Early intervention in autism

New autism research led by the Telethon Kids Institute and University of South Australia has backed the investment in early years’ intervention from an economic perspective.

The study, published this week in JAMA Network Open, evaluated the potential cost savings of a therapy for babies displaying early autism signs has predicted a three dollar return to Australia’s National Disability Insurance Scheme (NDIS) for every dollar invested in therapy.

It drew on the results of a landmark comprehensive clinical trial which reported the world’s first evidence that a therapy commenced in infancy could reduce early developmental disability to the point where a clinical diagnosis of autism in childhood was two-thirds less likely.

Now, researchers from the University of South Australia (UniSA) and Telethon Kids Institute, in partnership with the University of Manchester, La Trobe University, Griffith University and UWA, have used the trial data to model downstream cost implications for children up to 13 years of age.

By modelling downstream disability support costs to the NDIS system, they predicted that use of the iBASIS-VIPP therapy during infancy would return a net cost savings of $10,695 per child, representing a three-to-one return on investment by age 13.

Professor Andrew Whitehouse, the Director of CliniKids and Professor of Autism Research at Telethon Kids and UWA, said that as more than a third of all participants in the NDIS had an autism diagnosis the implications of these findings were enormous.

“Disability associated with autism has cost and quality of life implications for families and may result in extra government spending on areas such as health, education, disability services, and income support,” Professor Whitehouse said.

“Reducing disability associated with autism can relieve hardship to the individual, and in the process relieve costs to the individual, their family, and the broader systems that support them. At a time when NDIS sustainability is of great importance to everyone, these findings are very significant.

“[And] I want to make it crystal clear that this is about finding the best use of funds to create the best outcomes for children. This study is about how to provide the right supports to kids and families at the right time and in the right amount – when they need it.”

Lead author and health economist, UniSA’s Professor Leonie Segal, Chair of Health, Economics and Social Policy, explained that the estimated cost savings were conservative as they only covered support costs to the NDIS until a child turned 13, and did not consider cost savings to other systems such as health, education, and parental employment.

“Yet by investing in services early in life for babies showing early autism signs – and thereby reducing levels of disability – the study [still] predicted a net cost savings of $10,695 per child by age 13 years,” she said.

“The modelling also predicted that savings in support costs associated with disability would balance out therapy costs shortly after the child turned five – just four years after delivery of the therapy – and the findings clearly argue the case that investing in early support for babies represents a good investment for the whole community.”

Professor Segal pointed out that the challenge for health and disability systems globally is how to allocate finite funding to best support people with a disability, including autistic children and their families.

“Optimal resource allocation requires an understanding of the benefits versus costs of potential therapies, especially to inform at what age to provide supports,” Professor Segal said.

Professor Whitehouse noted that although autism is not typically diagnosed until three years of age, this study reinforced that pre-emptive therapies were a feasible, effective and an efficient clinical pathway.

“Therapies commencing during the first two years of life – when the initial signs of development difference are observed, and the brain is rapidly developing – can positively impact developmental outcomes,” he said.

“The discovery of therapies that reduce the disability experienced by children will often mean that that child requires fewer supports in later childhood. This is fantastic news for the child, their family and the systems that support kids and families.”