Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2017 Sep;56(9):777-783.
doi: 10.1016/j.jaac.2017.06.007. Epub 2017 Jul 4.

Cost Offset Associated With Early Start Denver Model for Children With Autism

Zuleyha Cidav  1 , Jeff Munson  2 , Annette Estes  2 , Geraldine Dawson  3 , Sally Rogers  4 , David Mandell  5
Affiliations
Randomized Controlled Trial

Cost Offset Associated With Early Start Denver Model for Children With Autism

Zuleyha Cidav et al. J Am Acad Child Adolesc Psychiatry. 2017 Sep.

Abstract

Objective: To determine the effect of the Early Start Denver Model (ESDM) for treatment of young children with autism on health care service use and costs.

Method: We used data from a randomized trial that tested the efficacy of the ESDM, which is based on developmental and applied behavioral analytic principles and delivered by trained therapists and parents, for 2 years. Parents were interviewed about their children's service use every 6 months from the onset of the intervention to follow-up (age 6 years). The sample for this study consisted of 39 children with autism who participated in the original randomized trial at age 18 to 30 months, and were also assessed at age 6 years. Of this sample, 21 children were in the ESDM group, and 18 children were in the community care (COM) group. Reported services were categorized and costed by applying unit hourly costs. Annualized service use and costs during the intervention and post intervention for the two study arms were compared.

Results: During the intervention, 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. The higher cost of ESDM was partially offset during the intervention period because children in the ESDM group used less applied behavior analysis (ABA)/early intensive behavioral intervention (EIBI) and speech therapy services than children in the comparison group. In the postintervention period, compared with children who had earlier received treatment as usual in community settings, children in the ESDM group used less ABA/EIBI, occupational/physical therapy, and speech therapy services, resulting in significant cost savings in the amount of about $19,000 per year per child.

Conclusion: Costs associated with ESDM treatment were fully offset within a few years after the intervention because of reductions in other service use and associated costs.

Clinical trial registration information: Early Characteristics of Autism; http://clinicaltrials.gov/; NCT0009415.

Keywords: Early Start Denver Model; autism; cost; early intervention; use.

PubMed Disclaimer

Conflict of interest statement

Drs. Cidav, Munson, and Estes report no biomedical financial interests or potential conflicts of interest.

Comment in

  • Understanding the Costs of Autism Services.
    Leslie DL. Leslie DL. J Am Acad Child Adolesc Psychiatry. 2017 Sep;56(9):727-728. doi: 10.1016/j.jaac.2017.06.014. J Am Acad Child Adolesc Psychiatry. 2017. PMID: 28838576 No abstract available.

References

    1. Buescher A, Cidav Z, Knapp M, Mandell D. Costs of autism spectrum disorders in the United Kingdom and the United States. JAMA Pediatrics. 2014. - PubMed
    1. Barrett B, Byford S, Sharac J, Hudry K, Leadbitter K, Temple K. Service and wider societal costs of very young children with autism in the UK. J Autism Devel Disord. 2012;42:797–804. - PubMed
    1. Rogers S, Vismara L. Evidence-based comprehensive treatments for early autism. J Clin Child Adolesc Psychol. 2008;37:8–38. - PMC - PubMed
    1. Eldevik S, Hastings RP, Hughes JC, Jahr E, Eikeseth S, Cross S. Meta-analysis of early intensive behavioral intervention for children with autism. J Clin Child Adolesc Psychol. 2009;38:439–450. - PubMed
    1. Dawson G, Bernier R. A quarter century of progress on the early detection and treatment of autism spectrum disorder. Dev Psychopathol. 2013; 25:1455–1472. - PubMed

Publication types

MeSH terms