Wednesday, November 18, 2009

What is the cost of living with Autism?

On my Google news feed, an article series popped up regarding Autism specialty schools in New Jersey.
This is the latest in the series, but all are linked if you're curious.

The school, named the Garden School, had to fight for state approval just to stay open, and with good reason - it costs $70-80,000 per year, per child for one-on-one ABA-based education. (For those who don't know, Applied Behavioral Analysis is the only study-proven behavioral intervention method for autism spectrum diagnoses, although half a dozen others are well recommended, and are often used in combination, especially when teachers aren't specifically trained in one method).

The article was friendly and had great pictures of the twins they followed, and the school seems to have been successful thus far but I had a shock when I got to the end. One anonymous commenter asked:

"And it costs the taxpayers exactly how much to spend a dozen years to teach one of these children to sweep a floor, or empty a garbage can, or even just to sit still for five minutes?

How many normal students could be put thru medical school for that same money?

Can't p**ss money away fast enough."

So, "blogbat999". Better question: How much does it save the taxpayers to educate these children in basic life skills now, instead of paying for lifelong (70+ years) care? Someone later mentioned that cost of education was "$864,000.00, plus transportation costs." I won't count the transportation costs, because they're a fact of life for everyone with a kid and they're built into any school's budget.

Regardless of the veracity of that number, I guarantee you 12-20 years of early intervention and ABA training will cost you far less than paying for the next 50 years of welfare, disability, and state-run group care homes. This is especially the case in states like PA where Act 62 promises to make regular insurance companies pay for wraparound services (what I do is covered under wraparound). For the money-oriented, that means that taxpayers will no longer be paying so much through MH/MR and state-sponsored insurance for these kids to get the care they need (or that more kids can get the same care as before, with less taxpayer funding per child). Instead, the private insurance companies, which are businesses which have pockets far deeper than our poor state, will pick up the slack and provide a certain amount of care. On the other hand, some families may end up with a co-pay or need to apply for Medicaid to cover the rest; we will see how well things actually work.

Run the numbers any way you like; early intervention and intensive childhood care pay off as a long term investment. This is especially true for less severe cases, where early intervention can lead to a child having a successful job and living outside the home on their own, paying taxes and bills into the system and generally being useful, instead of living with parents on disability pay or being shuffled to a group care home after their parents die - or worse, developing behaviors that can end lives . Ever heard "too little, too late"? It applies to autism very well. The less and later intensive, consistent care is given, the harder it is to change behaviors and make progress. There is no reason for any parent to suffer abuse at the hands of their child, no reason for any child to be hospitalized or jailed (and run up more bills for you loving taxpayers!) when they can be diagnosed early, treated early and improve before they get too big to control.

Note that the commenter, as usual, didn't specify what to do with the kids who are currently going to the school, either. Most of them can not be mainstreamed; they'd be put into special ed classrooms or, if they're lucky, "life skills" classrooms where they'll spend the next 12 years of their academic careers in understaffed classrooms with overworked aides and one teacher (vs the one-on-one the private school can offer), where their progress won't be tracked as cleanly, their needs won't be met as consistently and they'll often be shoved into mainstream classrooms long before they're actually ready, which will strain the special ed room even further as they push aides into the classrooms with these kids to deal with the "problems" that crop up. And do you think the schools, when faced with such an influx of children from these private institutions, will simply sit back and go "ok, we need to re-balance the budget"? In your dreams, guys. More special needs students means more school funding, which comes out of... oh, hey! Your pockets. You're paying for it either way, people.

But of course; it's all about the money NOW. Never mind that an $80,000 investment in your child's future isn't really that much when you consider we pay most sports stars more than that for 30 minutes of play time when some of them have fewer skills than the average autistic kid I work with, and you're paying THAT out of pocket too if you subscribe to cable or FIOS TV, buy tickets to the game, or pay taxes which fund new sports fields. The only difference is that taxes are money we can't choose what to do with; in this case I'd much rather my portion of the state's fat pie go toward education in all its forms than to paying for a new stadium. Wouldn't you?

P.S. I'd also like to note that I find it interesting that this person equates "normal" students with med school (see Temple Grandin, who worked herself through a Ph.D), and thinks it's a fair comparison between a chosen profession and an unasked-for diagnosis, and all the costs that come with each. Please keep in mind that you can churn out all the doctors you want, but until someone finds a "cure" for autism (and I doubt many people would accept a cure anyway), you're still going to have at least 1 in 150 citizens of the United States diagnosed with autism this year (and next, and next... and the numbers keep going up!). Chances are, someone you know already has a child, sibling, or relative with the diagnosis... and they're not getting the support they need because so many of us don't want to "waste" our money. Think about that next time you whine about your taxes. Then go vote for someone who will handle the budget properly, and get your kids the education they so very much deserve.

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