The short answer is “very”.
The long answer is, well, long
Note – I use ASD to mean “autism spectrum disorder”.
Let’s start with therapy. I estimate the average ASD child needs Speech/Language therapy for about 5 years and Occupational Therapy for about 3 years. That is 16 “therapy years”. This is about $300K to the family or insurance. The cost to public schools is about $4K per year for 13 years. Cost in babysitters because they can’t go to a regular daycare is about $5K to 26K per year needed, perhaps for average of 10 years. Summer care would add another $5K. Increased medical care due to specialists, studies like EEGs, and lab work is about $3K for 18 years. Special programs (social groups, special schools, special camps, etc.) maybe up to $30,000 per child for 10 years. If the family has Medicaid, of course it is less for the family, but still time intensive. I’m not even accounting for ABA or other specialized interventions that are purely out of pocket. Most families are middle class and this presents a huge financial burden. Then many families have a full time parent because of the time demands, leading to lost income – maybe about $40K for 10 years. It all comes out of everyone’s pockets – through taxes, insurance premiums, or direct pay. Direct costs for the average family – close to $1 million excess cost to get the average ASD child to 18 years. There are also lost income taxes to the state and federal governments for the spouse who is not employed. Theses are all, of course, my gross estimate. While it may sound inflated to some, I think it represents most my families. Some families have more than one child on the spectrum, and many have other children with other developmental disorders (ADHD, learning disabilities, language delays, anxiety disorders, mood disorders, etc.) leading to even more costs.
In our family’s case, my husband stopped being employed when our son was 3 because of his needs. He had a great deal of therapy over the years – speech, occupational, social skills, and summer programs. He went to a specialized school for “bright children who learn differently” for 9 years. Up to now, I estimate he has cost us over $1.7 million, plus the lost tax revenues to the government. This is not all out of pocket, but the most expensive thing is the loss of my husband’s income – he was an electrical engineer in the semiconductor industry.
What is the cost if this money is not spent? All this intervention can mean the difference between an adult who can be an employed member of society or a disabled adult Dependent on the state and federal governments. The cost of that for 45 years can be from $1.3 million (residential care) to $2.2 million (jail, intense supported living, psychiatric care). The vast majority of my patients have the potential to be independent, employed adults, instead of disabled, dependent adults. Notice I assume a lifespan of only 65. If that is extended to 80, then the costs range from $1.7 to $3 million, each. Not to mention the lost contributions (and tax dollars) of this very special population.
So for each dollar spent on a child with an ASD, it saves society about $6. Yet when I remember the 3 year old who could not talk to me and I see my wonderful 18 year old who is ready to start college, every penny was worth it. I shudder to think about how he would have ended up if he had been born 30 years earlier, when he would have been dismissed as mentally retarded and we would have been urged to institutionalize him (the advice to Temple Grandin’s mother).
If we assume 1% of the pediatric population has an ASD, they will cost $3 BILLION to society without intervention. And I’ll bet this is a low estimate. The next time someone complains about how your child costs so much to society, remember these numbers!