Study: How eliminating wait time for autism treatment leads to better outcomes and saves money

Parents of children with Autism Spectrum Disorder (ASD) face many challenges, but one of the biggest challenges Canadian families face are the long wait times for treatment. In a new study published in the journal JAMA Pediatrics on Monday, researchers have found that eliminating these wait times would be a win-win solution for both families and health care costs. Timely treatment, they found, doesn’t just have long-term benefits for the child, it’s also more cost-effective for taxpayers.

Conducted by Holland Bloorview Kids Rehabilitation Hospital, the Children’s Hospital of Eastern Ontario, and University of Toronto, the study is the first of its kind to analyze the costs behind wait times for the government-funded intensive behavioural intervention (IBI), which provides 20 to 40 hours of therapy to kids with severe autism each week. The researchers found that starting treatment immediately after diagnosis resulted in $53,000 in savings in social services costs for the province for each person with ASD over their lifetime. These social services include income support and other supports for people with developmental disabilities. They also found that removing wait times would save society $267,000 per person with ASD over their lifetime, as the child would have a higher probability of living independently as a result of the early treatment.

“This analysis reinforces that investing in timely access to IBI improves outcomes for children with ASD,” says Melanie Penner, senior author of the study and developmental pediatrician at Holland Bloorview Kids Rehabilitation Hospital. “These benefits are in turn shared by governments and society, showing that we all benefit when people with ASD and their families do well.”

The researchers looked at Ontario data from 2012. That year there were 1,700 kids in the province waiting for treatment. The researchers found that if those 1,700 kids had received treatment, it would have saved the province $90.1 million with costs associated to health and social services and $454.4 million with costs that dealt with caregiving, lost wages and productivity loss. While previous research has highlighted the importance of early access to autism interventions, this study factored in the amount of time kids have to wait in order to receive IBI as well as the gains they were expected to make from the treatment.

In June, Michael Coteau, Minister of Children and Youth Services, announced that the Ontario government would be backtracking on the age restriction of five years old and older imposed for IBI treatment, now making it available for kids until they are 18. As part of this program, the government will also be investing $200 million over the next four years in addition to the original $330 million they had proposed over the next five years. An estimated one in 94 Canadian children is living with ASD.

But despite the government extending the age limit to 18, there’s no guarantee kids with ASD will receive the treatment in time, which adds to the frustration for families waiting for ASD services. “It was these experiences that inspired me to do this work,” says Penner. According to the study, the wait time for IBI in Ontario around is about 2.7 years.

“These wait times occur after families have spent months waiting to obtain the ASD diagnosis,” says Penner. “And that adds to the sense of urgency in accessing early intervention.”

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