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© Krantz News Service, May 22, 2016


Autism spectrum disorder (ASD) may impact the United States economy as much as the current defense budget within a decade, according to one study.

The costs involved are not just health care costs. They are the lost productivity of people with ASD who currently participate in the economy at just a fraction of their full potential. Studies show that people with ASD are a vastly untapped resource, and their underemployment is unfair both to them and their communities.

The National Center for Biotechnology Information estimated that direct medical, direct non-medical and productivity costs of ASD in the U.S. could surge to 3.6 percent of GDP in 2025, which is a slightly greater share of GDP than the World Bank's estimate for U.S. military expenditures in 2014.

States are sharpening their focus on ASD, generally starting with health care coverage, a marked change from a few years ago.

On May 5 Oklahoma became the 44th state to mandate certain health care coverage for individuals with ASD.

But as experts around the world study ASD more closely, they say the threshold issues of screening and treatment are not enough; they say society fails to see the enormous contribution people with ASD can make to the world we live in.

In the United Kingdom, for example, a May 3 question period in the House of Commons spotlighted the lack of attention to workforce issues for people with ASD.

George Freeman, Conservative MP and Minister for Life Sciences, spoke of the U.K.'s 100-million pound ($145 million) per year Access to Work program, which he said helps over 36,000 people.

At that, Lisa Cameron, Scottish National Party MP, rose and was called upon by the Speaker of the House. Dr. Cameron has been a clinical psychologist in the U.K.'s National Health Service.

"The autism employment gap is much larger than the disability employment gap, with only 15 percent in full-time employment and 26 percent of graduates remaining unemployed," she said. "We are losing the potential that people with autism spectrum disorder can offer to our economy.

"What specific programmes (programs) and support will be provided to employers and jobseekers to close this startling gap, and will the Government produce disaggregated data to evidence progress?"

Freeman responded that "the hon. Lady makes an important point," but he offered no specifics other than to say "we are actively engaging with employers of different sizes and sectors to promote access to work for people with autism."

Even with this vague effort, the U.K. is ahead of many U.S. jurisdictions where the initial policy focus has been on health care.

The new Oklahoma bill, passed as HB 2962 and signed by Republican Gov. Mary Fallin, illustrates this common starting point for public policy and ASD.

All health insurance plans issued or renewed in the state on or after November 1, 2016 must provide coverage for screening, diagnosis and treatment of ASD for children less than nine years of age. Plans must also cover applied behavior analysis for up to 25 hours per week and up to $25,000 per year.

The provision on applied behavior analysis is a recognition that the autistic person's social adjustment is often critically important.

Children with Asperger's Syndrome, which is now diagnosed as an autism spectrum disorder, have advanced vocabularies and unusual learning abilities, coupled with delayed social maturity and social reasoning, according to Tony Attwood, a leading expert.

So they need the kind of therapy provided by the Oklahoma bill.

But the screening and paperwork can be daunting. So they could also benefit from a Kentucky requirement, just signed into law by Republican Gov. Matt Bevin, requiring insurers to make available "a liaison to facilitate communication between the member (with ASD) and the insurer."

Also helpful is the growing recognition of ASD. Thus last year California's Democratic Gov. Jerry Brown signed a resolution relating to the state's Early Intervention Services Act noting, in part, "that nationally one in every 68 children were affected by autism spectrum disorder in 2014."

And Illinois Republican Gov. Bruce Rauner signed a bill into law last year requiring health insurers to cover dental anesthesia for individuals with ASD under the age of 19.

The Connecticut General Assembly is looking at a bill that goes beyond these efforts and addresses the broader lifestyle and workforce concerns raised by Lisa Cameron in the U.K.'s House of Commons.

A 2013 report written for the Connecticut Department of Labor Office of Workforce Competitiveness assessed "the pre-employment training and employment of young adults with autism spectrum disorder and other developmental disabilities." The report identified a "need for more services for young adults transitioning from school to work."

In February of this year the Committee on Public Health, a joint standing committee of the General Assembly, heard testimony on a bill to establish an internship program for adults with autism. Connecticut Comptroller Kevin Lembo, a father of two sons affected by ASD, said the right support can be highly beneficial.

"An internship program would offer the opportunity for adults with ASD to realize their piece of the American Dream and become taxpaying members of our community," he said. "The program will also continue to raise awareness that those with ASD can live successful, independent lives if they have the right support."

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