Introduction
ASD, autism, Autism, ’s social communication, Autism spectrum disorder, a disability, autistic, repetitive and sensory behaviors, disability, neurodevelopmental disability
POSITIVE, RECRUITMENT, INTERACTION
Autism spectrum disorder (ASD; autism) is the term for a neurodevelopmental disability characterized by qualitative and lifelong challenges in social interaction and communication as well as the presence of repetitive and sensory behaviors and interests.Many countries, including Australia, have reported a marked increase in ASD diagnoses over recent decades, with global prevalence estimates of 1.2% to 2%.The disability associated with ASD has cost implications for familiesA challenge for health and disability systems globally is how to apportion finite funding to best support persons with a disability, including autistic individuals, and their families. Optimization of resource allocation requires an understanding of both the efficacy and efficiency (benefits vs costs) of potential interventions, especially to inform when to intervene. The typical clinical pathway for autistic children is to commence the delivery of interventions at the time of diagnosis. Autism emerges in early development, but diagnosis mostly occurs in the late preschool years worldwide.The iBASIS–Video Interaction to Promote Positive Parenting (iBASIS-VIPP) intervention is one such preemptive approach that seeks to support infant development by using video feedback techniques to increase caregiver awareness of their infant’s social communication and to guide caregiver responses to build infant social engagement and interaction.A second trial of iBASIS-VIPPPolicy recommendations rely on a combination of evidence for efficacy and cost-effectiveness—that is, whether observed outcomes represent good value for resources allocated. Consistent with the structured approach for evaluating the iBASIS-VIPP intervention and given evidence of its efficacy and effectiveness (noting a community-based recruitment strategy through maternal and child health nurses and a child development service),The aim of this study was to assess whether iBASIS-VIPP represents an efficient use of societal resources, taking a government (insurer) third-party payer perspective and incorporating several performance measures as follows: (1) cost analysis measured by net present value (NPV), (2) cost-effectiveness analysis (cost per outcome of ASD incident cases), (3) timing of break-even cost (child age when intervention cost was matched by downstream cost savings), and (4) dollars saved per dollar invested.