An Economic Evaluation of Emerging and Ineffective Interventions: Examining the Role of Cost When Translating Research into Practice

Abstract

Schools bear the burden of funding the majority of the services received by children with autism spectrum disorder (ASD) with the assumption that spent resources will result in meaningful positive outcomes for these students. Interventions lacking empirical support remain popular in schools despite lacking or limited evidence that students will experience positive outcomes. Economic evaluation methods provide a useful method of understanding the time and financial influences of these interventions. This study introduces a novel use of economic evaluation methods to examine the time and financial costs associated with two popular interventions lacking strong empirical evidence of effectiveness. The results of this study suggest that implementing either emerging interventions or those determined to be ineffective or harmful can pose a significant cost to schools with varying likelihood of benefit to children with ASD. Financial risk increases when implementing ineffective or harmful interventions in the form of opportunity cost. Implications and further application of these methods to research synthesis methods to better support educators selecting interventions is discussed.

Feasible Adaptation of ESDM for Statewide Implementation: A Look at Potential Effects, Implementation Conditions, and Cost

“…This extended reach of ESDM with available professionals was achieved while still ensuring children received high-quality services which that resulted in decreases in communication, social reciprocity, and peer interaction issues for children with autism. Furthermore, the relatively low per child cost (US$2,511/child) of an adapted ESDM model stands in stark contrast to other popular interventions for young children with ASD such as DIR/Floortime which carries an estimated cost of US$9,976/child (Scheibel et al, 2022). These results suggest this adaptation of ESDM may address the need for high-quality cost-efficient EIs that can be feasibly implemented without compromising effectiveness (D’Agostino et al, 2023; Vivanti & Stahmer, 2018).…”

Prelims

“…In too many instances, special education has strayed from the scientific model (to which Harden, 2021, refers) of figuring out difficult educational problems. Scheibel et al (2022) described the probable economic costs of ignoring scientific evidence, compounding the ethical and moral costs of implementing interventions that lack the support of reliable empirical evidence.…”

Unpacking the prevalence: A warning against overstating the recently narrowed gap for Black autistic youth

“…The limited representation of Black participants in intervention studies (Kasambira Fannin, 2017; Malone et al, 2022; Steinbrenner et al, 2022) may result in proliferation of service delivery methods that are applied to all autistic people, despite lack of culturally representative test samples (Mire et al, 2023), and regardless of questionable treatment effects (Crosland et al, 2013; Kazdin, 1990; Nielsen et al, 2017; Pierce et al, 2014). Because using either ineffective or unvalidated interventions for diverse populations can result in significant financial burdens and risks for schools and service providers (Scheibel et al, 2022; Vanegas et al, 2022), we thereby emphasize the need for heterogeneous samples to develop more broadly applicable evidence‐based interventions (Zamora et al, 2016).…”