive recreation programs.

Phone Maria Auger oat (703) 771-5013 or email her at mauger@loudoun.gov for more info. Info on Adaptive Recreation Camps is at http://www.loudoun.gov/Default.aspx?tabid=824, and on VSA Integrated visual and performing arts program is at http://www.loudoun.gov/Default.aspx?tabid=807. For more on the VSA arts program, phone Benjamin Shoenberger at (540) 338-7973 or email him at Benjamin.shoenberger@loudoun.gov. https://www.student-sitters.com/parentareas.html has info on a national organization called Student Sitters. Email them at contact@student-sitters.com for more info.

The only respite care provider that I do NOT recommend is Jesse Kuschner and Professional Education and Respite Service at (888) 664-9886 or www.vacationrespite.com. He is an authorized TRICARE ABA and respite provider, but I would never recommend him due to his very questionable business practices.

While I try to keep all the information in this reference sheet up to date, I am sure that I am not 100%

successful. This is particularly true when it comes to the web site information. As such, if you have found any errors in any part of this information, please let me know, so I can fix it for folks that read it after you. Thanks very much! Scott