The economic costs and its predictors for childhood autism spectrum disorders in Ireland: How is the burden distributed?
Irish families pay twice what the state pays for autism services, and severity only raises the family bill.
01Research in Context
What this study did
Roddy et al. (2019) asked Irish parents to list every euro they spent on autism care in one year.
They also collected what the state paid for the same children.
Families noted therapy, transport, special diets, and lost wages.
What they found
Parents paid about €28,000 per child.
The state paid about €14,000—half as much.
When autism traits were more severe, the family bill rose, but the state cost stayed flat.
How this fits with other research
Sakhardande et al. (2026) used the same survey style in urban India. They found 71% of families spent over 10% of monthly income on care, showing the Irish pattern repeats in lower-income settings.
Raz et al. (2013) asked Israeli parents and saw a median out-of-pocket bill of $4,473—far below the Irish total—yet still a heavy load, proving the problem is global.
Goodwin et al. (2012) looked at US states, not single families. States that spent more Medicaid dollars per child cut family costs—evidence that higher state share can lighten the parent load, the opposite of what Ireland shows today.
Why it matters
You now have hard numbers to show funders: families carry twice the cost burden.
Use this fact when you write grant budgets or ask school districts to cover more therapy hours.
If you serve immigrant families, note the India and Israel data—cost pain crosses borders, so link them to charity funds or Medicaid waivers early.
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02At a glance
03Original abstract
Autism spectrum disorders are associated with a substantial economic burden; although little is known about the relationship between state and family out-of-pocket expenditure. The objective of this study is to estimate the societal cost of childhood autism spectrum disorders and explain the variation in costs between state and family out-of-pocket expenditure. A bottom-up prevalence based cost-of-illness methodology was implemented using data from a combination of multiple convenience samples in Ireland of 195 parents of 222 children aged between 2 and 18 years of age with a clinically diagnosed autism spectrum disorder collected in 2014/2015. The findings show the average annual cost per child for families amounted to €28,464.89 related to private autism spectrum disorder services, lost income and informal care. By comparison, annual state expenditure per child on autism spectrum disorder-related health, social and educational resources was €14,192. Regression analyses indicate that autism spectrum disorder severity is significantly associated with higher out of pocket expenditures but not state health expenditures. The results suggest that parents are central to meeting the needs of young people with autism spectrum disorders in Ireland. Policy implications of these findings suggest that significant investment and commitment is needed to address the needs of individuals living with autism spectrum disorders and their families.
Autism : the international journal of research and practice, 2019 · doi:10.1177/1362361318801586