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Early Intensive Behavioral Intervention
One of the main barriers to the
implementation of Early Intensive Behavioral Interventions (EIBI) for Autism has
been cost. Recently, researchers in Texas analyzed the overall cost
of implementing an ABA EIBI program versus the overall cost of serving a child
with Autism throughout their school years. The results were solidly in
support of EIBI saving school districts money over the long-term. Chasson, Harris, and Neely, in a recent issue of the Journal of Child and
Family Studies (2007), reported that: The financial implications of the increased prevalence of autism, though
rarely discussed, will be extremely important to society. We compared the costs
associated with 18 years of special education to the costs associated with the
implementation of an average of 3 years of Discrete Trial Training as an Early
Intensive Behavioral Intervention (EIBI) in an effort to minimize the need for
special education. Our results indicate that the state of Texas would save
$208,500 per child across eighteen years of education with EIBI. When applied to
the conservative estimate of 10,000 children with autism in Texas, the State
would save a total of $2.09 billion with EIBI. Implications for taxpayers,
policymakers, and treatment are discussed. (Abstract: Cost Comparison of Early Intensive Behavioral Intervention and
Special Education for Children with Autism, 16, 401-413) An earlier article by Jacobson, Mulick, and Green in 1998 looked at the
cost-benefit of EIBI for young children with Autism had a broader scope in its
review of overall costs. Research has shown that without effective
intervention, most people with autism and other pervasive developmental
disorders (PDD) require lifelong specialized educational, family, and adult
services, at a total cost that is estimated at upwards of $4 million per person.
The overall average savings from implementation of EIBI are estimated to range
from well over $1 million to over $2 million per individual across their life
span. Jacobson, J.W.,Mulick, J. A., & Green, G. (1998). Cost-benefit estimates for
early intensive behavioral intervention for young children with autism: General
model and single state case. Behavioral Interventions, 13,
201–226. Another report on the cost savings of implementation of EIBI comes from
Ontario, Canada. "The Cost-Effectiveness of Expanding Intensive
Behavioural Intervention to All Autistic Children in Ontario." The
increased awareness of IBI and its high program cost have made the financing of
IBI and its cost-effectiveness relevant concerns for governments. The cost
of expanding IBI to all autistic individuals (ages 2 to 5) is small (less than
10% of total costs) compared to the significant cost of educating and supporting
semi- and very dependent individuals over their lifetime. Sanober S. Motiwala, Shamali Gupta, Meredith B. Lilly, Wendy J. Ungar, Peter
C. Coyte Department of Health Policy, Management and Evaluation University of
Toronto, ON Vol.1 No.2, 2006 The Canadian government commissioned a cost-benefit analysis of providing
cash grants to parents in order for them to hire competent EIBI/ABA in-home
providers versus the direct provision of services through the provincial
government. The Auditor General’s Report [November 4, 2004] revealed the
following comparative: DSO vs. DFO Costs [Page 13 of the report] The
Governments Direct Service Option (DSO) averaged from $48 to $92 thousand per
year by providing 23 hours of services weekly. Costs per hour of
Government provided direct services was between $82.00 to $136.00 (averages at
$109). IN comparison, the cost of parents hiring professionals, the
Direct Funding Option (DFO), was from $21 to $36 thousand per year for
providing 25 hrs of services weekly. Cost per hour between $22.00 to
$32.00 (averages at $27.) This represents an average cost savings of $82 per
hour! (All figures are in Canadian Dollar amounts)
The Motiwala, Gupta, Lilly, Ungar, & Coyte article can be found online
at: http://www.hcerc.utoronto.ca/PDF/autism_healthcarePolicy.pdf |
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