Journal of the American Academy of Child & Adolescent Psychiatry
New researchCost Offset Associated With Early Start Denver Model for Children With Autism
Section snippets
Setting and Sample
ESDM is a comprehensive, naturalistic developmental behavioral intervention for infants through preschool-aged children with ASD that integrates naturalistic ABA principles with developmental and relationship-based approaches.24 In this 2-year clinical trial, postbaccalaureate paraprofessionals who were trained to provide therapy and supervised by doctorate-level clinicians delivered the intervention. In addition, parents were offered weekly or biweekly coaching sessions on the use of
Results
Sample characteristics are reported in previous studies21, 22 and were replicated in this study: The ESDM and COM groups did not differ at baseline in severity of autism symptoms, chronological age, IQ, sex, or adaptive behaviors, nor were there baseline group differences for the subgroup of children who completed the 2-year assessment.21, 22 In addition, 9 children lost to age-6 assessment and 39 children included in the sample of this study did not differ in demographic characteristics of
Discussion
In this study of the cost offsets associated with early intensive delivery of ESDM, we found that during the intervention period, children who received the ESDM had average annualized total health-related costs that were higher by about $14,000 than those of children who received community-based treatment, although this difference did not reach statistical significance. The higher cost of ESDM was partially offset during the intervention period because children in the ESDM group used fewer
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2023, Tunisie MedicaleEffects of Parent-Implemented Interventions on Outcomes of Children with Autism: A Meta-Analysis
2023, Journal of Autism and Developmental Disorders
This article is discussed in an editorial by Dr. Douglas L. Leslie on page 727.
The clinical trial was supported by National Institute of Mental Health grant U54MH066399 (Dawson, PI), which was registered at www.clinicaltrials.gov with identifier NCT00090415. Additional grants supported the long-term follow-up study (Estes, PI) funded by the National Institute of Child Health and Human Development (U19HD34565, P50HD066782, R01HD-55741), and the National Institute of Mental Health (U54MH066399). Autism Speaks also provided financial support.
Dr. Cidav conceptualized the study and its design, conducted the analyses, and drafted the initial manuscript. Dr. Munson assisted with the analyses, especially the coding of different service types, and assisted with interpretation of data. Dr. Estes oversaw original data collection for the follow-up study, and assisted with acquisition and interpretation of data. Dr. Dawson designed and oversaw the original randomized controlled trial and its data collection, and assisted with the acquisition of data and interpretation of data. Dr. Rogers provided training and consultation on the original randomized controlled trial and assisted with interpretation of data. Dr. Mandell helped draft the initial manuscript, and assisted with analysis and interpretation of data. All authors assisted with revising the manuscript for important intellectual content, gave final approval of the version to be published, and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Drs. Cidav and Munson served as the statistical experts for this research.
Disclosure: Dr. Dawson has served on the scientific advisory boards of Janssen Research and Development and Akili, Inc., as a consultant to Roche, and has received grant funding from Janssen Research and Development, LLC and PerkinElmer. She has received royalties from the sale of the Early Start Denver Model manuals, Guilford Press, and Oxford University Press. Dr. Rogers has received royalties from the sale of the Early Start Denver Model manuals. Dr. Mandell has served on the scientific advisory board of the Autism Science Foundation and serves as the editor-in-chief of Autism: The International Journal of Research and Practice, for which he receives a stipend. Drs. Cidav, Munson, and Estes report no biomedical financial interests or potential conflicts of interest.