Sunday, April 08, 2007

In Special Autism Issue, Medical Journal Cites Economics, Early Diagnosis

Cover The American Medical Association's Archives of Pediatrics and Adolescent Medicine published a special autism edition for its April 2007 issue that includes coverage of four important issues including the costs of autism services, a simple test for early diagnosis, the influence of autistic children on the development of younger siblings and an editorial citing the benefits of early diagnosis and treatment and more.

You can find good information about the articles in this issue by going to this resources website set up for the media. With one exception, the full-text versions of the articles are available online only to subscribers or for a fee. This article provides information on two of the articles. A future post will cover more information from this journal. Here is a rundown of the two articles, starting with the piece that is available free online.

1. The Costs of Autism Cases.

Autism costs society an estimated $3.2 million per patient for medical and other services and indirect costs including lost productivity taken over life of a person with autism spectrum disorder. That's according to Boston-based researcher Michael L. Ganz of Abt Associates and Harvard School of Public Health. Ganz's projections cover the life of a hypothetical group of people, born in 2000, and diagnosed with autism in 2003, and his report projects the costs out, in real dollars to the year 2066. He notes that the costs start off very high, then taper off and then "spike again in early adulthood, due to things like adult care and lost productivity. From the press release on Ganz's report:

“Direct medical costs are quite high for the first five years of life (average of around $35,000), start to decline substantially by age 8 years (around $6,000) and continue to decline through the end of life to around $1,000,” Dr. Ganz writes. “Direct non-medical costs vary around $10,000 to approximately $16,000 during the first 20 years of life, peak in the 23- to 27-year age range (around $27,500) and then steadily decline to the end of life to around $8,000 in the last age group. Indirect costs also display a similar pattern, decreasing from around $43,000 in early life, peaking at ages 23 to 27 years (around $52,000) and declining through the end of life to $0.”

Over an individual’s life, lost productivity and other indirect costs make up 59.3 percent of total autism-related costs. Direct medical costs comprise 9.7 percent of total costs; the largest medical cost, behavioral therapy, accounts for 6.5 percent of total costs. Non-medical direct costs such as child care and home modifications comprise 31 percent of total lifetime costs.

Because these costs are incurred by different segments of society at different points in an autistic patient's life, a detailed understanding of these expenses could help planners, policymakers and families make decisions about autism care and treatment, Dr. Ganz notes. "Although autism is typically thought of as a disorder of childhood, its costs can be felt well into adulthood," he concludes.

Parents will note that Ganz concludes the results of his study suggests "that physicians and other care professionals should consider recommending that parents of children with autism seek financial counseling to help plan for the transition into adulthood."

Noted. You can see an online version of this study, "The Lifetime Distribution of the Incremental Society Costs of Autism," including statistical tables, by clicking here.

Also noted: autism costs society more than $35 billion per year in direct and indirect expenses, Ganz writes.

2. A simple, early autism test: If baby doesn't respond to name at age one, watch for diagnosis of developmental delay.

Researchers found that 12-month-olds who don't respond when their names are called "may be more likely to be diagnosed with an autism spectrum disorder or other developmental problem at age 2" -- and so pediatricians should do this simple test at one-year checkups to rule out such a diagnosis or identify children who need further monitoring.

Baby responding to her name is "one of the most consistently documented behaviors in infancy that distinguishes children later diagnosed with autism from those with typical development or developmental delays," the researchers write in this report. The driver for this study is the potential for early intervention making a real difference for children diagnosed with autism spectrum disorders. See an abstract of the study, "A Prospective Study of Response to Name in Infants at Risk for Autism," here.

Researchers at the M.I.N.D. Institute at the University of California at Davis, the University of California at Sacramento, and the University of California at Los Angeles performed the study. They looked at children who were younger siblings of children who had autism, and therefore have a risk for ASD, and a control group. At age 12 months, the researchers write, 100 percent of the control group responded on the first or second name call, while 86 percent of the children in the risk group did.

Also see: "60 Minutes" reported about the M.I.N.D. Institute research into early diagnosis. See more about that here.

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