1. Barrett B, Mosweu I, Jones CR, Charman T, Baird G, Simonoff E, Pickles A, Happe F, Byford S. {{Comparing service use and costs among adolescents with autism spectrum disorders, special needs and typical development}}. {Autism};2014 (Jun 9)
Autism spectrum disorder is a complex condition that requires specialised care. Knowledge of the costs of autism spectrum disorder, especially in comparison with other conditions, may be useful to galvanise policymakers and leverage investment in education and intervention to mitigate aspects of autism spectrum disorder that negatively impact individuals with the disorder and their families. This article describes the services and associated costs for four groups of individuals: adolescents with autistic disorder, adolescents with other autism spectrum disorders, adolescents with other special educational needs and typically developing adolescents using data from a large, well-characterised cohort assessed as part of the UK Special Needs and Autism Project at the age of 12 years. Average total costs per participant over 6 months were highest in the autistic disorder group ( pound11,029), followed by the special educational needs group ( pound9268), the broader autism spectrum disorder group ( pound8968) and the typically developing group ( pound2954). Specialised day or residential schooling accounted for the vast majority of costs. In regression analysis, lower age and lower adaptive functioning were associated with higher costs in the groups with an autism spectrum disorder. Sex, ethnicity, number of International Classification of Diseases (10th revision) symptoms, autism spectrum disorder symptom scores and levels of mental health difficulties were not associated with cost.
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2. Buescher AV, Cidav Z, Knapp M, Mandell DS. {{Costs of Autism Spectrum Disorders in the United Kingdom and the United States}}. {JAMA Pediatr};2014 (Jun 9)
IMPORTANCE The economic effect of autism spectrum disorders (ASDs) on individuals with the disorder, their families, and society as a whole is poorly understood and has not been updated in light of recent findings. OBJECTIVE To update estimates of age-specific, direct, indirect, and lifetime societal economic costs, including new findings on indirect costs, such as individual and parental productivity costs, associated with ASDs. DESIGN, SETTING, AND PARTICIPANTS A literature review was conducted of US and UK studies on individuals with ASDs and their families in October 2013 using the following keywords: age, autism spectrum disorder, prevalence, accommodation, special education, productivity loss, employment, costs, and economics. Current data on prevalence, level of functioning, and place of residence were combined with mean annual costs of services and support, opportunity costs, and productivity losses of individuals with ASDs with or without intellectual disability. EXPOSURE Presence of ASDs. MAIN OUTCOMES AND MEASURES Mean annual medical, nonmedical, and indirect economic costs and lifetime costs were measured for individuals with ASDs separately for individuals with and without intellectual disability in the United States and the United Kingdom. RESULTS The cost of supporting an individual with an ASD and intellectual disability during his or her lifespan was $2.4 million in the United States and pound1.5 million (US $2.2 million) in the United Kingdom. The cost of supporting an individual with an ASD without intellectual disability was $1.4 million in the United States and pound0.92 million (US $1.4 million) in the United Kingdom. The largest cost components for children were special education services and parental productivity loss. During adulthood, residential care or supportive living accommodation and individual productivity loss contributed the highest costs. Medical costs were much higher for adults than for children. CONCLUSIONS AND RELEVANCE The substantial direct and indirect economic effect of ASDs emphasizes the need to continue to search for effective interventions that make best use of scarce societal resources. The distribution of economic effect across many different service systems raises questions about coordination of services and sectors. The enormous effect on families also warrants policy attention.
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3. Hoffman K, Falcomata TS. {{An evaluation of resurgence of appropriate communication in individuals with autism who exhibit severe problem behavior}}. {J Appl Behav Anal};2014 (Jun 9)
We evaluated resurgence of mands exhibited by 3 individuals with autism and histories of problem behavior. The experimental conditions consisted of (a) reinforcement of a mand, (b) extinction, (c) reinforcement of a 2nd mand, and (d) extinction to test for resurgence of the 1st mand. This 4-component sequence was implemented 3 times with each participant, and resurgence occurred during 8 of 9 tests for resurgence. Results are discussed in terms of implications for the prevention of clinical relapse.
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4. Levey EJ. {{Effective Treatment Strategies for Autism During the First Five Years of Development}}. {J Am Psychoanal Assoc};2014 (Jun 9)
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5. Shattuck PT, Roux AM. {{Autism: Moving Toward an Innovation and Investment Mindset}}. {JAMA Pediatr};2014 (Jun 9)
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6. Strunk JA, Pickler R, McCain NL, Ameringer S, Myers BJ. {{Managing the Health Care Needs of Adolescents With Autism Spectrum Disorder: The Parents’ Experience}}. {Fam Syst Health};2014 (Jun 9)
Parents of adolescents with autism spectrum disorder (ASD) experience the challenges of navigating the health care system, locating information about ASD, lacking an understanding of prescribed medications, and experiencing minimal social support from health care providers. The purpose of this phenomenological study was to describe the experiences of parents who manage the health needs of an adolescent with ASD. Qualitative interviews were conducted at a university setting with 12 parents of 10 adolescents with ASD residing in Central Virginia. Data were analyzed using Moustakas’ method in which the phenomenologist asks the following questions: What are the individual’s experiences and in what context did they experience them? This study maximized credibility using 3 strategies: prolonged engagement, peer debriefing, and member checking. « Parents needing assistance » emerged as the essence of the parents’ experiences. Four themes representing the essential challenging elements of the parents’ experiences included concern with medications, frustrations with health care services, recognizing secondary health issues, and the need for resources and services. Findings of the current study revealed key factors to be considered in the development and delivery of health care for adolescents with ASD. These include creating and planning interventions for parents, sharing information about resources and services, and collaborating with others in the health care field. Additional research, both qualitative and quantitative, is needed to understand how parents and adolescents with ASD experience this transitional period. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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7. Veness C, Prior M, Eadie P, Bavin E, Reilly S. {{Predicting autism diagnosis by 7 years of age using parent report of infant social communication skills}}. {J Paediatr Child Health};2014 (Jun 9)
AIM: The aim of this study is to identify social communication skills in infancy which predict autism spectrum disorder (ASD) diagnosis by 7 years as compared with children with other developmental difficulties or typical development from within a population sample. METHODS: Children with an ASD (n = 41), developmental delay (n = 28), language impairment (n = 47) and typical development (n = 41) were drawn from a large, longitudinal community sample following children from 8 months to 7 years of age, the Early Language in Victoria Study. At 7 years of age, early social communication skills at 8, 12 and 24 months from the Communication and Symbolic Behavior Scales Infant-Toddler Checklist and the MacArthur-Bates Communicative Development Inventory: Words and Gestures were compared between groups and used to predict ASD diagnosis. RESULTS: Significant predictors of ASD diagnosis were found from 8 months, predominantly focused on gesture use and communicative behaviours, such as requesting and joint attention. While comparisons between children with ASD and children with language impairment and typical development revealed differences from 8 months of age, the developmental delay group did not differ significantly from ASD on any measure until 24 months of age. At 24 months, children with ASD had lower Communication and Symbolic Behavior Scales Use of Communication scores as compared with all other groups. CONCLUSIONS: The capacity to identify early markers of ASD should facilitate awareness of the risk of an ASD as compared with other developmental problems and point to the need for further developmental assessment, monitoring and provision of early intervention if indicated.
