Intensive early intervention can make a huge difference when it comes to autism.
But some insurers and state and local early-intervention programs have balked at the cost.
For years, researchers have speculated that if kids on the autism spectrum received early intervention, they would likely improve so much that they wouldn’t need as many services down the line.
And needing fewer services yields real savings, said David Mandell, director of the University of Pennsylvania’s Center for Mental Health Policy and Services Research.
Families avoid co-pays and out-of-pocket costs. School systems save because the students spend more time in mainstream classrooms. Special-education classes, he said, cost three times as much money.
Scientists believed it would take decades to realize the savings. But after analyzing data from another study in Washington state, Mandell and his team found that it didn’t take that long.
“What our study finds is that, within two years, high-quality early intervention has returned its investment in that these children are functioning well enough that they don’t need many of the expensive services that we often deliver to young children with autism,” he said.
The team calculated the savings at $19,000 annually per child in the first two years after the intervention.
When he says “high-quality early intervention,” he’s talking about the “Early Start Denver Model.” The approach, which includes a highly trained staff and also coaches parents, is evidence based. But it can cost more — about $14,000 — than early-intervention programs that run between $40,000 to $80,000 a year.
Not all early-intervention programs are created equal, he noted.
“The model is really intensive,” said Mandell, adding that a highly trained specialist works with the child for 20 to 30 hours a week.
In community-based settings, “it’s always a negotiation” about how many hours a week the child will be in the program. The Denver model also offers more staff supervision, which ensures consistency.
The approach, however, isn’t widely available. To fill the gap, Mandell suggested, community-based programs might invest in highly skilled employees. But that would depend on buy-in from payers, including early-intervention programs and insurance companies.