What they don't realize is that cutting these programs that are helping so many children will only come back to slap all of us in the face later. When these tens of thousands of autistic children all over the country don't receive early intervention and they reach the age of 18, the taxpayers are going to be hit with monumental costs to help the state pay for their care. We are talking trillions of dollars.Meleck is certainly not the first to make this argument - that we must pay now (for intensive early intervention) or pay later (for adult residential and care services). By comparing the costs, of, say, three years of early intervention to decades of adult care, it's easy to show that it's smarter to pay for early intervention. But only, of course, if it's also easy to show that early intervention will guarantee that no adult services will be needed.
Unfortunately, such is not the case.
Yes, it is very likely indeed that intensive early intervention (in the form of behavioral therapy, social skills therapy, speech therapy, play therapy, and so forth), to the tune of tens of thousands of dollars per year, will have a positive impact on any child with autism. Many children who receive early intervention are able to function in a typical classroom -most with accomodations and supports - for at least the first few years of elementary school.
But there is very little evidence to suggest that early intervention is the key to independent adult functioning for the majority of people with autism. A quick search of Pubmed.com (all NIH-funded papers) turned up nothing at all regarding the impact of early intervention on adult functioning. NIH itself supports the idea of early intervention, but only because it results in "improved" outcomes, and not because it results in independence for adults on the autism spectrum.
Even worse, perhaps, we don't know which children will respond to which form of early intervention - and we certainly don't know how much progress any given child will make. I've often heard doctors remark on surprisingly positive outcomes for children who seemed profoundly disabled. At the same time, I've also heard of situations in which apparently very capable children on the autism spectrum hit roadblocks or developed new issues which compromised their progress.
So, is "pay now or pay later" a reasonable argument when pushing for early intervention services? In my opinion, such an argument is jumping the gun, when there's really no solid evidence that early intervention for toddlers = independent functioning for adults. In fact, there's no guarantee that any particular intervention will lead to any particular outcome for any individual child.
Without the "pay now or pay later" argument, though, how do we justify huge public bills for early intervention? How do we know it's "worth it?" The answer, I think, won't come from a cost-benefit analysis.
When it comes to state and federal programs, an issue also is for those families that never qualified to begin with for them. Although I myself have heard often that the sooner the early intervention the better, intervention doesn’t stop there. It’s on going. There’s no evidence that says what ever age child a child begins intervention, that they wont progress if they miss that ‘magical’ age.
Our state a few years back had programs cut too, upon election of the new Gov. Of course the cuts always effect the lower income and programs for the disabled but honestly, I think what we’re going to see in this era is many things cut. The economy is in such a poor state. It’s sad when so many have to rely on state or school funded programs for intervention, but when one does the thing is at any given year they can be cut. Parents really need some sort of back up plan.
I was surprised to see that the cheap intervention was not mentioned. There was no point made of the benefit of medical intervention. Half the kids on the Autism Spectrum could be treated by their parents through diet. Diet can heal their gut thus healing such major brain injury symptoms as seizures. Your talking about in some cases saving money by removing the need for anti-seizure medicine. Without a Doctor I achieved this outcome and my child is healthy and happy.
People simpley don’t understand the full scope of this epidemic.
Patrick~ not all with autism has major brain injury or seizures. My son has neither. Some times more is needed than diet change as well. A child with delayed speech is still going to need a speech therapist, some will still need PT and OT.
I’m glad these things worked for you but for many other’s, they’ll need much more.
Patric, why do you thing autism is an epidemic?
The cost/benefit analysis of intervention vs institutionalization was done in the Reagan Era. Tens of thousands of drugged and institutionalized developmentally and mentally disabled were turned out of institutional care into community programs and onto city streets. The remedial services for those who were able, and the support services for those who never had reasonable training and remediation are researchable. Convert those expenditures to current dollar value, reflecting current cost of creating the community services, facilities, the training of attendant and local medical staff for the autism population for a normal lifetime as opposed to the more fragile previous population and it is easy to see the foolish speculation presented here is merely a rambling of one who has no sense of time and place in the greater picture of the impact of autism.
One thing we have learned in these last several weeks of financial reality checks is to dismiss those who would forestall yet another debt in favor of handing a mess to the next and subsequent generations.
“YOU” don’t have to know whether it is “worth it”…only the families and communities that would be faced with the result of yet another financial mismanagement fiasco get to make that choice – yes, even at the public expense. The C/BA is well recorded over time in the history of behavioral health services in this country and world-wide.
it may be a pay now or pay later to some, as a parent what ever i do for my son is now and every day, and that is that, if it is not now where is the chance for his future, if he can grow and maybe even go to college in his future, if it is just the slightest chance for him and others like him not all great people had great minds some just was able to stand up and be counted for what they learned to be right our country spends billions on everything in the would and leave little for the children. i work to teach my son every day if he learns one thing a day i may have to reteach him the same the next some day he may learn a hundred things a day and know it forever, would he be taught to learn as an adult if we don’t open the mind now.
Well, I don’t know what the hub bub is all about. After all, we’ve always had this many people with autism, we’ve just started realizing it better now. In fact, considering how little early intervention there was thirty years ago, one wonders why we need intervention at all?
Common sense tells us that previous generations of autistics did just fine; after all, they comprise 1% of all males of every age group. It hasn’t seemed to cause society too much trouble up until now.
Considering this, maybe we should just stop all spending on research, early intervention, and the rest.
- pD
Pd- even if you are correct that there is no “autism epidemic” (and you may well be!), many people who would now diagnosed with autism were NOT just fine in the past.
In fact, from what I’ve learned, many were institutionalized with diagnoses of schizophrenia; others were radically under-educated because they were presumed to be severely mentally retarded.
Of course, there were plenty of people who are now diagnosed with Asperger syndrome and high functioning autism who did muddle through the system without any supports. Some really did do “just fine;” others were quite traumatized as a result of the experience and wound up marginalized or coping with anxiety disorders that could have been prevented with appropriate supports.
In short, I’m not convinced that just “toughing it out” is a good choice for most people with autism diagnoses.
Lisa (autism guide)
Re: Patrick’s comment re: diet. Eating healthier will make anyone feel better and communicate and behave better.
Those with comorbid issues that can be solved by diet change will improve.
However, there is no evidence that a significantly greater number of autistics have ‘gut’ problems than the general population. My son does, and he’s seeing a gastroenterologist to look into it. Though it took quite some time to get a referral from his pediatrician. I wonder if it was because he wasn’t sure if I was asking for it because of all these reports of autism in the gut, rather than because my son does have a problem…
However, since whatever gut problem my son has (we’re waiting for test results) has not affected his activity level or his growth, I’m only going to expect to see small improvements in his behaviors after we figure out what’s wrong and change his diet. Dietary interventions should only be made with the assistance of a Dr, a Gastroenterologist or a Nutritionist. Therefore, they aren’t exactly cheap.
My son does not have seizures, however in some clinical studies, according to a professor at the UofM, there is a 30% rate of comorbid seizure disorders in children with autism. Something we definitely SHOULD research further, and also whether the seizures can trigger symptoms/make them worse, even though my son won’t be helped with such research (he doesn’t have seizures) it seems a significant percentage of children with autism would be.