Parent coaching intervention for children with suspected autism spectrum disorder: Cost analysis

Background: Parent coaching interventions for young children suspected of having autism spectrum disorder (ASD) have shown promise. The objectives were to measure the costs of parent coaching and the pre-diagnosis utilization of services and treatments related to autism and to compare costs between families who received parent coaching (PC) and those who received enhanced community treatment (ECT).Methods: This analysis was conducted prospectively alongside a randomized comparative effectiveness trial of a PC intervention in British Columbia, Canada. Twenty-four participants were randomly assigned to the PC group and received 24 weeks of coaching support and 25 participants were assigned to the ECT group. Families in both groups also received health, education and community services. Parent-reported service utilization was collected for the 6 months prior to initiation of parent coaching and for the period coinciding with receipt of one of the two interventions. Services were costed from the public payer (i.e., provincial government) and societal perspectives; the latter included out-of-pocket family costs, parental time losses due to caregiving, and public payer costs.Results: Families in the PC group used fewer services than did those in the ECT group. The estimated incremental mean cost per family over two time periods for PC compared to ECT was $2515 CAD (95% CI: -1302, 5071) from the public payer perspective and $6994 CAD (95% CI: -4395, 19,299) from the societal perspective.Conclusions: The findings can be used to inform funding and policy decision-making to enhance the treatment options available for young children awaiting an ASD diagnosis.