Wednesday, February 4, 2009

Why Does Autism Intervention Have to be so Expensive?

We understand the negative reactions being voiced over CNN’s reported cost of $20,000 for RES-Q (Autism 911), but there is more to the story. In fact, the cost is $2500 per day and is usually completed in five days (which was the length of time for Marissa's intervention).

RES-Q is actually a very tiny part of the work we do. Out of more than 300 children we see yearly, an average of only 5 will need the intensive in-home intervention. The families who have participated in RES-Q have been able to obtain funding for the intervention through a variety of means. One of the reasons why funding agencies recognize the value of and need for this intervention is that it often means the difference between continuing to live at home vs. requiring residential placement.

We work diligently to keep costs as low as possible, but we are not willing to sacrifice the quality of services. To develop staff with the level of expertise and training that Rick has is costly. Although it might seem as simple as sending a therapist out for a few hours, there is extensive support and time behind the scenes to ensure a successful outcome for treatment. The intervention is a team effort which includes psychologists with more than 30 years of experience working with children, adolescents and adults with ASD.

Those of us who founded Autism Partnership and all of our staff members did not enter this field out of a desire to get rich. If that was the goal, we would have chosen other fields. We take seriously our commitment to helping parents and their children. We provide a variety of services including direct intervention, parent support, and consultations in schools to help teachers and school districts provide effective education. We work collaboratively with funding agencies so that parents get financial support and can afford the intervention that is so vital to their child. We also conduct low fee and free workshops, as well as writing books to help families.

Our goal in participating in the CNN report was for parents to see that there is hope, that children can change. As Marissa’s mom said, she didn’t realize that Marissa could be capable of accomplishing so much. We are thrilled that Autism Partnership was able to help Marissa and her family. It is gratifying that they are able to enjoy life in ways they thought were not possible. Children with Autism have amazing potential. Our job is showing parents and teachers how to help them achieve the high quality of life they deserve.



  1. Thanks for the clarification on the cost, RES-Q, and your agency.

    Additional thanks for the good work with and for Marissa and her family.

  2. I very much enjoyed watching the story on CNN. Keep up the good work!

  3. If this is a round-the-clock service, $2500 per day is not unreasonable. If the therapist stays at the house, they may get to sleep 8 hours, and should be paid for the remaining 16. But like most families in such crisis, there may be little sleep. But if the therapist is able to sleep (or go to a hotel), they still should be compensated for their expenses of going to the home. Further more, there is work done behind the scenes prior to acceptting a case, and most likely other staff contributing as well.

    So it you look at 24 hours for $2500, that's just a tad over $100/hr, well within the average, and perhaps even below, for these services! Even deducting the time the therpist sleeps (say 8 hours), the additional work (pre-planning before arrival, and additional staff working behind the scenes)are billable by industry standards.

    If someone paid for 24 hours/week of services for 5 weeks, they'd still end up paying about the same. And good luck finding someone to come to the home for 5 days straight. It's just a shock because it was so condensed. There is a lot of work that goes into ABA and behind the scenes data input, graphing, analysis and program planning, and the providers are entitiled to be paid for. There are many other professions that charge more that $100/hour yet don't do anything to help improve people's lives.

    While I think spacing the interventions out over time allows for deeper processing and learning, there may be other overriding variables that make that unavailable (living in an area with few providers, needing immediate crisis-oriented treatment, etc). This is a good option, and certainally not priced outside of the norm for the amount of work involved.

    ABA student/intern

  4. Why didn't this family receive intensive ABA for their daughter as a toddler? California provides for it. Sorry, but the mother seemed totally clueless. So much of that child's screaming was attention seeking and the mother fed right into it in those clips. A little too late now--how sad.

  5. I was very impressed with the coverage of RES-Q. The therapist clearly had the necessary expertise to change the child's behavior as well as, and perhaps more importantly, the family's behavior. As a parent of a child with autism I can imagine a radical change in the quality of life for that child and family. Please continue your great work.

  6. In response to Anonymous: Such harsh criticism of the parents is unjustified. Many people fail to appreciate just how profound is the effect of autism on a child’s behavior and how difficult it is to teach children a better way to respond. While the intervention strategies adopted by Rick may seem obvious and merely common sense, being able to implement them successfully often requires a very high level of expertise, far more than is reasonable to expect of parents. It would be analogous to saying I should be able to fix my own car, just read the manual.

    It would also be unfair to blame the parents for Marissa not having received intensive early intervention. For parents, identifying what intervention they should seek for their child is incredibly difficult, given the myriad options and contradictory information they encounter. And if they make the choice for ABA, there is further difficulty finding services and obtaining funding. -JM

  7. Like many others, my first reaction to the $20k price tag was disbelief... CNN only showed a few days of intervention with maybe 10 minuets of airtime.

    My second response was to find a way to help cut those costs by offering AP whatever I can. $2500/day does still seem high for therapy in general but just slightly higher than an inpatient hospital stay, with multiple patients per staff member. It depends then on how many person-hours of time are actually spent - and I can't believe that Rick is the only one with a hand in this therapy. A hospital stay can easily exceed 20k, so I find it quite believable that AP's total investment in a week's intensive therapy is > 100 person-hours.

    I was impressed in the behavior change over the five days, and hope Marissa is able to continue maturing. At this stage of her life, outward appearance of maturity is so critical that almost any amount of money is a worthwhile investment.

    Insurance companies need to include this in their coverage - it's as important as treatment for depression. On the flip side, it's more important than ever for organizations like AP to demonstrate responsible use of those funds so that insurance companies can see the justification.

  8. It is very unfortunate that so many kids are not able to receive ABA, which is clearly recommended and effective, due to parents being priced out of this intervention. It is ridiculous that one has to be either wealthy or literally go bankrupt affording this intervention for their child. Something needs to change.

  9. I fully support ABA and all that it can do, the science of it and the rich routines it provides...but it is not accesible to all the students who need it...It is a shame that our federal govermenment does not recongize this and make ABA a "required" thearpy in our school systems...much like Speech and OT...I do understand the 'complexities" and the science base...but no one should lose their house or sacrifice their standard of living to have this therapy....

  10. I had the privilege of being trained at your center about 6 years ago before moving back home to Northern Maine. I will forever be grateful for the education, information, and the knowledge I gained from that experience. While I miss the Southern California sun, and the wonderful co-workers, I am happy to be able to provide help for the children in my area at the level at which I was taught. Thank you.