Service Delivery

Healthcare Costs of Pediatric Autism Spectrum Disorder in the United States, 2003-2015.

Zuvekas et al. (2021) · Journal of autism and developmental disorders 2021
★ The Verdict

U.S. kids with autism add about $4-5,600 a year in health-care costs—money you can cite to win funding or shape safety and medication plans.

✓ Read this if BCBAs who write funding requests or work with school-age kids in medical-home or clinic settings.
✗ Skip if Practitioners focused only on adult day programs or non-medical community skills.

01Research in Context

01

What this study did

The team looked at U.S. health-care bills for kids with autism.

They pulled 2003-2015 records on 3- to young learners.

Two counting rules were used: narrow autism only, and a wider list that added speech delay plus special-ed codes.

02

What they found

Each child with autism costs about $4,000-$5,600 extra per year.

The exact number moved a little depending on which counting rule was picked.

All figures were updated to 2018 dollars so the numbers still match today’s prices.

03

How this fits with other research

Hamama et al. (2021) extends these dollars into the teen years.

They show youth with autism keep racking up bigger mental-health and primary-care bills than peers with ADHD or typical development.

Yamashiro et al. (2019) flips the lens to adults: people with autism in disability services swallow far more psychotropic meds—likely a hidden engine behind the child price tag you see here.

Lee et al. (2008) adds another cost driver: preschoolers with autism land in the ER two to three times more often for injuries, so part of that $4-5k is probably stitches and casts.

04

Why it matters

Use the $4-5k figure when you write budget requests or justify intensive ABA to insurers.

Point out that injury prevention and medication reviews can chip away at these extra costs while you still target skill gains.

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Add a one-page cost slide to your next authorization packet: show the $4-5k baseline and note that behavior plans lowering injuries or med need can trim the bill.

02At a glance

Intervention
not applicable
Design
other
Sample size
45944
Population
autism spectrum disorder
Finding
not reported

03Original abstract

Published healthcare cost estimates for children with autism spectrum disorder (ASD) vary widely. One possible contributor is different methods of case ascertainment. In this study, ASD case status was determined using two sources of parent reports among 45,944 children ages 3-17 years in the Medical Expenditure Panel Survey (MEPS) linked to the National Health Interview Survey (NHIS) Sample Child Core questionnaire. In a two-part regression model, the incremental annual per-child cost of ASD relative to no ASD diagnosis was $3930 (2018 US dollars) using ASD case status from the NHIS Child Core and $5621 using current-year ASD case status from MEPS. Both estimates are lower than some published estimates but still represent substantial costs to the US healthcare system.

Journal of autism and developmental disorders, 2021 · doi:10.1111/j.1475-6773.2009.00995.x