A survey of out-of-pocket expenditures for children with autism spectrum disorder in Israel.

Raz et al. (2013) asked 134 Israeli parents to list every shekel they spent on ASD care. Kids were 3-11 years old. Parents wrote down therapy bills, travel, special food, and equipment for one full year.

The median family paid $4,473 out of pocket in one year. One in four paid more than $8,000. Higher costs showed up when the child had severe symptoms or when parents held college degrees.

Ouyang et al. (2014) extends these numbers. They studied US families and added kids with ASD plus intellectual disability or fragile X. Those families lost more money and jobs than ASD-only families.

Alnahdi et al. (2026) is the successor. They looked at US Medicaid teens with ASD. As the teens aged, costs shifted from therapy visits to hospital and long-term care, showing the money story keeps changing.

Drahota et al. (2008) is the predecessor. They asked US parents of preschoolers with ASD about IDEA services, not cash. Still, both papers use parent surveys to map service gaps.

If you write treatment plans, know that families may quietly carry heavy bills. Ask about money stress at every review. Offer low-cost group parent training or telehealth when you can. Help parents find state funding lists. A five-minute chat can keep a child in therapy.