On the other hand, the choice of at-home care means that someone -- usually a parent -- must be willing and able to stay at home with an autistic youngster. Obviously, this is not always an option.
Beyond the obvious and critical issue of finances, the role of stay-at-home parent to a child with autism is not for everyone. The role usually entails acting as a therapist during at least part of the day, managing your child's behaviors outside of the home while shopping and going to playgrounds and other settings, and acting as a case manager for the many therapists and doctors you may now have in your life. While some parents find this type of challenge interesting and even stimulating, others find it depressing, difficult and exhausting.
Another issue to consider is the therapy you choose for your child. Some therapies, such as Applied Behavioral Analysis (ABA), are generally given by non-parents for many hours a week. If your child is receiving ABA, then the at-home setting may not be as critical.
Developmental therapies, such as RDI, Floortime, and Sonrise, are generally given by parents in a natural setting. Specialized preschools and clinics may not even offer these programs. If you are providing a developmental therapy, then home may be your best or only option.
Of course, in most communities the stay-at-home parent need not go it alone; school districts and/or regional autism agencies offer a good deal of support as well as itinerant therapists, and autism support groups are great sources for playdates and other community opportunities. A great way to start accessing these options is to contact your local autism agency for early intervention services, and to connect with local support groups to meet other parents or caregivers like you.