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. 2022 Jun;52(6):2627-2643.
doi: 10.1007/s10803-021-05120-7. Epub 2021 Jul 18.

Autism Tsunami: the Impact of Rising Prevalence on the Societal Cost of Autism in the United States

Mark Blaxill  1 , Toby Rogers  2 , Cynthia Nevison  3
Affiliations

Autism Tsunami: the Impact of Rising Prevalence on the Societal Cost of Autism in the United States

Mark Blaxill et al. J Autism Dev Disord. 2022 Jun.

Retraction in

Abstract

The cost of ASD in the U.S. is estimated using a forecast model that for the first time accounts for the true historical increase in ASD. Model inputs include ASD prevalence, census population projections, six cost categories, ten age brackets, inflation projections, and three future prevalence scenarios. Future ASD costs increase dramatically: total base-case costs of $223 (175-271) billion/year are estimated in 2020; $589 billion/year in 2030, $1.36 trillion/year in 2040, and $5.54 (4.29-6.78) trillion/year by 2060, with substantial potential savings through ASD prevention. Rising prevalence, the shift from child to adult-dominated costs, the transfer of costs from parents onto government, and the soaring total costs raise pressing policy questions and demand an urgent focus on prevention strategies.

Keywords: ASD prevalence; Autism spectrum disorder; Cost; Future cost projections; Time trends.

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Conflict of interest statement

CN and TR declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. MB is the CFO of the Holland Center, a public and private insurance-funded day treatment program serving children and young adults with autism.

Figures

Fig. 1
Fig. 1
Three scenarios for future growth in US severe autism prevalence, which are assumed to follow a logistic growth equation. Black squares show the California DDS 2020 ASD prevalence snapshot, which is used as the basis for the Base Case and Prevention scenarios. Gray circles show the California DDS 2014 snapshot, which is used as the basis for the Low scenario
Fig. 2
Fig. 2
Three scenarios for future growth in US total ASD prevalence, using a 2.1–3.5 range of multipliers applied to the severe prevalence curves in Fig. 1. The shaded areas reflect the uncertainty in this scalar approach of converting prevalence of severe autism from California DDS into total ASD, with the mean value shown as a solid line
Fig. 3
Fig. 3
Total cost of autism in the U.S. from 2016 through 2060, showing three scenarios for future growth in US autism prevalence. Ranges of variability around each scenario reflect uncertainty in the scalars applied to severe ASD prevalence to estimate total (severe + milder) ASD prevalence. The scalars range from 2.1 to 3.5, with the mean value shown as a solid line
Fig. 4
Fig. 4
Total cost of autism in the U.S. from 2016 through 2060, broken down by cost category, comparing Base Case (left) and Prevention (right) scenarios, assuming a mean total/severe ASD ratio of 2.8 (mean of full 2.1–3.5 range shown in Fig. 3). Top row shows costs in absolute inflation-adjusted dollars. Bottom row shows costs as percent of total
Fig. 5
Fig. 5
Total cost of autism in the U.S. from 2016 through 2060, broken down by age group, comparing Base Case (left) and Prevention (right) scenarios, assuming a mean total/severe ASD ratio of 2.8. Top row shows costs in absolute inflation-adjusted dollars. Bottom row shows costs as percent of total
See this image and copyright information in PMC

References

    1. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). American Psychiatric Association.
    1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.
    1. Bertrand J, Mars A, Boyle C, Bove F, Yeargin-Allsopp M, Decoufle P. Prevalence of autism in a United States population: The Brick Township, New Jersey, investigation. Pediatrics. 2001;108(5):1155–1161. doi: 10.1542/peds.108.5.1155. - DOI - PubMed
    1. Blaxill MF. What's going on? The question of time trends in autism. Public Health Reports. 2004;119(6):536–551. doi: 10.1016/j.phr.2004.09.003. - DOI - PMC - PubMed
    1. Blumberg SJ, Bramlett MD, Kogan MD, Schieve LA, Jones JR, Lu MC. Changes in prevalence of parent-reported autism spectrum disorder in school-aged US children: 2007 to 2011–2012. National Health Statistic Report. 2013;65:1–11. - PubMed

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