Service Delivery

The cost-effectiveness of supported employment for adults with autism in the United Kingdom.

Mavranezouli et al. (2014) · Autism : the international journal of research and practice 2014
★ The Verdict

Supported employment for autistic adults costs only £18 per extra week worked and can save public money compared to day services.

✓ Read this if BCBAs writing adult-transition plans or pitching vocational programs to funders.
✗ Skip if Clinicians who work only with early-childhood populations.

01Research in Context

01

What this study did

Mavranezouli et al. (2014) compared two paths for autistic adults in the UK. One group used supported employment. The other used traditional day services.

The team tracked how many weeks each person worked and what taxpayers paid for housing, day care, and job help.

02

What they found

Supported employment added one extra week of work for only £18.

When the researchers counted housing and service savings, the job program cost less overall than day services.

03

How this fits with other research

Cimera et al. (2012) warned that sending adults to sheltered workshops first raises costs and lowers pay. Ifigeneia’s numbers show the same pattern: skip workshops and go straight to supported employment.

Wehman et al. (2017) later pushed the idea further. Their Project SEARCH plus ABA supports landed 90% of autistic youth in jobs. The UK study proves the money side: even modest job gains still pay for themselves.

Maddox et al. (2015) reviewed ten studies and called the evidence “small and weak.” Ifigeneia’s cost data help fill that gap by giving funders hard numbers to defend the investment.

04

Why it matters

You can now tell funders that every £18 spent on supported employment buys an extra week of work and may save money on housing and day services. Use this figure when you write transition plans or defend job-coach hours in an IEP meeting.

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Add a line to the next ITP that cites the £18 cost per extra work week when you request ongoing job-coach funding.

02At a glance

Intervention
not applicable
Design
other
Population
autism spectrum disorder
Finding
positive
Magnitude
small

03Original abstract

Adults with autism face high rates of unemployment. Supported employment enables individuals with autism to secure and maintain a paid job in a regular work environment. The objective of this study was to assess the cost-effectiveness of supported employment compared with standard care (day services) for adults with autism in the United Kingdom. Thus, a decision-analytic economic model was developed, which used outcome data from the only trial that has evaluated supported employment for adults with autism in the United Kingdom. The main analysis considered intervention costs, while cost-savings associated with changes in accommodation status and National Health Service and personal social service resource use were examined in secondary analyses. Two outcome measures were used: the number of weeks in employment and the quality-adjusted life year. Supported employment resulted in better outcomes compared with standard care, at an extra cost of £18 per additional week in employment or £5600 per quality-adjusted life year. In secondary analyses that incorporated potential cost-savings, supported employment dominated standard care (i.e. it produced better outcomes at a lower total cost). The analysis suggests that supported employment schemes for adults with autism in the United Kingdom are cost-effective compared with standard care. Further research needs to confirm these findings.

Autism : the international journal of research and practice, 2014 · doi:10.1177/1362361313505720