Harvard researchers estimate that the added costs of autism-related healthcare and education average more than $17,000 per child per year in the United States. The figure represents expenses above those for a child without autism spectrum disorder (ASD). On a national level, the researchers estimated that these additional costs exceeded $11.5 billion in 2011.
The report appears today in the journal Pediatrics.
“The economic burden associated with ASD is substantial and can be measured across multiple sectors of our society,” the authors write. “Previous analyses that focused on healthcare underestimated this economic burden, particularly for school systems.”
The researchers called for public policies ensuring that schools have the resources to meet the growing need for autism services.
“These findings are important for better guiding policy makers about how to support the education and healthcare systems already under great financial strain,” comments epidemiologist Michael Rosanoff, Autism Speaks associate director for public health research. “Yet we have reason to believe that these numbers are only a portion of the financial impact on families and society.” Autism Speaks is currently funding a more in-depth study of autism's lifetime costs.
The Harvard analysis was based on samplings from two household surveys. The healthcare costs came from the 2011 National Health Interview Survey. It included responses from 109 families with a child who has autism and 18,775 comparison families. The non-healthcare costs came from GfK Custom Research. Its survey included 137 families in the autism group and 121 in the comparison group.
The largest chunk of additional costs was for school-based special education services – an average of $8,610 per child per year. Next came an additional $3,020 in annual medical costs per child with autism.
“This makes clear how important it is to recognize that early intervention for autism can more than pay for itself by reducing needs for special education services through the school years,” Rosanoff says. The cost effectiveness of early intervention is among the preliminary findings of a study being funded by Autism Speaks.
Costs to Families
Unexpectedly, the Harvard study found no autism-related increase in out-of-pocket expenses or lost income to families. This contrasts with recent reports of unreimbursed therapy costs forcing families to sell their homes in states that have yet to pass autism insurance reform laws.
“Numerous studies have demonstrated financial burden on families,” Rosanoff notes. One recent study, for example, found that mothers of children with autism earn, on average, 56 percent less than mothers of children without health limitations.
“There’s no clear explanation for this discrepancy,” Rosanoff says. “But studies that use different datasets at different points in time aren’t directly comparable.” Another possible explanation is that hard-won advances in health-insurance coverage for autism are reducing the burden on some families. However the majority of American families remain without health coverage for autism therapies. (For more on Autism Speaks advocacy efforts, click here.)
Looking beyond childhood
While the Harvard study looked at children, the majority of autism’s lifetime costs appear to be associated with adulthood, Rosanoff adds. These costs - including housing, disability support and lost productivity - are set to skyrocket as increasing numbers of children with autism reach adulthood. For these reasons, Autism Speaks is funding a broad range of research and family service projects designed to promote greater independence, employment and quality of life for adults with autism. (Learn more about these projects here.)
In addition, Autism Speaks continues to fund research on the lifetime costs of autism and how to meet them. Preliminary findings set the national costs of autism at around $137 billion annually. This translates into an average lifetime cost of $1.4 million for a person affected by autism that is not complicated by intellectual disability. An estimated 1 in 5 persons with autism also has intellectual disability. This increases the average lifetime cost of care to $2.3 million.
Explore all the research Autism Speaks is funding using this website’s grant search.
Subscribe to Autism Speaks Science Digest for autism research news, perspective and expert advice – delivered biweekly to your inbox.