1. What are the key questions for which the analysis provides an answer?

The question that is answered by the analysis is: What is the budget impact (for the government) of expanding (to all autistic children aged two to five) the IBI program? An important sub-question is: is expanding the IBI program cost-effective from a governmental perspective?

2. On which questions is the study silent?

  • Is IBI cost-effective from the perspective of persons with autism, families, employers?
  • What are the costs from a societal and patient perspective?
  • How does intensity and duration of IBI influence its cost-effectiveness?
  • What is the nature of autism?
  • Should autism be treated? Is providing IBI ‘medically necessary’ care?
  • Are there other treatment options (besides IBI)?
  • What are relevant outcome measures to assess the effects of autism treatment?

3. Discuss how a study like this might take into account the issues that have been raised regarding ABA for childeren with autism

A central issue raised regarding ABA for children with autism is its desirability: should autism be treated? Should you modify behaviour? The current study is silent about these issues. To take these issues into account, a study could:

  • Collect and use other sources of information: bioethics literature, opinion articles etc. to identify different views on the nature of autism and whether it should be treated.
  • Consult different stakeholders, and legal experts, to identify the normative issues that are involved.