Saturday, April 30, 2011
Dear Ms. Lerner:
Thank you for your recent article about autism treatment. This topic is an essential one, and as a society we do need to wrestle with important decisions about how to best allocate financial resources, particularly given the tough economic conditions facing our country.
Important conversations about autism treatment are sidetracked when journalists use sensationalism in the titles of their articles. Therefore, we take issue with your title: "Autism's $100,000 question." At first glance, the reader would be left with the misleading impression that average or typical costs are $100K per year. You later state that it could go as high as $100,000 but the norm is considerably lower.
Please know that your article may very well contribute to a child with autism being labeled "that $100,000 kid." Parents of children with autism did not choose this disability. I hope that you are not faced with autism in your own family, but if you were, I would suspect that as a journalist trained in culling facts you would be advocating for intervention that is based on the best available science.
With 400+ interventions touted to treat autism, treatments based on applied behavior analysis (ABA) are the only interventions informed and developed based upon hundreds and hundreds of research articles published in peer reviewed journals. These articles form the basis of a comprehensive treatment program that targets a full array of important areas such as social, communication, play, daily living, and cognitive skills, as well as addresses many of the behavioral concerns demonstrated by individuals with autism. Board certified behavior analysts are well trained and experienced in collecting information to objectively demonstrate the efficacy of their interventions, and to troubleshoot and modify their interventions if the data are not showing adequate improvement.
When considering costs and benefits, please bear in mind a few things:
1) Here in New Jersey, it costs $13,835 to educate each student during the 2010-2011 school year. Indeed, it costs more to educate a child with autism, but as per federal law, every child is entitled to a free, appropriate public education and the only appropriate education is one that is effective. We are not talking about elective surgery here. A healthy child's medical costs can easily fall under $1,000 per year. In contrast, the annual medical costs of a child with cancer could easily exceed $100,000. Children with more significant needs require interventions that cost more.
2) There is a tremendous amount of savings over the lifespan when children with autism receive effective treatment. If a child loses his or her diagnosis, these savings are vast and are in the millions. These children may very well become fully employable, tax-paying members of society. If a child improves considerably, it would translate into a lower allocation of special education resources and a lower need for services as an adult. These wonderful, albeit less significant, outcomes are also attached to savings over the lifespan.
3) Any discussion about autism costs should acknowledge that there are hundreds of treatments that are privately and/or publicly funded that have never been shown to be effective through published research; some of these treatments have actually been shown to be harmful.
Autism has become a multi-million dollar industry. Tax dollars are spent on treatments without any proof that that they are effective. Parents pay privately for many fringe interventions touted as "miracle cures;" some even remortgage their homes in pursuing these "treatments."
Perhaps the title of your next autism article should be: "The Million Dollar Question: Should Unsubstantiated Autism Treatment Be Funded?"
Joshua K. Pritchard, M.S., BCBA
Association for Science in Autism Treatment