In America, you have to be lucky or rich to get proper care for your young autistic child. Treatment regimens typically cost more than $50,000 annually for preschool children — one reason proven methods are available to perhaps only 10 percent of afflicted children during those crucial years.

CATHRYN GARLAND and MICHAEL O'HANLON in NY Times
Here

It may seems heartless to apply cost benefit analysis to children suffering from a devastating disorder, but when resources are limited - as in reality they always are - it must be done. In medicine the practice is called triage - dividing patients into three groups: those who do not need urgent medical attention, those who do and have a reasonable chance of survival given that attention, and those who are too badly injured or too sick to have a significant chance of survival. The second group gets the attention. The size of the third group is related to the resources available - personnel, equipment, medications, facilities. In a rich, peacful setting, the third group is going to be much smaller than on a raging battlefield or in the midst of a natural disaster.

But triage is practiced all the time in day to day medicine. Premature babies who may be able to be saved, but who would require enormous immediate and long term intervention and support in order to live a life of questionable quality, are allowed to die. Elderly patients who could benefit from transplant or other major surgery are passed over in favour of younger patients with similar needs. It is recognized in the medical system that is is not economically or practically possible to save or treat every patient who could possibly benefit - the resources simply are not there. Sometimes - probably much too often - triage decisions are not made entirely ethically, but even with perfect ethics, the decisions would still have to be made.

In the business world, of course, such things happen all the time and those who make the decisions get promoted and paid big bonuses, providing they make decisions that improve the bottom line. If there is no eventual net benefit to an endeavour, it isn't pursued.

Regarding autism, it appears that early intensive treatment can make a significant differece to these children. Given the above figure of $50,000 per year and 1 in 200 children suffering from the disorder, and assuming that about 10 percent of the US population is under 7, it would cost about $7.5 billion per year to provide the intensive treatment to all the children who might benefit from it. This may seems like a relatively small amount, but consider this: if $50,000 per year were to be spent on each "average" child on effective programs, all of those children would shine. And if that amount were spent on talented or otherwise gifted children, they would explode in brilliance. Imagine the potential benefits to society.

Of course it can be argued that the average or above average children don't need special treatment, that they will get by on their own, but in my reading and experience that often doesn't happen. Kids miss out on crucial foundations in math or literacy and never catch up, or bright kids get bored and turn to unproductive or dangerous outlets.

I am approaching this from a personal viewpoint, as my wife (a very talented Grade One teacher) has an autistic child in her class this year. So far she has spent almost as much time and energy on this one student as she has on the other 20 children in her class combined, because of his own needs plus demands of his parents, and demands of administration who are terrified of being labelled negligent for failing to bend over backwards to satisfy every whim of the parents. As a small example, the parents have said that school staff are not allowed to use "hands on" to direct or restrain the child, even if he is endangering himself or other students, or destroying books or classroom materials. You can imagine that this is an impossible situation, but there is no backing from administration to set things right.

Anyway, if you have got this far, thanks for listening.