From the Guidelines
Children with impaired communication should be provided with funding for assistive technology, including Augmentative and Alternative Communication (AAC) devices, as it is often necessary to overcome limitations in functional communication. The importance of funding for AAC devices is highlighted in a study published in Pediatrics in 2008 1, which notes that laws such as Section 504 of the Rehabilitation Act of 1973 and the Individuals With Disabilities Education Act (IDEA) mandate access to assistive technology for children with disabilities.
Key Points
- Funding for AAC devices can come from various sources, including schools, third-party payers, and philanthropic sources 1.
- Laws such as the IDEA and the Technology-Related Assistance for Individuals With Disabilities Act of 1988 provide financial assistance to states to develop projects to improve the delivery of assistive-technology devices to children with special education needs 1.
- Recent Medicare regulations authorize coverage for AAC devices, including Speech-Generating Devices (SGDs), with 80% of the cost paid for by Medicare funds 1.
- Medicaid payments for AAC systems are variable and dependent on state laws and rulings, with some states having strict limits for Medicaid and rarely paying for AAC systems for children 1.
Recommendations
- Funding for AAC devices should be prioritized to ensure that children with impaired communication have access to necessary assistive technology.
- Healthcare providers should be aware of the laws and regulations that provide financial assistance for AAC devices and help families navigate the funding process.
- Regular evaluations and reports by certified speech and language pathologists are necessary to determine the medical necessity of AAC devices and to ensure that children receive the appropriate device and support.
From the Research
Aides for HIV Treatment
- The PROGRESS study 2 compared a regimen of lopinavir/ritonavir (LPV/r) combined with either raltegravir (RAL) or tenofovir/emtricitabine (TDF/FTC) in antiretroviral-naive adults, finding similar efficacy and safety profiles between the two groups.
- The STARTMRK study 3 compared raltegravir or efavirenz combined with tenofovir/emtricitabine in treatment-naive patients, finding durable viral suppression and immune restoration with raltegravir.
- A phase 2 trial 4 evaluated the use of raltegravir/emtricitabine/tenofovir as a first-line treatment for HIV-2 infection, finding a success rate of 40% at 48 weeks.
Combination Therapies
- The combination of tenofovir disoproxil fumarate, emtricitabine, and raltegravir has been shown to reduce neural progenitor cell proliferation in vivo and in vitro 5.
- Emtricitabine and tenofovir have been highlighted as a key backbone for HIV prevention, treatment, and elimination 6, with emtricitabine being one of the most successful drugs in the fight against HIV/AIDS.
Key Findings
- Raltegravir has been shown to be a safe and effective option for first-line treatment of HIV-2 infection 4.
- The combination of tenofovir disoproxil fumarate, emtricitabine, and raltegravir may have adverse effects on neural stem cells and progenitors, contributing to the development of HIV-associated neurocognitive disorders (HAND) 5.