"Take off the mandates for coverage in the state of Nevada and all over the United States," [Nevada Republican Senate candidate Sharron] Angle says in a video from a speech she gave in 2009 at a Tea Party rally in Winnemucca. "You know what I'm talking about. You're paying for things that you don't even need. They just passed the latest one," Angle continues, then makes a reference to autism, using her fingers to make quotes around the term that describes a range of developmental disorders. "Everything they want to throw at us is covered under 'autism' so that's a mandate that you have to pay for...” --Las Vegas Review-Journal, Sept. 24, 2010

Apparently, Sharron Angle doesn't believe in autism. Or maybe she's like that character Joey from Friends and doesn't actually know what air quotes mean.

Either way, I don't understand her point: That autism doesn't affect enough children for it to be worth the cost increase in premiums that cover it? Well, I'm sure that premiums would be much lower if they excluded all diseases, disabilities and illnesses. Pure profit. Cover nothing; just charge premiums.

I think that some people in the country are under the impression that the second mandates when into effect – and Florida passed one of these laws – people were just beating down the door to get an autism diagnosis and jump on board for some fun, free speech, occupational and behavioral therapy. There's no better way to spend your day than sitting around the lobby of the speech and hearing clinic. I can't get enough of that place and its turtle tank.

Florida's law is a good piece of legislation that helps a lot of people. But not us. We're one of those families that slipped through the (rather large) gap in the law. My husband works at a company with fewer than 50 employees, so despite the fact that as a smaller group we pay higher premiums and higher deductibles, autism is not covered. (For some reason, our deductible went up $1,000 this past year, though.) We can, luckily, get some speech and occupational therapy by using a medical diagnosis code of “static encepholopathy,” provided by our neurologist.

As I mentioned last week, we looked into the option of switching to Florida KidCare. It's not one but actually several different programs. During the first call, a customer service rep told my mother that yes, all autism therapy was covered by KidCare.

On further investigation, though, we discovered that's not true. The good news: If your income qualifies you for a subsidized premium (about $20-30 a month) through Children's Medical Services, everything is covered – speech, OT, ABA therapy. If you think you would qualify and would like my contact at CMS, please email me privately at AmandaBroadfoot@gmail.com. She says that she can get you enrolled in 24 hours. (I don't want to post her email here, because I don't want her inundated by Robocommenter with ads for buying cialis online.)

The bad news: If your income doesn't qualify, you cannot buy into this program. You can't even pay an unsubsidized premium.

The good news: There is a KidCare plan that anyone can buy into and the premiums are reasonable (about $159/month) – Florida Healthy Kids.

The bad news: ABA therapy is not covered under this plan.

The good news: You can apply for a Medicaid DD waiver to help with costs of medically necessary therapy not covered.

The bad news: There is a three-year waiting list and it's getting longer every day. You can apply to be bumped to the top of the list, but I was told by my contact at CMS who was kindly lowering my expectations, “They're dealing every day with homeless children and those in life-threatening situations.”

Wow. It had never really dawned on me that there are homeless disabled children out there on the streets, but of course there are. Of course there are. There are homeless autistic children. There are autistic kids in the foster care system. There are autistic children battling other diseases as well. There are autistic children whose parents can't or won't advocate them for any number of reasons.

I still haven't found out how to get coverage for ABA therapy, but we're exploring some options. I have, however, had my eyes opened...

While I was wallowing in my hate hole last week, there were parents out there hoping and praying to God that one day they would end up as lucky as me -- living with a roof over their heads with plenty of time and money and food for their kids and the opportunity to give them the best kind of therapy available anywhere: the loving support of a happy home.

So I'm out of the hate hole – though I am sparing a little bit of intense dislike for Sharron Angle and her air quotes around “autistic.” If she doesn't believe in autism, I'd love to put her in a room with Billy and challenge her to get a word in edgewise during one of his recitations of Alvin and the Chipmunks.

But when I was ranting on Facebook about Angle and her wingnut disbelief in autism, my friend Brian responded succinctly, “That's OK. I don't believe in Sharron Angle.” Tru dat.

There's a line in the Disney story "Cars" that reads, "Sally was touched." It's the moment when the main car's girlfriend is overwhelmed by emotion when the neon lights of her Route 66 town are lit up for the first time in decades.

Billy loves "Cars." He doesn't call it "Cars," though. He calls it "Mater," after his favorite character. He loves the movie; he loves the books. He loves the matchbox-sized replicas of the characters. He loves his Mater-themed Pullups and his sippy cup with Lightning McQueen on it. If you have a kid going through a Cars phase, at first you consider yourself in luck, because it's everywhere. Then one day, you look around yourself and realize, "It's...everywhere."

So anyway, Sally was touched. Billy repeats this line as he reaches out his pointer finger and pokes me in the nose. "Sally was ... touched." Poke. Again and again. Sally was touched. Poke.

See? He's touching me.

It's almost like he realizes that he doesn't quite get this line. So he's working it out by thinking aloud.

A lot has been written about how literal autistic people can be, how they often don't get jokes or understand metaphor or irony. So I've been going out of my way to explain this line every time it comes up. "Sally was touched," I say, "means that she was happy, that she felt love. She was touched in her heart." And I pat myself on the chest.

Billy stares at my hand patting my chest. He's thinking.

Poke. "Mama was touched." He smiles. And for the millionth time, I wonder how much he actually knows.

It's like when we were practicing egg hunting this week at his friend EJ's house. Billy loves finding the eggs this year. He'll spot one, his face will light up and he'll go tearing across the yard toward it.

Then he opens it up, eats the candy out of it, and leaves the open plastic egg lying in his hiding place. I looked around the yard at one point and saw half a dozen plastic eggs, broken open and still lying in their hiding place, his basket long since abandoned.

I took his hand, led him to a hidden egg, and showed him how to pick it up and put it in the basket. He sighed, and moved on to the next egg, dutifully picking it up and dropping it in the basket. Then he started singing the "Clean up" song while he worked.

Any parent with a child in preschool knows the "Cleanup song:" Clean up, Clean up/Everybody everywhere/Clean up, clean up/Everybody does their share."

Dave watched him for a second and laughed. "You know," he said in his English accent, "I think Billy has a point. Easter egg hunting is a little bit like bleedin' 'clean up, clean up.'"

One of these days, Billy's gonna be watching "Cars" and finally turn to me and ask, "How can a car have a girlfriend? Or a condo in Hawaii? And if they're all cars, who changes their oil? And who installed the hardwood floors and ceiling fans in the court house?"

And then I'll know he's going to be just fine.

We made a few changes to the website over the weekend. I say "we," when I actually mean that Dave made changes to the website while I did 45 tons of laundry. That is apparently what "we" did instead of taking down the "Happy Birthday, Princess" decorations, which are now in danger of becoming a permanent part of our interior design. Well, my birthday is in May so I suppose I could just have the world's first 39-year-old Disney Princess party.

At the right, you'll find a list of the most recent blog posts, as well as what people have had to say about them (under "Comments"). If you want to make a comment, just press the "New Comment" button under a blog post and let me have it!

"News" is a new section we've added, because I got tired of searching for "Autism" and "News" every day, and Dave found this cool site that would let me stream it all directly to my blog.

And on that note, Friday is World Autism Awareness Day, a kickoff to April being Autism Awareness Month.
I know I'm opening a can of worms here, but I have to say that I'm kind of ambivalent about the whole "awareness" months and days and ribbons. Not that I think any of it is bad. I just don't know if that's the best use of money and energy.

We could have a thousand people in Tallahassee get together and do a walk for autism awareness. And that would make a great photo on the front page of the Democrat. And we could all wear ribbons that look like puzzles ... and then what?

While we're doing a walk-a-thon, school budgets are getting cut and there are already fewer speech and occupational therapists servicing more autistic kids in the school system than ever. Or not servicing them, because they just don't have time. Billy, luckily, is getting exceptional services from his school system, but I know that there are backlog of kids in schools across the country, waiting to be evaluated before they can even begin to receive treatment. I've spoken to their worried, exhausted, frustrated parents. Believe me, they're aware.

We can raise more money for research, but if we keep researching the same thing over and over again (vaccination-autism link, which has been studied more than 20 times by the CDC alone), then how much progress are we making? I cringe at the thought that Autism Awareness Month is going to bring a host of new opportunities for Jenny McCarthy to preach her hysterical non-science to unsuspecting crowds.

And sometimes "awareness" seems like a consolation prize: We can't cure it. We don't have the funds to adequately treat it. Researching it is a political snakepit. So we're going to hold a rally, name a month, and make everyone aware of it.

As I write what sounds, even to me, like a cynical, smug excuse for doing nothing, I can hear a little voice in the back of my head asking, "So smarty-pants, what are you going to do? What's your big idea?" For some reason, this voice always sounds a little bit like Pee-Wee Herman.

I didn't have a plan when I started writing this, but now I've kind of talked myself into a corner, and I'm going to make a commitment to you: I'm going to call and write to every local, state and federal government official I can find until I get some answers as to why we don't have more therapists in the school system, and an expedited system for getting kids into treatment. For many families school-provided therapy is still the only autism treatment to which they have access.

I'm going to share the information I get with you and maybe, together, we can all figure where the logjam is and who I need to call or write to next month. Because as much as I'd like to think that Yoko Ono, our new World Autism Ambassador, is going to get everything sorted out by April 30, I'm pretty sure I'll still be making phone calls by the time the November mid-term elections roll around.

I'm totally open to hearing the opposing point of view about the necessity of Autism Awareness Days and the important strides that have been made because of them in the past. I'd be happy to find out that I'm completely wrong on this one, because I want to think that the time and money that's going into promoting this is well worth the effort and resources.

Willow turns one on Sunday! I can't believe it's been a whole year since one of the best and worst days of my life. Oh yeah, I'm not going to lie to you. Labor was horrible; there was nothing beautiful about it either time for me. And there are still times when I look at my children's beautiful, giant heads that I get a cold shudder down my spine.

My sister used to joke that I was the Grinch Who Stole Pregnancy, but I felt like there was enough propaganda out there about the beauty of the experience; it was my job to be a living, breathing example of pregnancy's ugly dark side. I gained weight from the top of my head to, quite literally, the bottom of my feet (I went up a size and a half in shoes, and even after losing the baby weight, my feet are still as big as Christmas hams); I had non-stop morning sickness and was so hormonal that when I wasn't crying, I was breaking something ... on purpose.

But that is behind me, and my little WiFi is a daily source of hilarity and real inspiration to me. Until she came along, I didn't realize the things that Billy hadn't done as a baby. She hands me things. She pretends to talk. She learnes new words every day. Her vocabulary now includes "Mama," "Daddy," "BEE!" (Billy), "baby," "cat," "up," "ice," "buh-buh" (bottle), "Nan," "Pop," "bye," the list goes on.

And one horrifying profane word that I cannot print in this family-friendly forum. She didn't learn this word from us. This word is not one that gets spoken in our house or even when we get cut off in traffic.

No, this word is a strange example of how children learn to communicate. Willow plays with sounds, and two of her favorite words for a while were "cat" and "cook-cook" (cookie). Well, she kept playing around with variations on these words, changing the vowels around -- "cot," "bok" ... you see where this is going -- until she hit on just the right word to make Mama pop her head up and shout, "What did you say?!"

Well, it doesn't get much better than that reaction to Willow. Somewhere in her little brain, she logged this as the word that gets Mama's attention. And it does. I can't help it. I know the right reaction is to ignore it completely, but I'll be honest with you, if we're in public, I give her anything she wants to shut her up.

Yesterday, I was pushing her around the party store in the shopping cart; I had decorated her in this adorable little "Birthday Princess" crown and sash and she was smiling and happily shouting her new favorite word over and over again. People were giving me looks. So I started saying, "No, you can't have a COKE," in the hopes they would buy it. Or, "Oh, you want a COOKIE? No problem; here ya go." And she tossed the cookie down and shouted the word again. I just got out of there before anyone could call Child Services.

By the time she was born, we were already pretty sure Billy was autistic, even though we hadn't received the official medical diagnosis yet. At that point, his verbal skills were still very limited, so we didn't know how bad things would get. I didn't know if he'd ever learn to communicate and be independent or if he'd need care the rest of his life.

These days, we're very confident about the progress he's making, and feel very optimistic that within a couple of years he's going to be very close to his peers in development. But a year ago, I looked at my baby daughter and thought, You'll still be with him when we're gone. You're so small and already have such a big responsibility. I have known adults who care for adult siblings with special needs and they are unsung, uncelebrated, often unappreciated (sometimes even by those they care for) heroes.

So a year later, it does my heart good to see Billy pull his baby sister into his lap. When she sees him, she shouts, "Bee!" and "Up!" He smiles, hugs her and holds her, wrapping his big lanky body around her. When she's in the tub he says, "Willow, close your eyes. I'm going to wash your eyes," imitating the things I say to him when I wash his face. And then he gently helps me wash her hair and brush it.

It never occurred to me that he would take on the responsibility of looking after her so quickly. But he's the big brother. She's the baby sister. And with any luck, they'll spend the rest of their lives looking after one another.

I sat in the corner of the speech therapy room yesterday, holding my breath. Billy was cradling a baby doll. He carefully dipped a washcloth into a tub of water and then dabbed it on the "baby's" head. A small trickle of water ran into its eyes. "She needs a towel!" Billy informed us. "Wipe her eyes!"

And he did. Then he laid the baby down, covered it with the towel, and began to recite Good Night, Beach, one of his favorite bedtime stories. He reached for the toy bottle and gave it to the baby. Then he reached for the toy juice bottle and mimed pouring it on the baby's head. We all laughed, including Billy. So he did it again.

I couldn't believe it. My child was engaging in normal, imaginative play. When offered three choices -- a toy farm, Playdough, and the baby doll -- he chose the baby doll and acted out routines with which he was familiar: bath, story time, bedtime, feeding.

This is huge for us. It was only a few months ago, when we started Floortime therapy, that the most interactive play I could really get with Billy was opening and closing doors with him. We did a lot of opening and closing doors.

He liked his toy fort. And he liked his toy barn. But mostly what he did with them was open and close the doors. If I tried to introduce some of the toy figures and engage him in interactive play, he would just turn his back on me and move on to something else.

When I questioned my fellow Floortimers -- a Yahoo! user group composed of parents, caregivers, therapists and others who are engaged in Floortime therapy -- about it, they advised me, rightfully so, that he simply wasn't ready for this level of play yet. Take it back down a step, they advised, follow his lead, and then work your way back up.

So we opened and closed doors. And Dave created a game called, "Open the latch, Daddy!" He placed his hand on the door, making it impossible for Billy to open until he asked for it. We opened and closed doors on the fort. And eventually, we had the Mickey Mouse character demand, "Open the latch, Billy!"

Slowly, Billy started allowing us to introduce the toy figures into the fort game. Then one day, I caught him acting out, word-for-word, an episode of Mickey Mouse Clubhouse, using the fort and the toy figures. When I tried to join in, he backed away. But after a week, he'd let me play too, to assume one of the characters, as long as I didn't change the story. There are not words to describe how much I came to hate the episode, "Mickey's Color Adventure." I dreamed about it.

But then one day, something clicked and Mickey was forgotten. Instead, all his figures had a jumping contest. Uniqua from the Backyardigans won almost every time, for some reason. "Yay! She did the highest jump!" he told me. And Batman was universally crap at jumping. Puff the Magic Dragon won a couple of times, but he had wings, so he was kind of cheating. Day after day, we had jumping contests on the fort.

He began to call the figures by name: Mickey Mouse, Uniqua, "the dragon," and for some reason, known only to Billy, one of the plastic Little People, a blonde girl wearing a hat, introduced herself to the others as, "Hi, I'm Uncle Wes," in a deep, gruff voice. I have no idea why he decided this character was his Uncle Wes, who is actually tall, dark-haired and bears absolutely no resemblance to a blonde little girl, but nonetheless, in our house, Uncle Wes she is.

And for the first time in the past two months, he developed an attachment to a stuffed animal, a stage most children go through at a much younger age. Tah-Tah is named after the teddy bear in the cartoon "Ira Sleeps Over," and Tah-Tah sleeps with Billy every night and travels with Billy to Nan's house whenever he "sleeps over." In the last couple of weeks, Tah-Tah has been joined by Eggbert, a large colorful catepillar; Too-Too, Tah-Tah's little brother; and Eeyore from Winnie the Pooh. Each has a place on Billy's bed, and both Mama and Daddy have to kiss them all goodnight each night. I can hear him talking to them over the baby monitor sometimes, telling them stories and singing them songs. Sometimes, he tells them, "Too-too! Quiet! It's night-night!"

I know all this probably sounds like mundane childhood play to the parents of normally developing children, but to put things in perspective, a year ago, Billy was running over the baby doll with his Big Wheel, and he rarely said anything that wasn't repetition of a book or TV show.

In addition to practicing Floortime at home, both Billy's speech and occupational therapists at Tallahassee Memorial Hospital take a developmental approach; both are Floortime-trained. So his therapy sessions look a lot like play -- in fact, they are play -- where we try to create the desire to communicate, rather than teach him specific phrases to parrot without understanding their meaning.

We are so excited about Billy's growing interest in imaginative play that we keep adding things to his strange little town that includes a medieval fort, a carnival, an airport, two farms and a train station. It's kind of like a soap opera town. And now he also has a little play house with a Mama, Daddy and baby that allow us to act out routines and social situations and practice things like saying, "Hello" and "goodbye."

When I was looking for a doll house online, I found tons of sites where parents were demanding to know whether playing with a doll would turn their son gay. Seriously. When I was a kid, one of my favorite toys was a Easy-bake Oven, and I certainly hope my son has a stronger interest in babies when he grows up than I now have in cooking.

But after Billy had bathed and fed the baby and put it to bed, he had the baby jump back up and announce, "Baby wants to play barn!" So we took out the barn, and the cow, horse, sheep and chicken had a jumping contest. The cow won.

Floortime/DIR is our primary therapy protocol for Billy. "Protocol" makes it sound like something instigated by Jack Bauer at CTU, but the great thing about Floortime is that it's more of a "big picture" view, inside which you can continue with speech therapy, occupational therapy, which we're also doing.

Developed by Dr. Stanley Greenspan, Floortime/DIR therapy (DIR stands for Developmental, Individual differences, Relationship-based) is all about creating moments of joy during which you communicate with your child on their level, following their lead. Rather than try to force them to perform a series of tasks, like stacking blocks or sorting objects, your goal is to get the child to connect with people, to desire to communicate. And you create that desire by following their joy.

For instance, if Billy wants to open and close doors repeatedly, rather than try to stop him from doing that, we open and close doors with him. And when he's comfortable with us playing side-by-side, we take it to the next level, creating a "playful obstruction." Dave created the "Open the latch, Daddy," game, putting his own hand on the door, and requiring Billy to ask him to release it, thereby bringing him into the moment.

A couple of great things happened as a result of adopting the Floortime mindset: We surrendered the frustrating process of trying to get him to stop opening and closing doors (which upset him and us) and we connected with our child. I was amazed at how much fun it was to open and close doors the first time those big blues eyes looked up to me and Billy smiled as if to say, "You like this too? Isn't it great?"

We want to teach him that it's more fun, fulfilling, desirable to be connected to people than it is to be lost in his own world. And over the past few months since we first read Dr. Greenspan's book, Engaging Autism, at the suggestion of our occupational therapist, Kathy Merydith at TMH, we have seen huge strides in Billy's connection to people.

He has started reaching out to other children on a regular basis, wanting to play with them, rather than by himself. Some of his social skills need a little honing, but after all, he's still just three years old.

If he runs into another room in the house, he'll call, "Mama, where are you?" In the past, I wasn't even sure if he thought about me when I wasn't there. He regular takes my hand and demands, "Play castle," meaning he wants me to come with him and play with the fort he got for Christmas. And then a few weeks ago, completely unprompted, he threw his arms around me and said, "I love you, Mama."

Now let me put up a big warning sign here: I can't say that Floortime caused my son to say "I love you." We're doing a lot of things, and also, he's getting older. One of our primary frustrations is trying to figure out what works, what doesn't, what therapy (or lack thereof) is resulting in a particular behavior, either positive or negative. Within our Floortime "big picture," Billy has speech therapy (3 times a week at school and once a week in private clinical setting), occupational therapy (once a week at school, once a week private), therapeutic listening (twice a day, 30 minutes per session), music therapy (once/week) and Kindermusik (www.kindermusik.com, therapy for the whole family!).

When I say these therapies operate within the Floortime big picture, I mean that we make sure our goal in every setting is to encourage his connection to people, create moments of joy, and develop his ability and desire to communicate.

That being said, Floortime works (at least, for us) and it works every time. I know that, because my son looks up at me, joy on his face, and makes some new gain in communication every day. Because we're doing the things he wants to do -- opening doors, playing fort, sifting dry rice through our fingers, riding the roller coaster that Nan got him for Christmas (what kid wouldn't like that?!) or simply running around the yard non-stop screaming, "He's getting away!" -- because we're following his joy, he wants to communicate. As a side note, he's almost completely stopped opening and closing doors, opting instead for more creative play.

The upside to this therapy: you can see almost immediate results, depending on the severity of your child's communication challenges and neurological issues, however subtle. Because Billy is highly functioning and very verbal (though most of his speech is repetitive), we get a lot of immediate reward and feedback from this therapy; I can imagine it would be significantly more frustrating with a non-verbal or non-responsive child. By all accounts it will still work, but the gains may be slower than what we've experienced.

More upsides: you can practice Floortime anywhere, as long as you are engaging your child, following their lead and expanding their communication; and once you learn the basic theory, you can do it yourself (essentially, it's free -- the only "training" we have at the moment is a careful reading of Dr. Greenspan's book), but it's certainly more effective if you also have an OT or other therapist skilled in Floortime who can help coach you during sessions, brainstorm new ideas, etc. Both our OT and speech therapist are Floortime-trained, and we also regularly turn to our virtual friends on the Yahoo! Floortime Group with questions and for support.

There are also a couple of great websites that offer training, online and DVD-based, message boards, documents that can help you with everything from preparing for your IEP meeting to locating a Floortime-trained professional. Floortime.org is the website of the Interdisciplinary Council on Developmental and Learning Disorders, founded by Dr. Greenspan and Dr. Serena Wieder and is really just a wealth of great information. StanleyGreenspan.com also offers courses in child development, a selection of Dr. Greenspan's books, and information on the latest research and articles published.

OK, now the downside: If you follow Dr. Greenspan's guidelines, you'll be doing eight Floortime sessions per day, 20 minutes per session. That's in addition to school, organized therapy, etc. I can't say that we hit that goal every day, or even most days. Also, you're supposed to work toward four play dates with a peer each week. We're not there yet either.

Sometimes the book can be a bit vague about how to accomplish certain goals, like how do you follow the child's lead if he keeps flitting from one activity to the next? How exactly do you know when your child is ready for more imaginative play? When it comes to these kinds of specific answers to some of the vague generalities in the book, I've always found the answer in my kid. And to his credit, Dr. Greenspan says that when in doubt, take a step back and watch your child. What is he doing? Where is his joy?

Our plan is fluid, dynamic and ever-changing. But for the first time in a long time, I feel like everyone on our team (and they're a wonderful group) is working toward a common goal. And at the center of that goal is a beautiful, intelligent and thoroughly fascinating child named Billy.