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Tuesday, May 17, 2016

Autism: What Are We Spending Money On?

Yesterday, I cited a passage in The Politics of Autism: "A key question in autism policy evaluation is simple to pose, hard to answer: How do autistic people benefit?"  Indeed, uncertainty is a major theme of the book, which concludes with a call for research in what works.

The estimated annual cost of caring for individuals with autism is US$268 billion (Leigh and Du, 2015). What is this buying? Beyond a general knowledge of setting and type of service provided (e.g. educational, mental health, speech therapy, and occupational therapy), we know very little about the type and quality of interventions being delivered. For several reasons, it is imperative that we be able to accurately and efficiently characterize the treatment that children with autism receive in their communities.
  • One reason for this urgency links treatment to our basic understanding of mechanism and subtype in autism.
  • The second reason for characterizing intervention is the need to identify active mechanisms, with the goal of refining treatments (e.g. Kasari and Lawton, 2010;Schreibman et al., 2015)
  • The third reason to characterize interventions is that we can measure the quality of care individuals with autism receive.The service delivery infrastructure for individuals with autism has not kept pace with the dramatically increasing number of children diagnosed. Service providers rush to hang out shingles saying that they treat autism, but there are few licensure and credentialing practices in place.