Early autism intervention makes dollars and sense

Early autism intervention makes dollars and sense
By William Frea with Daily Breeze

Posted: 05/02/2009 07:13:13 PM PDT

With one in 150 children today diagnosed with autism, the debate rages on over what is the best treatment for this condition, and - just as importantly - who will pay for it.

In the wake of Autism Awareness Month in April, we have an opportunity to take a realistic and probing look at the most effective means for treating this developmental condition, and where resources should be placed for this treatment.

Today, beleaguered states with budget deficits, such as California, are evaluating all service programs to find ways to cut costs. States need to take a close look at what approaches deliver the best outcomes and the best return on investment. The question is not how much do autism services cost, but how much is saved by treating autism early and effectively, and how much is lost if this early intervention does not occur.

The Autism Society of America has calculated that autism costs the United States more than $90billion each year. There's no question that treatment for autism is expensive. However, there is a significant difference between autism and other severe developmental disabilities. With autism, it's been shown that with targeted early intervention using scientifically validated methods, many children can gain the skills they need to move into a mainstream classroom.

With evidence-based early interventions such as Applied Behavior Analysis, or ABA, the most widely accepted method for treating autism, as many as half of these children would no longer be on the autism spectrum, and most would go on to successful futures as independent adults.

The costs of caring for a person with autism over his or her lifetime is estimated to be at least $3.2 million, according to a study from Professor Michael Ganz at the Harvard School of Public Health. Others have pegged the cost even higher, up to $4.7 million. With ABA therapy averaging $40,000 to $70,000 a year, and most children requiring only several years of therapy starting around age 2, early intervention with this approach clearly delivers an enormous return on investment by avoiding the multi-millions required for lifetime treatment, residential housing and care.

Not included in this cost-benefit estimate is the value that a functioning adult can contribute back to society, or the joy of parents and families who recover the child they thought lost behind the veil of autism. This human benefit is truly priceless.

Unfortunately, California recently opted not to require insurance providers to cover behavioral interventions such as ABA, even though this treatment has been the gold standard for treating autism for more than 30 years. Insurance companies have taken the position that it is education-based rather than a medical treatment.

Other states disagree. Nevada is close to passing legislation requiring insurance companies to fund ABA therapies. Nevada Assemblywoman Melissa Woodbury made a compelling argument citing research that demonstrated 47 percent of children with autism were able to lead independent lives after receiving at least 30 hours per week of intensive ABA early intervention. Nevada would join Arizona, Florida, Illinois, Indiana, Louisiana, Pennsylvania, South Carolina and Texas as states that require insurance providers to cover intensive autism treatments.

We all hope researchers will soon discover the cause of the autism epidemic and how to prevent it. In the meantime, we need to deal with both today's reality and tomorrow's prognosis, as these children move on through middle school, high school and transition to adulthood and careers. The best investment that we can make today is early intervention with scientifically validated ABA therapy.

As policy makers in California struggle with tough financial choices and argue over how much support to give to autism treatments, we urge them to consider not only the dollars and cents of autism, but the dollars and sense. Funding based on the outcomes of evidence-based therapies is the prudent decision for both the short-term and the long-term interests of children with autism, their families and our society as a whole.

Dr. William Frea is chief clinical officer and co-founder of Autism Spectrum Therapies, an agency providing autism services throughout Southern California. He has served on the California State Legislative Blue Ribbon Commission on Autism.

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Posted in: EIP, Insurance, News, Therapy, Training