Swipe om te navigeren naar een ander artikel
The online version of this article (doi:10.1007/s10803-015-2447-0) contains supplementary material, which is available to authorized users.
Novel management strategies for autism spectrum disorder (ASD) propose providing interventions before diagnosis. We performed a cost-effectiveness analysis comparing the costs and dependency-free life years (DFLYs) generated by pre-diagnosis intensive Early Start Denver Model (ESDM-I); pre-diagnosis parent-delivered ESDM (ESDM-PD); and the Ontario Status Quo (SQ). The analyses took government and societal perspectives to age 65. We assigned probabilities of Independent, Semi-dependent or Dependent living based on projected IQ. Costs per person (in Canadian dollars) were ascribed to each living setting. From a government perspective, the ESDM-PD produced an additional 0.17 DFLYs for $8600 less than SQ. From a societal perspective, the ESDM-I produced an additional 0.53 DFLYs for $45,000 less than SQ. Pre-diagnosis interventions targeting ASD symptoms warrant further investigation.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
Supplementary material 1 (DOC 37 kb)10803_2015_2447_MOESM1_ESM.doc
Supplementary material 2 (DOC 35 kb)10803_2015_2447_MOESM2_ESM.doc
Supplementary material 3 (DOC 89 kb)10803_2015_2447_MOESM3_ESM.doc
Supplementary material 4 (DOC 93 kb)10803_2015_2447_MOESM4_ESM.doc
Supplementary material 5 (DOC 55 kb)10803_2015_2447_MOESM5_ESM.doc
Supplementary material 6 (DOC 283 kb)10803_2015_2447_MOESM6_ESM.doc
Supplementary material 7 (DOC 88 kb)10803_2015_2447_MOESM7_ESM.doc
Supplementary material 8 (DOC 87 kb)10803_2015_2447_MOESM8_ESM.doc
Supplementary material 9 (DOC 85 kb)10803_2015_2447_MOESM9_ESM.doc
Supplementary material 10 (DOC 63 kb)10803_2015_2447_MOESM10_ESM.doc
Auditor General of Ontario. (2011). Chapter 3, section 3.14. Supportive Service for People with Disabilities. 2011 Annual report of the Office of the Auditor General of Ontario. Government of Ontario, Queen’s Park, Toronto.
Auditor General of Ontario. (2013). Ministry of Child and Youth Services: Autism services and supports for children. 2013 Annual Report of the Office of the Auditor General of Ontario (Section 3.01). Queen’s Park, Toronto.
Bank of Canada. (2014a). Annual average exchange rates. Retrieved 04/21, 2014, from http://www.bankofcanada.ca/rates/exchange/annual-average-exchange-rates/
Bank of Canada. (2014b). Inflation calculator. Retrieved 03/04, 2014, from http://www.bankofcanada.ca/rates/related/inflation-calculator/
Buescher, A., Cidav, Z., Knapp, M., & Mandell, D. S. (2014). Costs of autism spectrum disorders in the United Kingdom and the United States. JAMA Pediatrics, E1–E8 (Published online June 9, 2014).
Canadian Agency for Drugs and Technology in Health. (2006). Guidelines for economic evaluation of health technologies: Canada (3rd ed.). Ottawa: CADTH.
Canadian Institute for Health Information. (2008). The cost of acute care hospital stays by medical condition in Canada 2004– 2005. Retrieved 07/18, 2014, from https://secure.cihi.ca/free_products/nhex_acutecare07_e.pdf
Canadian Institute for Health Information. (2014). Reasons for inpatient hospitalization and surgery in Canada. Retrieved 07/18, 2014, from http://www.cihi.ca/web/resource/en/public_summary_ih_12-13_en.pdf
Drummond, M., Sculpher, M., Torrance, G., O’Brien, B., & Stoddart, G. (2005). Methods for the economic evaluation of health care programmes (3rd ed.). New York: Oxford University Press.
Dudley, C., & Emery, J. C. H. (2014). The value of caregiver time: Costs of support and care for individuals living with autism spectrum disorder. The School of Public Policy Research Papers, 7(1), 1–48.
Eldevik, S., Hastings, R. P., Hughes, J. C., Jahr, E., Eikeseth, S., & Cross, S. (2009). Meta-analysis of early intensive behavioral intervention for children with autism. Journal of Clinical Child & Adolescent Psychology, 38(3), 439–450. CrossRef
Engstrom, I., Ekstrom, L., & Emilsson, B. (2003). Psychosocial functioning in a group of Swedish adults with Asperger syndrome or high-functioning autism. Autism, 7(1), 99–110. PubMed
Farley, M. A., McMahon, W. M., Fombonne, E., Jenson, W. R., Miller, J., Gardner, M., et al. (2009). Twenty-year outcome for individuals with autism and average or near-average cognitive abilities. Autism Research: Official Journal of the International Society for Autism Research, 2(2), 109–118. CrossRef
Flanagan, H., Perry, A., & Freeman, N. (2012). Effectiveness of large-scale community-based intensive behavioral intervention: A waitlist comparison study exploring outcomes and predictors. Research in Autism Spectrum Disorders, 6, 673–682. CrossRef
Freeman, N., & Perry, A. (2010). Outcomes of intensive behavioral intervention in the Toronto preschool autism service. Journal on Developmental Disabilities, 16(2), 17–32.
Gordon, A. (2012). The autism project: Wait times. The Toronto Star. Retrieved March 4, from http://www.thestar.com/news/gta/2012/11/23/the_autism_project_wait_times.html.
Granpreesheh, D., Dixon, D., Tarbox, J., Kaplan, A., & Wilke, A. (2009). The effects of age and treatment intensity on behavioral intervention outcomes for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 3, 1014–1022. CrossRef
Howlin, P., Mawhood, L., & Rutter, M. (2000). Autism and developmental receptive language disorder—a follow-up comparison in early adult life. II: Social, behavioural, and psychiatric outcomes. Journal of Child Psychology and Psychiatry and Allied Disciplines, 41(5), 561–578. CrossRef
Howlin, P., & Moss, P. (2012). Adults with autism spectrum disorders. Canadian Journal of Psychiatry - Revue Canadienne De Psychiatrie, 57(5), 275–283. PubMed
Ontario Disability Support Program. (2013). Ontario disability support program act. Retrieved 11/29, 2013, from http://www.e-laws.gov.on.ca/html/regs/english/elaws_regs_980222_e.htm#BK6
Ontario Ministry of Child and Youth Services. (2006). Autism intervention program— Program guidelines.
Ontario Ministry of Health and Long-Term Care. (2013). Ontario health insurance plan (OHIP) schedule of benefits and fees. Retrieved 09/30, 2013, from http://www.health.gov.on.ca/english/providers/program/ohip/sob/sob_mn.html
Payakachat, N., Tilford, J. M., Kovacs, E., & Kuhlthau, K. (2012). Autism spectrum disorders: A review of measures for clinical, health services and cost-effectiveness applications. Expert Review of Pharmacoeconomics & Outcomes Research, 12(4), 485–503. CrossRef
Perry, A., Cummings, A., Dunn Geier, J., Freeman, N., Hughes, S., Managhan, T., et al. (2011). Predictors of outcome for children receiving intensive behavioral intervention in a large, community-based program. Research in Autism Spectrum Disorders, 5, 592–603. CrossRef
Rogers, S. J., & Dawson, G. (2009). Early Start Denver Model for young children with autism: Promoting language, learning and engagement. New York: The Guilford Press.
Rogers, S. J., Estes, A., Lord, C., Vismara, L., Winter, J., Fitzpatrick, A., et al. (2012). Effects of a brief Early Start Denver Model (ESDM)-based parent intervention on toddlers at risk for autism spectrum disorders: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 51(10), 1052–1065. PubMedCentralCrossRefPubMed
Rogers, S. J., Vismara, L., Wagner, A., McCormick, C., Young, G., & Ozonoff, S. (2014). Autism treatment in the first year of life: A pilot study of Infant Start, a parent-implemented intervention for symptomatic infants. Journal of Autism & Developmental Disorders, 44(12), 2981–2995. CrossRef
Statistics Canada. (2014). Average weekly earnings, health care and social assistance, by province and territory. Retrieved 07/04, 2014, from http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/health23-eng.htm
The Standing Senate Committee on Social Affairs, Science and Technology. (2007). Pay now or pay later: Autism families in crisis. Ottawa: Government of Canada.
Turygin, N., Matson, J., Williams, L., & Belva, B. (2014). The relationship of parental first concerns and autism spectrum disorder in an early intervention sample. Research in Autism Spectrum Disorders, 8(2), 53–60. CrossRef
Zegarac, G., Drewett, B., Swan, R. & Ontario Ministry of Education. (2008). Special education in Ontario— closing the gap as the overarching goal: Changing special education practice and outcomes. Retrieved 03/04, 2014, from http://www.edu.gov.on.ca/eng/research/speced_aera_csse.pdf
- Cost-Effectiveness Analysis Comparing Pre-diagnosis Autism Spectrum Disorder (ASD)-Targeted Intervention with Ontario’s Autism Intervention Program
S. Wendy Roberts
Rebecca L. Hancock-Howard
Peter C. Coyte
- Springer US