Thursday, October 27, 2011

Autism and ABA Translated: Jacobson, Mulick and Green 1998

The fight to ensure that children with autism disorders receive treatment for their disorders engages many different people with many different priorities.  Autism advocates do meet political leaders and civil services officials who genuinely care.  But we also encounter those whose only concern is the bottom line, the mighty dollar.  To persuade these people that autistic children deserve treatment for their autism disorders you have to speak their language.  That is exactly what Jacobson, Mulick and Green did in 1998 with their paper Cost-Benefit Estimates For Early Intensive Behavioral Intervention For Young Children With Autism-General Model And Single State Case, Behavioral Interventions, Behav. Intervent., 13, 201-226 (1998)(headnote):

"Clinical research and public policy reviews that have emerged in the past several years now make it possible to estimate the cost-bene®ts 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 e€ects, 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."

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