In Child and Adolescent Psychiatry, Zuleyha Cidav and colleagues, including David Mandell, examine the effect of the Early Start Denver Model (ESDM) for treatment of young children with autism on health care service use and costs. ESDM is a comprehensive behavioral intervention for young children with autism that utilizes teaching strategies based on applied behavior analysis. Such early interventions have previously been associated with significant behavioral outcome improvements and long-term cost savings.
The authors find that, while ESDM is more expensive than community-based interventions up front, children who use ESDM use less applied behavioral analysis therapy, occupational or physical therapy, and speech therapy services. Children who received ESDM had annual health-related costs that were higher by abut $14,000 than those of children receiving community-based treatment, however the lower utilization of health services resulted in a post-intervention period savings of about $19,000 per year per child. The authors conclude that costs associated with ESDM were fully offset within a few years after the intervention due to reductions in other service use and associated costs.