Through the Autism Care Demonstration (ACD), beneficiaries have access to applied behavior analysis services and, for beneficiaries new to the ACD as of Oct.1, 2021, Autism Services Navigators.
Visit www.tricare.mil/autism and www.tricare.mil/isitcovered for full TRICARE benefit details.
Applied Behavior Analysis
Applied behavior analysis (ABA) is a type of service that focuses on specific behaviors that affect individuals with autism spectrum disorder (ASD). The overall goal of ABA is to decrease challenging/interfering behavior and teach appropriate replacement behavior to improve quality of life for the beneficiary and their family and caregivers, ultimately reducing or eliminating the need for direct services.
Strategies used in ABA include, but are not limited to:
- shaping behavior patterns through reinforcement and consequences
- differential schedules of reinforcement
- discrete trial teaching
- natural environmental training
- pivotal response training
Not all strategies may be implemented for every beneficiary. That's because ABA services are authorized and rendered under the Autism Care Demonstration (ACD) according to the patient’s individual needs as determined by assessments and treatment progress.
ABA is most effective when family members/caregivers actively participate by consistently reinforcing the ABA interventions in the home setting in accordance with developed treatment plan.
What to Expect in an ABA Program
ABA services included as part of an ABA program are:
- initial assessments and reassessments
- development of a treatment plan
- one-on-one ABA services
- training of immediate family members on ABA
- modifications based on the progress of treatment plan goals, outcome measures and parent engagement
There is no minimum or maximum age limit or duration limit. All services are authorized based on clinical necessity.
Autism Services Navigators
On Oct. 1, 2021, TRICARE introduced the Autism Services Navigator (ASN) role to the ACD.
To be eligible for an ASN, your child must be new to the ACD as of Oct. 1, 2021. You are considered “new” if you:
- Entered the ACD on or after Oct. 1, 2021
- Paused or discontinued services for more than 365 days if in the ACD before Oct. 1, 2021
If you were assigned an ASN and move, you remain eligible for an ASN as long as you continue to meet eligibility requirements.
If you were assigned an ASN but decline the support, you will no longer be eligible for the ACD.
To learn more about ASNs as well as the case management services available to families not eligible for an ASN, please visit our Autism Services Navigator page.
What if I am not new and not eligible for an ASN?
If you are not eligible for an ASN, you can still access case management services through HNFS, your assigned military hospital or clinic (if available), or the Exceptional Family Member Program (EFMP).
HNFS’ case management team offers support to help you coordinate care and services for your child. To get started, visit our Care Management page. You can also connect with our case management eam by calling our dedicated case/care management line at 1-844-524-3578.