The Economic Costs of Autism Spectrum Disorder: A Literature Review

Abstract

Autism is associated with a range of costs. This paper reviews the literature on estimating the economic costs of autism spectrum disorder (ASD). More or less 50 papers covering multiple countries (US, UK, Australia, Canada, Sweden, the Netherlands, etc.) were analysed. Six types of costs are discussed in depth: (i) medical and healthcare service costs, (ii) therapeutic costs, (iii) (special) education costs, (iv) costs of production loss for adults with ASD, (v) costs of informal care and lost productivity for family/caregivers, and (vi) costs of accommodation, respite care, and out-of-pocket expenses. A general finding is that individuals with ASD and families with children with ASD have higher costs. Education costs appear to be a major cost component for parents with children with ASD.

This is a preview of subscription content, log in to check access.

Notes

  1. 1.

    Alternatively, one could opt to include the individual diagnostic labels [autistic disorder, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS), and Asperger syndrome] in the search process.

  2. 2.

    In the transformation of the cost figures, reported cost figures were first inflated to the year 2018. Subsequently, inflated cost figures were all converted to US $ thereby adopting the conversion rate as on 1 January 2018 (£1.00 = $1.3491 US, €1.00 = $1.20 US, $1.00 Canadian = $0.800961 US, $1.00 Australian = $0.788955 US).

  3. 3.

    For North America, Payakachat et al. (2018) found an increase in the use of treatment services for individuals with ASD, with the top three of the most frequently received services including speech therapy (67%), occupational therapy (50%) and behavioural therapies/services (28%) such as ABA, Lovaas therapy, (Early Start) Denver Model, and Discrete Trial Training (DTT).

  4. 4.

    In a sensitivity analysis carried out to address uncertainty and lack of good evidence for IBI efficacy, Motiwala et al. (2006) also tested more optimistic and pessimistic efficacy rates for IBI. Based on these parameter settings, Motiwala et al. (2006) obtained estimates of savings that are lower than the figures reported by Chasson et al. (2007) (i.e., between 34.479 and 53.720 Canadian $ per individual vs. 208,500 US $ per child as in Chasson et al. 2007).

  5. 5.

    Several cost-effectiveness analysis studies showed that offering EIBI during the first years of childhood results, on average, in cost savings during a lifetime (e.g., Butter et al. 2003; Chasson et al. 2007; Cidav et al. 2017; Peters-Scheffer et al. 2012).

  6. 6.

    It is discussed in the literature (e.g., Garber and Phelps 1997) that ICERs can be useful as a decision rule in resource allocation particularly for making decision about (relatively new) intervention and/or therapy programmes that are costly but generate improved effects over time. ICERs can be compared with an a priori established cost-effectiveness threshold (i.e., willingness-to-pay value per unit of effect) in order to decide whether the new intervention is an efficient use of resources.

  7. 7.

    Amendah et al. (2011) found that residential schools are more common for children with ASD in Sweden compared to children with ASD in the US.

  8. 8.

    Lavelle et al. (2014) provided detailed estimations of ASD-related education costs by distinguishing between eleven mutually exclusive school placement categories for children with ASD based on type of school (public, private day, residential, home and other), type of classroom (special or general education) and age [preschool age (3- to 4-year olds) or school age (5- to 17-year olds)]. The (regression-based) analysis revealed large different estimates of education costs for children with ASD depending on the type of school placement category the child with ASD attended. Based on the cost estimates, Lavelle et al. (2014) concluded that education was the biggest cost category in the total cost for children with ASD.

  9. 9.

    It is important to note that Ganz (2007) assumed that the cost of lost productivity for individuals with ASD and additional learning disabilities was assumed to be zero. The authors emphasized that this cost figure of zero did not correspond to the real cost figure but was merely due to a lack of available information.

  10. 10.

    Based on findings of previous studies, Järbrink and Knapp (2001) assumed that individuals with high functioning ASD work in low-skilled, low-paid jobs, often despite a high level of education. For this group, the cost of lost productivity was estimated based on gross wages according to the human capital method (Järbrink and Knapp 2001, p. 9).

  11. 11.

    Similar time loss figures were found by Järbrink (2007) for Sweden, with parents reporting that they spend on average 977 h per year on caring for their child with ASD.

  12. 12.

    In another cost estimation study for the UK, Knapp et al. (2009) reported similar percentages, i.e. a higher percentage of adults with ASD and intellectual disabilities living in supported living accommodation (7% vs. 5%), in residential care (52% vs. 16%), and in a hospital (6% vs. 0%) as compared to adults with ASD, yet, without intellectual disabilities (Knapp et al. 2009, p. 320).

  13. 13.

    Another possible reason for the cross-country differences in ASD-related costs are the differences in ethno-racial and demographical diversity across countries. For instance, Shattuck et al. (2012) provided empirical evidence which suggests the presence of racial and/or demographical disparities in access to health services across a wide range of health conditions and service systems.

  14. 14.

    With efficiency we refer to the link between inputs and outputs of ASD services (e.g., how do the resources invested in the organization and implementation of EIBI programmes relate to the number of young children with ASD effectively being able to enter in such programmes), whereas with effectiveness we refer to the link between the outputs and the outcomes of ASD services [e.g., how does the number of people being provided with the organized EIBI programme relate to the total number of dependency-free life years (DFLYs) generated by this programme].

  15. 15.

    A linear regression analysis revealed that the cross-state variation in the administrative prevalence of ASD relate to characteristics of the education and health system with the administrative prevalence of ASD being positively associated with education-related spending as well as the number of paediatricians and the number of school-based health centers in the state.

  16. 16.

    As a possible explanation for this higher cost figure, Cimera and Cowan (2009) pointed out that the proportion of individuals with ASD is small (0.55% in 2006) in the overall vocational rehabilitation population. Vocational rehabilitation counsellors might thus be unfamiliar with the ASD population and their unique needs. This could result in a ‘trial and error’ method of providing services” (Cimera and Cowan 2009, p. 298), which increases the cost of vocational rehabilitation.

References

  1. Amendah, D., Grosse, S. D., Peacock, G., & Mandell, D. S. (2011). The economic costs of autism: A review. In D. Amaral, D. Geschwind, & G. Dawson (Eds.), Autism spectrum disorders (pp. 1347–1360). Oxford: Oxford University Press.

    Google Scholar 

  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5 ® ). American Psychiatric Publ.

  3. ASDEU. (2018). Autism spectrum disorders in the European Union—ASDEU. Summary of Report WP1. Task 1.2 Burden of ASD and Task 1.3 Cost of ASD screening. http://asdeu.eu/.

  4. Atladóttir, H. Ó., Parner, E. T., Schendel, D., Dalsgaard, S., Thomsen, P. H., & Thorsen, P. (2007). Variation in incidence of neurodevelopmental disorders with season of birth. Epidemiology, 18(2), 240–245.

    PubMed  Article  Google Scholar 

  5. Baio, J., Wiggins, L., Christensen, D. L., et al. (2018). Prevalence of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveillance Summary, 67(No. SS-6), 1–23. https://doi.org/10.15585/mmwr.ss6706a1.

    Article  Google Scholar 

  6. Baird, G., Simonoff, E., Pickles, A., Chandler, S., Loucas, T., Meldrum, D., et al. (2006). Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: The Special Needs and Autism Project (SNAP). The Lancet, 368(9531), 210–215.

    Article  Google Scholar 

  7. Bambha, K., & Kim, W. R. (2004). Cost-effectiveness analysis and incremental cost-effectiveness ratios: Uses and pitfalls. European Journal of Gastroenterology and Hepatology, 16(6), 519–526.

    PubMed  Article  Google Scholar 

  8. Barrett, B., Byford, S., Sharac, J., Hudry, K., Leadbitter, K., Temple, K., et al. (2012). Service and wider societal costs of very young children with autism in the UK. Journal of Autism and Developmental Disorders, 42(5), 797–804.

    PubMed  Article  Google Scholar 

  9. Barrett, B., Mosweu, I., Jones, C. R. G., Charman, T., Baird, G., Simonoff, E., et al. (2015). Comparing service use and costs among adolescents with autism spectrum disorders, special needs and typical development. Autism: The International Journal of Research and Practice, 19(5), 562–569.

    Article  Google Scholar 

  10. Bouder, J. N., Spielman, S., & Mandell, D. S. (2009). Brief report: Quantifying the impact of autism coverage on private insurance premiums. Journal of Autism and Developmental Disorders, 39(6), 953–957.

    PubMed  PubMed Central  Article  Google Scholar 

  11. Buescher, A. V. S., Cidav, Z., Knapp, M., & Mandell, D. S. (2014). Costs of autism spectrum disorders in the United Kingdom and the United States. JAMA Pediatrics, 168(8), 721–728.

    PubMed  Article  Google Scholar 

  12. Butter, E. M., Wynn, J., & Mulick, J. A. (2003). Early intervention critical to autism treatment. Pediatric Annals, 32(10), 677–684.

    PubMed  Article  Google Scholar 

  13. Chasson, G., Harris, G., & Neely, W. (2007). Cost comparison of early intensive behavioral intervention and special education for children with autism. Journal of Child and Family Studies, 16(3), 401–413.

    Article  Google Scholar 

  14. Cidav, Z., Lawer, L., Marcus, S. C., & Mandell, D. S. (2013). Age-related variation in health service use and associated expenditures among children with autism. Journal of Autism and Developmental Disorders, 43(4), 924–931.

    PubMed  PubMed Central  Article  Google Scholar 

  15. Cidav, Z., Marcus, S. C., & Mandell, D. S. (2012). Implications of childhood autism for parental employment and earnings. Pediatrics, 129(4), 617–623.

    PubMed  PubMed Central  Article  Google Scholar 

  16. Cidav, Z., Munson, J., Estes, A., Dawson, G., Rogers, S., & Mandell, D. S. (2017). Cost offset associated with early start denver model for children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 56(9), 777–783.

    PubMed  Article  Google Scholar 

  17. Cimera, R. E., & Burgess, S. (2011). Do adults with autism benefit monetarily from working in their communities? Journal of Vocational Rehabilitation, 34(3), 173–180.

    Google Scholar 

  18. Cimera, R. E., & Cowan, R. J. (2009). The costs of services and employment outcomes achieved by adults with autism in the US. Autism: The International Journal of Research and Practice, 13(3), 285–302.

    Article  Google Scholar 

  19. Cohen, D. J., & Reynolds, M. R. (2008). Interpreting the results of cost-effectiveness studies. Journal of the American College of Cardiology, 52(25), 2119–2126.

    PubMed  PubMed Central  Article  Google Scholar 

  20. Croen, L. A., Najjar, D. V., Ray, T., Lotspeich, L., & Bernal, P. (2006). A comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health plan. Pediatrics, 118(4), e1203–e1211.

    PubMed  Article  Google Scholar 

  21. Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., et al. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: Evidence from a US cross-sectional study. PLoS ONE, 5(7), e11551.

    PubMed  PubMed Central  Article  Google Scholar 

  22. Eldevik, S., Hastings, R. P., Hughes, J. C., Jahr, E., Eikeseth, S., & Cross, S. (2009). Meta-analysis of early intensive behavioral intervention for children with autism. Journal of Clinical Child and Adolescent Psychology, 38, 439–450.

    PubMed  Article  Google Scholar 

  23. Ganz, M. L. (2007). The lifetime distribution of the incremental societal costs of autism. Archives of Pediatrics and Adolescent Medicine, 161(4), 343–349.

    PubMed  Article  Google Scholar 

  24. Garber, A. M., & Phelps, C. E. (1997). Economic foundations of cost-effectiveness analysis. Journal of Health Economics, 16(1), 1–31.

    PubMed  Article  Google Scholar 

  25. Hodgetts, S., Zwaigenbaum, L., & Nicholas, D. (2015). Profile and predictors of service needs for families of children with autism spectrum disorders. Autism: The International Journal of Research and Practice, 19(6), 673–683.

    Article  Google Scholar 

  26. Holland, C. D. (2010). Autism, insurance, and the idea: Providing a comprehensive legal framework. Cornell Law Review, 96(6), 1253–1282.

    Google Scholar 

  27. Horlin, C., Falkmer, M., Parsons, R., Albrecht, M. A., & Falkmer, T. (2014). The cost of autism spectrum disorders. PLoS ONE, 9(9), e106552.

    PubMed  PubMed Central  Article  Google Scholar 

  28. Hughes, J. R. (2009). Update on autism: A review of 1300 reports published in 2008. Epilepsy and Behaviour, 16(4), 569–589.

    Article  Google Scholar 

  29. Jacob, A., Scott, M., Falkmer, M., & Falkmer, T. (2015). The costs and benefits of employing an adult with autism spectrum disorder: A systematic review. PLoS ONE, 10(10), e0139896.

    PubMed  PubMed Central  Article  Google Scholar 

  30. Jacobson, J. W., & Mulick, J. A. (2000). System and cost research issues in treatments for people with autistic disorders. Journal of Autism and Developmental Disorders, 30(6), 585–593.

    PubMed  Article  Google Scholar 

  31. Järbrink, K. (2007). The economic consequences of autism spectrum disorder among children in a Swedish municipality. Autism: The International Journal of Research and Practice, 11(5), 453–463.

    Article  Google Scholar 

  32. Järbrink, K., Fombonne, E., & Knapp, M. (2003). Measuring the parental service and cost impacts of children with autistic spectrum disorder: A pilot study. Journal of Autism and Developmental Disorders, 33(4), 395–402.

    PubMed  Article  Google Scholar 

  33. Järbrink, K., & Knapp, M. (2001). The economic impact of autism on Britain. Autism: The International Journal of Research and Practice, 5(1), 7–22.

    Article  Google Scholar 

  34. Knapp, M., Romeo, R., & Beecham, J. (2009). Economic cost of autism in the UK. Autism: The International Journal of Research and Practice, 13(3), 317–336.

    Article  Google Scholar 

  35. Kogan, M. D., Strickland, B. B., Blumberg, S. J., Singh, G. K., Perrin, J. M., & van Dyck, P. C. (2008). A national profile of the health care experiences and family impact of autism spectrum disorder among children in the United States, 2005–2006. Pediatrics, 122(6), e1149–e1158.

    PubMed  Article  Google Scholar 

  36. Lavelle, T. A., Weinstein, M. C., Newhouse, J. P., Munir, K., Kuhlthau, K. A., & Prosser, L. A. (2014). Economic burden of childhood autism spectrum disorders. Pediatrics, 133(3), e520–e529.

    PubMed  Article  Google Scholar 

  37. Leigh, J. P., & Du, J. (2015). Brief report: Forecasting the economic burden of autism in 2015 and 2025 in the United States. Journal of Autism and Developmental Disorders, 45(12), 4135–4139.

    PubMed  Article  Google Scholar 

  38. Leslie, D. L., & Martin, A. (2007). Health care expenditures associated with autism spectrum disorders. Archives of Pediatrics and Adolescent Medicine, 161(4), 350–355.

    PubMed  Article  Google Scholar 

  39. Liptak, G. S., Stuart, T., & Auinger, P. (2006). Health care utilization and expenditures for children with autism: Data from U.S. national samples. Journal of Autism and Developmental Disorders, 36(7), 871–879.

    PubMed  Article  Google Scholar 

  40. Lokhandwala, T., Khanna, R., & West-Strum, D. (2012). Hospitalization burden among individuals with autism. Journal of Autism and Developmental Disorders, 42(1), 95–104.

    PubMed  Article  Google Scholar 

  41. Lyall, K., Croen, L., Daniels, J., Fallin, M. D., Ladd-Acosta, C., Lee, B. K., et al. (2017). The changing epidemiology of autism spectrum disorders. Annual Review of Public Health, 38, 81–102.

    PubMed  Article  Google Scholar 

  42. Mandell, D. S., Cao, J., Ittenbach, R., & Pinto-Martin, J. (2006). Medicaid expenditures for children with autistic spectrum disorders: 1994 to 1999. Journal of Autism and Developmental Disorders, 36(4), 475–485.

    PubMed  Article  Google Scholar 

  43. Mandell, D. S., & Palmer, R. (2005). Differences among states in the identification of autistic spectrum disorders. Archives of Pediatrics and Adolescent Medicine, 159(3), 266–269.

    PubMed  Article  Google Scholar 

  44. Marcus, L. M., Rubin, J. S., & Rubin, M. A. (2000). Benefit–cost analysis and autism services: A response to Jacobson and Mulick. Journal of Autism and Developmental Disorders, 30(6), 595–598.

    PubMed  Article  Google Scholar 

  45. Meltzer, D. (1997). Accounting for future costs in medical cost-effectiveness analysis. Journal of Health Economics, 16(1), 33–64.

    PubMed  Article  Google Scholar 

  46. Mendoza, R. L. (2010). The economics of autism in Egypt. American Journal of Economics and Business Administration, 2(1), 12–19.

    Article  Google Scholar 

  47. Montes, G., & Halterman, J. S. (2008). Association of childhood autism spectrum disorders and loss of family income. Pediatrics, 121(4), e821–e826.

    PubMed  Article  Google Scholar 

  48. Motiwala, S. S., Gupta, S., Lilly, M. B., Ungar, W. J., & Coyte, P. C. (2006). The cost-effectiveness of expanding intensive behavioural intervention to all autistic children in Ontario. Healthcare Policy, 1(2), 135.

    PubMed  PubMed Central  Google Scholar 

  49. Murphy, D. G. M., Beecham, J., Craig, M., & Ecker, C. (2011). Autism in adults. New biological findings and their translation implications to the cost of clinical service. Brain Research, 1380, 22–33.

    PubMed  Article  Google Scholar 

  50. Parish, S., Thomas, K., Rose, R., Kilany, M., & McConville, R. (2012). State insurance parity legislation for autism services and family financial burden. Intellectual and Developmental Disabilities, 50(3), 190–198.

    PubMed  Article  Google Scholar 

  51. Parish, S. L., Thomas, K. C., Williams, C. S., & Crossman, M. K. (2015). Autism and families’ financial burden: The association with health insurance coverage. American Journal on Intellectual and Developmental Disabilities, 120(2), 166–175.

    PubMed  Article  Google Scholar 

  52. Payakachat, N., Tilford, J. M., & Kuhlthau, K. A. (2018). Parent-reported use of interventions by toddlers and preschoolers with autism spectrum disorder. Psychiatric Services, 69(2), 186–194.

    PubMed  Article  Google Scholar 

  53. Penner, M., Rayar, M., Bashir, N., Roberts, S. W., Hancock-Howard, R. L., & Coyte, P. C. (2015). Cost-effectiveness analysis comparing pre-diagnosis autism spectrum disorder (ASD)-targeted intervention with Ontario’s autism intervention program. Journal of Autism and Developmental Disorders, 45(9), 2833–2847.

    PubMed  Article  Google Scholar 

  54. Peters-Scheffer N. (2015). Vroegtijdige gedragstherapie: een kostenplaatje. In B. E. B. M. Huskens & H. C. M. Didden (Eds.), Applied Behavior Analysis bij kinderen en adolescenten met autisme (pp. 133–147).

  55. Peters-Scheffer, N., Didden, R., Korzilius, H., & Matson, J. (2012). Cost comparison of early intensive behavioral intervention and treatment as usual for children with autism spectrum disorder in the Netherlands. Research in Developmental Disabilities, 33(6), 1763–1772.

    PubMed  Article  Google Scholar 

  56. Raz, R., Lerner-Geva, L., Leon, O., Chodick, G., & Gabis, L. V. (2013). A survey of out-of-pocket expenditures for children with autism spectrum disorder in Israel. Journal of Autism and Developmental Disorders, 43(10), 2295–2302.

    PubMed  Article  Google Scholar 

  57. Reichow, B. (2012). Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(4), 512–520.

    PubMed  Article  Google Scholar 

  58. Roleska, M., Roman-Urrestarazu, A., Griffiths, S., Ruigrok, A. N., Holt, R., Van Kessel, R., et al. (2018). Autism and the right to education in the EU: Policy mapping and scoping review of the United Kingdom, France, Poland and Spain. PLoS ONE, 13(8), e0202336.

    PubMed  PubMed Central  Article  Google Scholar 

  59. Sallows, G. O., & Graupner, T. D. (2005). Intensive behavioral treatment for children with autism: Four-year outcome and predictors. American Journal on Mental Retardation, 110(6), 417–438.

    PubMed  Article  Google Scholar 

  60. Sharpe, D. L., & Baker, D. L. (2007). Financial issues associated with having a child with autism. Journal of Family and Economic Issues, 28(2), 247–264.

    Article  Google Scholar 

  61. Sharpe, D. L., & Baker, D. L. (2011). The financial side of autism private and public costs. In M.-R. Mohammadi (Ed.), A comprehensive book on autism spectrum disorders (pp. 275–296). Rijeka: InTech.

    Google Scholar 

  62. Shattuck, P. T., Roux, A. M., Hudson, L. E., Taylor, J. L., Maenner, M. J., & Trani, J. F. (2012). Services for adults with an autism spectrum disorder. The Canadian Journal of Psychiatry, 57(5), 284–291.

    PubMed  Article  Google Scholar 

  63. Shimabukuro, T. T., Grosse, S. D., & Rice, C. (2008). Medical expenditures for children with an autism spectrum disorder in a privately insured population. Journal of Autism and Developmental Disorders, 38(3), 546–552.

    PubMed  Article  Google Scholar 

  64. Taylor, L., Brown, P., Eapen, V., Midford, S., Paynter, J., Quarmby, L., et al. (2016). Autism spectrum disorder diagnosis in Australia: Are we meeting best practice standards?. Brisbane: Autism Co-operative Research Centre.

    Google Scholar 

  65. United Nations Department of Public Information. (2015). “Employment: The Autism Advantage” in observance of World Autism Awareness Day on Thursday, 2 April 2015. https://www.un.org/en/events/autismday/events2015.shtml.

  66. Vohra, R., Madhavan, S., & Sambamoorthi, U. (2017). Comorbidity prevalence, healthcare utilization, and expenditures of Medicaid enrolled adults with autism spectrum disorders. Autism, 21(8), 995–1009.

    PubMed  Article  Google Scholar 

  67. Wang, L., Mandell, D. S., Lawer, L., Cidav, Z., & Leslie, D. L. (2013). Healthcare service use and costs for autism spectrum disorder: A comparison between Medicaid and private insurance. Journal of Autism and Developmental Disorders, 43(5), 1057–1064.

    PubMed  PubMed Central  Article  Google Scholar 

  68. Xiong, N., Yang, L., Yu, Y., Hou, J., Li, J., Li, Y., et al. (2011). Investigation of raising burden of children with autism, physical disability and mental disability in China. Research in Developmental Disabilities, 32(1), 306–311.

    PubMed  Article  Google Scholar 

  69. Young, A., Ruble, L., & McGrew, J. (2009). Public vs. private insurance: Cost, use, accessibility, and outcomes of services for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 3(4), 1023–1033.

    Article  Google Scholar 

  70. Yuen, T., Carter, M. T., Szatmari, P., & Ungar, W. J. (2018). Cost-effectiveness of universal or high-risk screening compared to surveillance monitoring in autism spectrum disorder. Journal of Autism and Developmental Disorders, 48(9), 2968–2979.

    PubMed  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Contributions

The search and the filtering of the papers for the review article was performed by JJ (under supervision and with help from NR). JJ performed the abstraction of the data from the papers. Both NR and JJ worked on the writing of the paper manuscript. JJ mainly worked on the writing of the first draft. NR considerably reworked this draft and designed the tables for the figure. The revision of the paper was done by NR.

Corresponding author

Correspondence to Nicky Rogge.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The authors declare that the writing of the paper was done in compliance with all ethical standards.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Rogge, N., Janssen, J. The Economic Costs of Autism Spectrum Disorder: A Literature Review. J Autism Dev Disord 49, 2873–2900 (2019). https://doi.org/10.1007/s10803-019-04014-z

Download citation

Keywords

  • Autism
  • Autism spectrum disorder
  • Direct costs
  • Indirect costs
  • Financial burden