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      The Cost of Autism Spectrum Disorders

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          Abstract

          Objective

          A diagnosis of an autism spectrum disorders is usually associated with substantial lifetime costs to an individual, their family and the community. However, there remains an elusive factor in any cost-benefit analysis of ASD diagnosis, namely the cost of not obtaining a diagnosis. Given the infeasibility of estimating the costs of a population that, by its nature, is inaccessible, the current study compares expenses between families whose children received a formal ASD diagnosis immediately upon suspecting developmental atypicality and seeking advice, with families that experienced a delay between first suspicion and formal diagnosis.

          Design

          A register based questionnaire study covering all families with a child with ASD in Western Australia.

          Participants

          Families with one or more children diagnosed with an ASD, totalling 521 children diagnosed with an ASD; 317 records were able to be included in the final analysis.

          Results

          The median family cost of ASD was estimated to be AUD $34,900 per annum with almost 90% of the sum ($29,200) due to loss of income from employment. For each additional symptom reported, approximately $1,400 cost for the family per annum was added. While there was little direct influence on costs associated with a delay in the diagnosis, the delay was associated with a modest increase in the number of ASD symptoms, indirectly impacting the cost of ASD.

          Conclusions

          A delay in diagnosis was associated with an indirect increased financial burden to families. Early and appropriate access to early intervention is known to improve a child's long-term outcomes and reduce lifetime costs to the individual, family and society. Consequently, a per symptom dollar value may assist in allocation of individualised funding amounts for interventions rather than a nominal amount allocated to all children below a certain age, regardless of symptom presentation, as is the case in Western Australia.

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          Most cited references12

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          The lifetime distribution of the incremental societal costs of autism.

          To describe the age-specific and lifetime incremental societal costs of autism in the United States. Estimates of use and costs of direct medical and nonmedical care were obtained from a literature review and database analysis. A human capital approach was used to estimate lost productivity. These costs were projected across the life span, and discounted incremental age-specific costs were computed. United States. Hypothetical incident autism cohort born in 2000 and diagnosed in 2003. Discounted per capita incremental societal costs. The lifetime per capita incremental societal cost of autism is $3.2 million. Lost productivity and adult care are the largest components of costs. The distribution of costs over the life span varies by cost category. Although autism is typically thought of as a disorder of childhood, its costs can be felt well into adulthood. The substantial costs resulting from adult care and lost productivity of both individuals with autism and their parents have important implications for those aging members of the baby boom generation approaching retirement, including large financial burdens affecting not only those families but also potentially society in general. These results may imply that physicians and other care professionals should consider recommending that parents of children with autism seek financial counseling to help plan for the transition into adulthood.
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            Early intensive behavioral intervention: outcomes for children with autism and their parents after two years.

            An intervention group (n=23) of preschool children with autism was identified on the basis of parent preference for early intensive behavioral intervention and a comparison group (n=21) identified as receiving treatment as usual. Prospective assessment was undertaken before treatment, after 1 year of treatment, and again after 2 years. Groups did not differ on assessments at baseline but after 2 years, robust differences favoring intensive behavioral intervention were observed on measures of intelligence, language, daily living skills, positive social behavior, and a statistical measure of best outcome for individual children. Measures of parental well-being, obtained at the same three time points, produced no evidence that behavioral intervention created increased problems for either mothers or fathers of children receiving it.
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              Brief report: early intervention in autism.

              S Rogers (1996)
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                5 September 2014
                : 9
                : 9
                : e106552
                Affiliations
                [1 ]School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, Australia
                [2 ]School of Education and Communication, CHILD Programme, Institute of Disability Research, Jönköping University, Jönköping, Sweden
                [3 ]School of Psychology, CHIRI, Curtin University, Perth, Australia
                [4 ]Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Linköping University & Pain and Rehabilitation Centre, Linköping, Sweden
                [5 ]School of Occupational Therapy, La Trobe University, Melbourne, VIC, Australia
                Emory University School Of Medicine, United States of America
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: CH MF MA TF. Performed the experiments: CH MF. Analyzed the data: CH RP MA TF. Wrote the paper: CH MF RP MA TF.

                Article
                PONE-D-14-02229
                10.1371/journal.pone.0106552
                4156354
                25191755
                b56c64b8-a690-42cc-bbeb-d65d35b8c3e4
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 15 January 2014
                : 4 August 2014
                Page count
                Pages: 11
                Funding
                This study was funded by the Department of Social Services (DSS), formerly the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA), with in-kind support of the Autism CRC, established and supported under the Australian Government's Cooperative Research Centres Program. The research was also conducted in collaboration with Disabilities Services Commission Western Australia (DSC). DSS had no active role in the design, implementation, data collection, analysis or interpretation of the study. DSC collaborated with the authors and assisted in data collection by in-kind contribution of its employee's time in some aspects of the study. Writing of the report and the decision to submit this manuscript were solely the role and responsibility of the authors. However, approval to submit this study for publication was sought from CRC Living with Autism Spectrum Disorders, DSS and DSC. All researchers are independent from both DSS and DSC and take full responsibility for the integrity of the data and the accuracy of the analyses. (DSS grant number - RES-HEA-CRD-TB-50940 http://www.dss.gov.au/)
                Categories
                Research Article
                Biology and Life Sciences
                Psychology
                Clinical Psychology
                Developmental Psychology
                Medicine and Health Sciences
                Health Care
                Health Economics
                Health Care Sector
                Socioeconomic Aspects of Health
                Mental Health and Psychiatry
                Pediatrics
                Child Health
                Public and Occupational Health
                Social Sciences
                Economics

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                Uncategorized

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