Resilience

Autism Spectrum Disorders and Health Care Expenditures: The Effects of Co-Occurring Conditions

Journal of Developmental & Behavioral Pediatrics: Peacock, Georgina MD January 2012 - Volume 33 - Issue 1.

Abstract

"Children with autism spectrum disorders (ASDs) often have co-occurring conditions, but little is known on the effect of those conditions on their medical care cost. Medical expenditures attributable to ASDs among Medicaid-enrolled children were calculated, and the effects of 3 commonly co-occurring conditions—intellectual disability (ID), attention deficit/hyperactivity disorder (ADHD), and epilepsy—on those expenditures were analyzed. Conclusion: Medicaid-enrolled children with ASD incurred higher medical costs than did Medicaid-enrolled children without ASD. Among Medicaid-enrolled children with ASD, cost varied substantially based on the presence of another neurodevelopmental disorder. In particular, children with ID had much higher costs than did other children with ASD."

Read the full abstract here.   Full article may require payment.

The Lifetime Distribution of the Incremental Societal Costs of Autism

Archives of  Pediatric & Adolescent Medicine 2007;161(4):343-349; by Ganz ML.

Abstract

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.

To read the complete article, click here.

 

Collaborating for Effective Health Systems for Children with Autism Spectrum Disorder in New Mexico

CHCS, Technical Assistance Briefs & Tools, University of New Mexico Health Sciences Center, April 2005.

Summary

Through a CHCS Best Practices Grant, officials at the University of New Mexico Health Sciences Center convened a workgroup to identify the appropriate mix of services for children with ASD and determine how to finance these services within New Mexico's Medicaid managed care program. 

The workgroup developed an action plan, policy brief, and summary of findings and recommendations, which were distributed to state officials to garner support to enhance programs for children with ASD. As a result, state funding was approved during New Mexico's 2005 legislative session to improve and coordinate services for children with ASD.  (CHCS)

To read the technical brief, action plan, or complete summary of findings at CHCS, click here.

Collection of Evidence-based Practices for Children and Adolescents with Mental Health Treatment Needs, 4th Edition

 Virginia Commission on Youth, 2010.

 

 

Summary

This publication is intended to provide information to families, clinicians, administrators, policymakers and others seeking information about evidence-based practices for child and adolescent mental health disorders. The revised Collection has categories that represent different levels of scientific support for a particular treatment:  1. What Works, 2. What Seems to Work, 3. What Does Not Work, 4. Not Adequately Tested, and 5. Not Tested.  Because research is ongoing, treatments are expected to move around among the categories with time.  The Collection 4^th Edition also includes information on assessment in order to emphasize that all clinical decisions should be made in consultation with the data.

Early Intervention Practices for Children With Autism: Descriptions From Community Providers

PubMed, Focus Autism Other Dev Disabl. 2005; 20(2): 66–79,  by A.C. Stahmer, N. M. Collings, and L. A. Palinkas

Abstract

Across the country, states are reporting increases in the number of children with autism enrolled in the education system. Although a few specific treatment methods have been established as efficacious for some children with autism in controlled settings, research examining the translation of these treatments into early intervention programs has been minimal. The current study examined provider self-reports of the use of interventions in community settings through focus groups. Providers report the use of both evidence-based and non–evidence-based techniques and indicate that they often combine and modify these techniques based on child, personal, and external factors. Few providers had a clear understanding of evidence-based practice, and all providers reported concerns about adequate training. Implications for early intervention research are discussed. (PubMed)

Click here to read the entire article at PubMed.

Characterizing Community-Based Mental Health Services for Children with Autism Spectrum Disorders and Disruptive Behavior Problems

PubMed/J Autism Dev Disord. 2010 October; 40(10): 1188–1201. Published online 2010 March 4.

Abstract

This study describes the characteristics of children with autism spectrum disorders (ASD) with disruptive behavior problems served in community-based mental health clinics, characterizes psychotherapy process and outcome, and examines differences between children with ASD and a non-ASD comparison group. Results indicate that children with ASD served in this setting are high functioning and diagnostically complex. Certain research-based behavioral and cognitive behavioral psychotherapeutic strategies were observed frequently, while parent training strategies and active teaching strategies were observed less frequently. The intensity or thoroughness with which strategies were pursued was relatively low. Outcome analyses indicate improvement in child symptoms and family functioning. Treatment delivery and outcome were similar for children with and without ASD. These findings represent the first detailed observational data characterizing community-based mental health services for children with ASD.

Child Care Problems and Employment Among Families With Preschool-Aged Children With Autism in the United States

PEDIATRICS, Vol. 122 No. 1 July 2008, pp. e202-e208; Guillermo Montes, Jill S. Halterman; Children's Institute, Rochester, NY; Dept of Pediatrics, School of Medicine and Dentistry, University of Rochester, Rochester, NY.

 

 

Abstract

BACKGROUND. The impact of childhood autism on parental employment is largely unknown.

OBJECTIVE. The purpose of this work was to describe the child care arrangements of children with autism and to determine whether families of preschool-aged children with autism are more likely to report that child care arrangements affected employment compared with typically developing children and children at high risk for developmental problems.

METHODS. Parents of 16282 preschool-aged children were surveyed by the National Survey of Children's Health. An autism spectrum disorder was defined as an affirmative response to the question, "Has a doctor or health professional ever told you that [child] has any of the following conditions? Autism?" There were 82 children with autism spectrum disorder in the sample, and 1955 children at high risk on the basis of the Parent's Evaluation of Developmental Status. We used ² and multivariate logistic regression analyses.

RESULTS. Ninety-seven percent of preschool-aged children diagnosed with autism spectrum disorder were cared for in community settings, particularly preschool and Head Start, with only 3% in exclusive parental care. Thirty-nine percent of the parents of children with autism spectrum disorder reported that child care problems had greatly affected their employment decisions, compared with 16% of the children at high risk and 9% of those who were typically developing. In multivariate analyses, families with a child with autism spectrum disorder were 7 times more likely to state that child care problems affected employment than other families, after controlling for household and child covariates. This effect was 3 times larger than the effect of poverty.

CONCLUSIONS. Developmental problems and autism spectrum disorder are associated with higher use of child care services and higher probability that child care problems will greatly affect employment. These findings warrant evaluation of the community resources available to families with children with special needs.

To read the complete article, at PEDIATRICS, click here.