Synergies was engaged by the AEIOU Foundation for Children with Autism to assess the impact of providing good practice Early Intervention (EI) to children with autism, focusing on those children with moderate to severe autism. The aim of the advice was to assess what level of funding is required for the delivery of good practice EI and whether that level is met by the funding made available for small group interventions by the National Disability Insurance Agency (NDIA). In doing so, the advice sought to support AEIOU’s advocacy on the provision of good practice, high quality EI to children with autism, including the provision of adequate funding by the NDIA to support to accredited providers of these services.
Autism is a lifelong disorder that has a major impact on quality of life, with the majority of adults with autism unable to live independently or participate in the workforce. Effective EI is widely recognised, including by the NDIA, as being critical to improving outcomes for individuals with autism.
However, mainstream childcare settings are not conducive to the provision of good practice EI to children with moderate to severe autism. Where intervention is delivered in this environment, as is proposed under the NDIA’s Early Childhood Early Intervention framework, shortfalls in adequate staffing, training and expertise are likely to prevent EI from being provided in a manner that is consistent with good practice guidelines, threatening developmental outcomes for children with moderate to severe autism.
Whilst there is some evidence of effective provision of EI in mainstream settings to children with autism, improvement was only demonstrated in children with mild to moderate autism and without intellectual impairment. The application of the NDIA’s model to children with moderate to severe autism is inconsistent with the body of evidence which indicates that this is likely to result in sub-optimal outcomes for children and their families, in addition to posing a considerable risk to their typically developing peers and childcare professionals.
To avoid these adverse outcomes, an appropriate level of funding is needed to support the adequate delivery of EI to children with autism in an accredited environment.
In order to achieve this objective for children with moderate to severe autism, EI services need to be provided in an autism-specific environment that enables highly trained and experienced staff to deliver evidence-based practices commensurate with the good practice guidelines. Synergies investigated what level of funding is required for the effective delivery of these services and whether that level of funding was available through NDIA.
We found that the costs of delivering AEIOU’s program were consistent with the price for the NDIA line item for specialised group early childhood interventions. This service involves the provision of group-based interventions with a maximum child to staff ratio of 4:1.
Enabling children with autism to participate in an inclusive society through improved social behaviour, better education and employment outcomes and increased living independence is the ultimate goal of the provision of EI to children with autism.
In 2013, Synergies Economic Consulting conducted a cost-benefit analysis on the provision of good practice EI to a cohort of children with autism, with the cohort being broken down into three groups – children with severe autism; children with moderate autism; and children with High Functioning Autism.
Based on an update of this analysis, the net economic benefit of providing good practice EI to children in the moderate and severe cohorts was estimated at $1.15 million and $1.25 million per child respectively. These results reflect the quantum of the cost savings, both for the individual and the wider community, that are achievable through the provision of good practice EI to children with moderate to severe autism.
Based on our analysis of the cost of providing good practice, effective EI to children with moderate to severe autism under the NDIS and the associated benefits, we recommended that the NDIA line item for specialised group early childhood interventions be applied to accredited service providers of good practice EI to children with moderate to severe autism.