Evaluation of the Costs and Benefits of Early Screening for Children with Autism

Autism spectrum disorder (“autism”) is a brain disorder that results in abnormal development in social and communication skills and manifests with repetitive and obsessive behaviors, and currently affects about one in 150 children in the United States. Recent recommendations by the American Academy of Pediatrics suggest that pediatricians should start screening during well-child visits at 9, 18, 24, and 30 months. Research has shown that the benefits of early therapy include minimizing the core expressions of autism, increasing quality of life, increasing independent functioning, and decreasing family distress. Would early screening result in better outcomes? Would frequent time-series screening result in better outcomes? Here, we evaluated cost and benefits of screening for autism through a meta-analysis review and supplemented our data collection with the utilization data from Early Intervention Program at the Massachusetts State Department of Public Health. We addressed changes in specialty health services for the increased number of identified children with autism through recommended screening mechanisms. We designed a decision-analytic model that will show the different parameters affecting the benefits from early and frequent screening following these guidelines. Our results will determine whether the total cost of early interventions due to early identification of autism before 30 months of age will be more cost-effective than receiving therapy at a later age between 3-5 years of age due to late diagnosis of autism. The conclusions drawn from the cost-effectiveness analysis will identify the critical parameters affecting the cost and effectiveness in screening and treatment for children with autism.