Autism treatment unaffordable for many parents in Georgia
Despite recent efforts to raise awareness about autism in Georgia, the challenge of how to change public perceptions about this disease and provide affordable treatment still remains. To provide a deeper look into this challenge, Georgia Today has included two articles in this week’s issue prepared by Mari Khanjaliashvili and Rousan Safaryan.
Salome Shikhashvili, Tamar Chikviladze, Mariam Pirtskhalava and Tina Eradze also contributed to the project.
They are all students of The Caucasus School of Journalism and Media Management (CSJMM) at GIPA.
When Tbilisi resident Irina Kobakhidze, 40, took her 5-year-old son Luka to the doctor, she learned her child had a condition she only remembered seeing in the movie Rain Man. As an unemployed mother, whose only income is a state-provided pension, Irina couldn’t afford even the most inexpensive treatment for her child. So as a solution, she set out to educate herself on autism.
According to the results of the first screening conducted by the Tbilisi Pediatric Neurology and Neuro- Rehabilitation Center, the prevalence of autism in Georgia is the same as it is worldwide: 1 per 100 children.
Autism is an officially recognized disorder that belong to the Autism Spectrum Disorders (ASDs). ASDs are characterized by problems with social, emotional and communication skills. The term was in use from the first half of 20th century, but the problem only began receiving attention in 1980s. That’s when the role of behavior therapy, now the main approved therapy for autism, began to emerge.
Applied behavioral analysis (ABA) teaches a child step-by-step to change his behavior. This method combines psychological and educational techniques that are tailored to the needs of each individual child to alter their behaviors. ABA involves teaching functional skills and evaluating progress.
“According to the research, ABA treatment outcomes are better than that of other therapies,” explained the Head of Tbilisi’s Pediatric Neurology and Neuro-Rehabilitation Center, Nana Tatishvili. “In some countries, they still provide other therapies such as music and art. But behavioral therapy has proved to be the best.”
According to Sophio Kereselidze, the founder of the Autism Association of Georgia, alternative therapies are more expensive everywhere in the world. She has lived in the United States with her 3-year-old child, who was diagnosed with autism. One of the therapies she tried was hippotherapy (horse-riding), which would cost $150-200 per session. Therapeutic horse riding without a licensed physical or occupational therapist costs significantly less ($15-40 per session).
“We did hours of therapeutic riding in the U.S., but I found that it was not effective enough,” Kereselidze said, adding that ABA therapy is the best and cheaper compared to other therapies.
Many families become victims of marketing strategies of alternative therapies that have not been proven beneficial or even safe for their children. Recent studies have estimated that the lifetime cost of caring for an individual with ASD can reach as high as the millions in the US.
Medea Zirakashvili, a pediatric neurologist at Iashvili Children’s Central Hospital in Tbilisi, recalls a Chechen family that tried almost all alternative therapies, but finally found behavioral therapy the most effective.
“They sold everything, took their child to the United States, tried dolphin therapy, oxygen therapy, later they even tried additional therapies in Turkey and in Israel but right now they are attending ABA therapy at our center,” Zirakashvili said. So she recommends ABA therapy as a first choice.
In Georgia, while the costs of autism diagnosis are subsidized through the state budget, no free therapies are available for autistic children. Both alternative and traditional treatments are costly.
For instance, an hour of ABA therapy costs 20 lari, and to be effective, an autistic child needs 40 hours a week of this therapy. Concerning alternative treatment costs such as hippotherapy (horse-riding) and dolphin therapy, one hour of hyppo therapy costs 20-25 lari and half an hour of dolphin therapy costs 100-150 lari in Batumi, Georgia’s Black Sea resort.
“We are just starting to turn the government’s attention towards this problem,” Zirakashvili said.
Meanwhile, many parents of autistic children can afford none of the available therapies due to financial reasons.
Luka Akolashvili, now 9 years- old, goes every day to a special school along with other children who also have limited abilities. “We don’t have access to ABA therapy, because it is very expensive for us,” the boy’s mother complained.
By Rousan Safaryan