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Dear Autism Daily Newscast,

We at the Association for Science in Autism Treatment (ASAT) would like to applaud you for your recent article which highlighted an important study by Drs. Leigh and Du regarding the financial projections of caring for individuals diagnosed with autism spectrum disorder (ASD), if effective interventions and/or preventative treatments are not identified and made available. ASAT supports the use of evidence-based treatments for the ASD population, such as applied behavior analysis (ABA). ABA has nearly five decades of research to support its use with individuals with ASD and many studies have shown that it can increase appropriate behaviors and teach new skills (National Autism Center, 2015; Wong et al., 2014, 2015). However, ABA information and services are not always easily accessed when families must sift through myriad advertised treatments on the Internet and in the media, and navigate through insurance companies, medical doctors and therapists.

As you point out, the authors of the study, published in the Journal of Autism and Developmental Disorders, found that the “comprehensive costs of ASD will range from $162 to $367 billion for 2015…and from $276 billion to $1 trillion…for 2025.” These estimates are staggering, and it is interesting that the authors compare ASD to three well defined and researched conditions—stroke, hypertension and diabetes. If appropriate lifestyle and treatment protocols are followed with these conditions, they can be largely controlled. Despite the fact that autism ranges in severity across individuals (and therefore the specific needs of those diagnosed varies significantly), Leigh and Du’s report indicates that ASD is not given equivalent medical attention and research funds offered to these other conditions. We strongly concur with the authors’ recommendation to increase the research investment in ASD at least equal to that for diabetes, as they conjecture that this will help reduce these large cost estimates.

We echo Dr. Leigh’s hopes that the findings of their study will inspire policy changes that “emphasize early intervention to reduce ASD symptoms,” as early intervention is well supported by a body of literature (Reichow, 2012) and is recognized by the Center for Disease Control (2014). Additionally, we, too, hope to see policy changes that promote “employment and other programs that support the independence of adults with the disorder.” The need for such changes is clear, as ABA may produce large gains in development and reductions for the need for special services (Reichow, 2012); thereby decreasing the cost estimates proposed by the authors. However, large studies with strong experimental designs are needed to confirm the results reported for intensive, early intervention.

Future articles on autism, its financial implications and funding could be improved by including information on evidence-based treatments, such as applied behavior analysis. Thousands of long-standing research studies have demonstrated the effectiveness of ABA-based interventions to not only increase behaviors and teach new skills as previously mentioned, but also remediate social and language impairments, as well as help individuals make sustained gains in IQ, academic performance, and adaptive skills (Carr & LeBlanc, 2007; Myers & Johnson, 2007; Munshi, Gonzalez-Heydrich, Augenstein, & D’Angelo, 2011), and reduce problem behaviors (Horner, Carr, Strain, Todd, & Reed, 2002). By including this information in your future stories, you may assist readers in developing a more comprehensive view of autism and autism treatment, thereby potentially creating more savvy consumers.

Thank you again for providing coverage of an essential topic related to autism treatment. As a society that is confronted with many diseases, disorders, and illnesses, we are constantly wrestling with how to best allocate our financial resources. Perhaps because ASD is not a life-threatening disorder, the urgency for research funding has been sadly not forthcoming. In closing, we commend you for shining a light on the potential costs of ASD if, as a culture, we do not adopt a proactive rather than a reactive approach.

Franca Pastro, BA and Elizabeth G. Callahan, MA, BCaBA
Association for Science in Autism Treatment

References

Carr, J. E., & LeBlanc, L. A. (2007). Autism spectrum disorders in early childhood: An overview for practicing physicians. Primary Care: Clinics in Office Practice, 34, 343-359.

Horner, R. H., Carr, E. G., Strain, P. S., Todd, A. W., & Reed, H. K. (2002). Problem behavior interventions for young children with autism: A research synthesis. Journal of Autism and Developmental Disorders. 32, 423-446.

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Myers, S. M., Johnson, C. P., & American Academy of Pediatrics Council on Children With Disabilities. (2007). Management of children with autism spectrum disorders. Pediatrics,120, 1162-1182.

Munshi, K. R., Gonzalez-Heydrich, J., Augenstein, T., & D’Angelo, E. J. (2011). Evidence-based treatment approach to autism spectrum disorders. Pediatric Annals, 40, 569-574. National Center for Complementary and Alternative Medicine (2000). Expanding horizons of healthcare: Five year strategic plan 2001-2005. Washington, D.C.: U.S. Department of Health and Human Services.

National Autism Center. (2015). Findings and conclusions: National standards project, phase 2. Radolph, MA: Author.

Reichow, B. (2012). Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42, 512-520.

Wong, C., Odom, S. L., Hume, K. Cox, A. W., Fettig, A., Kucharczyk, S., … Schultz, T. R. (2014). Evidence-based practices for children, youth, and young adults with Autism Spectrum Disorder. Chapel Hill: The University of North Carolina, Frank Porter Graham Child Development Institute, Autism Evidence-Based Practice Review Group.

Wong, C., Odom, S. L., Hume, K. A., Cox, C. W., Fettig, A., Kurcharczyk, S., et al. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders. Advance online publication. doi: 10.1007/s10803-014-2351-z.

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