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Cost benefit Analyses of behavioral intervention

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Cost-Benefit Analyses

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Ganz ML. The costs of autism. In: Moldin SO, Rubenstein JLR, eds. Understanding Autism: From Basic Neuroscience to Treatment. Boca Raton, Fla: Taylor and Francis Group; 2006.


Ganz, M.L. (2007). The lifetime distribution of the incremental societal costs of autism

Archives of Pediatric and Adolescent Medicine, 161, 343-349.


Objective: To describe the age-specific and lifetime incremental societal costs of autism in the United States.

Design: 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.


Setting: United States.


Participants: Hypothetical incident autism cohort born in 2000 and diagnosed in 2003.


Main Outcome Measures: Discounted per capita incremental societal costs.


Results: 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.


Conclusions: 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.

Arch Pediatr Adolesc Med. 2007;161:343-349.



Hildebrand DG. Cost-benefit analysis of Lovaas treatment for autism and autism spectrum disorder (ASD).

Vancouver, British Columbia: Columbia Pacific Consulting; 1999.


Jacobson JW, Mulick JA, Green G. (1998). Cost-benefit estimates for early intensive behavioral intervention for young children with autism

—general model and single state case.

Behavioral Interventions, 13, 201-226.



Clinical research and public policy reviews that have emerged in the past several years now make it possible to estimate the cost-benefits of early intervention for infants, toddlers, and preschoolers with autism or pervasive development disorder - not otherwise specified (PDD - NOS). Research indicates that with early, intensive intervention based on the principles of applied behavior analysis, substantial numbers of children with autism or PDD - NOS can attain intellectual, academic, communication, social, and daily living skills within the normal range. Representative costs from Pennsylvania, including costs for educational and adult developmental disability services, are applied in a cost-benefit model, assuming average participation in early intensive behavioral intervention (EIBI) for three years between the age of 2 years and school entry. The model applied assumes a range of EIBI effects, with some children ultimately participating in regular education without supports, some in special education, and some in intensive special education. At varying rates of effectiveness and in constant dollars, this model estimates that cost savings range from $187,000 to $203,000 per child for ages 3-22 years, and from $656,000 to $1,082,000 per child for ages 3-55 years. Differences in initial costs of $33,000 and $50,000 per year for EIBI have a modest impact on cost-benefit balance, but are greatly outweighed by estimated savings. The analysis indicates that significant cost-aversion or cost-avoidance may be possible with EIBI.


Järbrink K, Knapp M. (2001). The economic impact of autism in Britain.

Autism, 5, 7-22.

Little is known about the economic impact of autism. This study estimated the economic consequences of autism in the United Kingdom, based on published evidence and on the reanalysis of data holdings at the Centre for the Economics of Mental Health (CEMH). With an assumed prevalence of 5 per 10,000 (1 per 2000) , the annual societal cost for the UK was estimated to exceed £1 billion. The lifetime cost for a person with autism exceeded £2.4 million. The main costs were for living support and day activities. Family costs account for only 2.3 percent of the total cost, but a lack of relevant information limited our ability to estimate these costs. Minor improvements in life outcome for people with autism could substantially reduce costs over the lifetime.


Maltby J. (2000).The costs of autism: more than meets the eye.

Advocate, 33(6),12-16.



Related papers


Liptak, G.S., Stuart, T., & Auinger, P. (2006). Health care utilization and expenditures for children with autism.

Journal of Autism and Developmental Disorders, 36, 871-879.


Mandell, D.S., Cao, J., Ittenbach, R., & Pinto-Martin, J. (2006). Medicaid expenditures for children with autistic spectrum disorders.

Journal of Autism and Developmental Disorders, 36, 475-485.


Mandell, D.S. (2007). Psychiatric hospitalization among children with autism spectrum disorders.

Journal of Autism and Developmental Disorders, Online paper


Shimabukuro, T.T., Grosse, S.D., & Rice, C. (2007). Medical expenditures for children with an autism spectrum disorder in a privately insured population.

Journal of Autism and Developmental Disorders, 38, 546-552.





How Private Health Insurance Works: A Primer

2008 Update

April 2008

Henry J. Kaiser Family Foundation








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