Special Education Costs Research Articles

Fiscal analysis of the pediatric immunization program in Belgium applying a lifetime government perspective framework

ABSTRACT Objectives A public economic framework was used to explore lifetime government costs and benefits in relation to the Pediatric Immunization Program (PIP) in Belgium based on cases and deaths averted. Methods To estimate changes in net government revenue, we developed a decision-analytic model that quantifies lifetime tax revenues and transfers based on changes in morbidity and mortality arising from Belgium’s Pediatric Immunization Program (PIP). The model considered differences in incidence rates with vaccines included in Belgium’s PIP: compared with the pre-vaccine era. Changes in deaths and comorbid conditions attributed to PIP on the Belgium 2020 birth cohort were used to estimate gross lifetime earnings changes, tax revenue gains attributed to averted morbidity and mortality avoidance, disability transfer cost savings, and averted special education costs associated with each vaccine. Results Vaccinating a single birth cohort according to the PIP gives rise to fiscal gains of €56 million in averted tax revenue loss, €8 million disability savings, and €6 million special education cost-savings. Based on the costs of implementing the PIP, we estimate the fiscal benefit–cost ratio (fBCR) of €2.2 investment return for the government from every €1 invested excluding longevity costs. Conclusions Reducing vaccine-preventable conditions generates tax revenue for the government, providing fiscal justification for sustained immunization investments.

Public economic gains from tax-financed investments in childhood immunization in the United States.

The emergence of COVID-19 has displayed the importance of immunization and the need for continued public investment in vaccination programs. Globally, national vaccination programs rely heavily on tax-financed expenditure, requiring upfront investments and ongoing financial commitments. To evaluate annual public investments, we conducted a fiscal analysis that quantifies the public economic consequences to government in the United States attributable to childhood vaccination. To estimate the change in net government revenue, we developed a decision-analytic model that quantifies lifetime tax revenues and transfers based on changes in morbidity and mortality arising from vaccination of the 2017 U.S. birth cohort. Reductions in deaths and comorbid conditions attributed to pediatric vaccines were used to derive gross lifetime earnings gains, tax revenue gains attributed to averted morbidity and mortality avoided, disability transfer cost savings, and averted special education costs associated with each vaccine. Our analysis indicates a fiscal dividend of $41.7 billion from vaccinating this cohort. The bulk of this gain for government reflects avoiding the loss of $30.6 billion in present-value tax revenues. All pediatric vaccines raise tax revenues by reducing vaccine-preventable morbidity and mortality in amounts ranging from $7.3 million (hepatitis A) to $20.3 billion (diphtheria) over the life course. Based on public investments in pediatric vaccines, a benefit-cost ratio of 17.8 was calculated for each dollar invested in childhood immunization. The public economic yield attributed to childhood vaccination in the U.S. is significant from a government perspective, providing fiscal justification for ongoing investment.

Pediatric Research Challenge, Alignment with the National Research Agenda

Pediatric Research Challenge, Alignment with the National Research Agenda

Reducing special education costs by providing early intervention for autistic children

AbstractAutism symptoms vary from child to child, but the overall severity can be lessened through early intervention—often specifically early intensive behavioral intervention—when administered at a young enough age. The high costs and heavy time commitment of this intervention, however, tend to discourage public school districts from spending on these programs. In this paper, the cost of early intervention and its impact on the subsequent costs of special education, is compared to the costs of public school special education for autistic children who do not receive intervention. The analysis suggests that North Carolina potentially saves an estimate of over $250,000 per child in reduced annual special education costs by implementing early intervention for their autistic population.

Child Abuse and Neglect: An Overview

Child abuse and neglect are serious global problems and can be in the form of physical, sexual, emotional or just neglect in providing for the child's needs. These factors can leave the child with serious, long-lasting psychological damage. Child maltreatment is a complex life experience occurs when a parent or caregiver does an intentional or potential damage to a child, including acts of commission and omission. Child abuse is not an uncommon event, but it is not always recognized. Identifying the real number of maltreated children is a challenge because of the large variability in reported prevalence data across studies. It is associated with important economic and social costs (such as physical and mental health, productivity losses, child welfare, criminal justice and special education costs) due to its high prevalence and its long-term and short-term consequences.

ЛЮДСЬКИЙ КАПІТАЛ ЯК СКЛАДОВА ІННОВАЦІЙНО-ОРІЄНТОВАНОЇ ЕКОНОМІКИ

The article explores human capital as an embodied and integrated resource of socio-economic development of the country, influencing the level and quality of life in society, the possibilities of sectoral and intersectoral development of the economy, given current global trends and national potential. It is determined that human capital is formed as a result of investment and accumulation of a certain reserve of health, knowledge, skills, abilities, motivations, which are appropriately used in a particular area of social reproduction, contribute to the growth of labor productivity and manufacturing efficiency. In the innovation-oriented economy it is important to create appropriate conditions for the formation and reproduction of human capital in order to transform basic human resources in relation to the formation of incentives for productive work, the growth of the welfare of the population, balancing social costs, ensuring sustainable growth of the national economy, etc. The modern stage of social development strengthens the role of the human capital as a component of innovation-oriented and sustainable economy, which determines the need to increase the efficiency of use of accumulated experience, adaptation of methods of research of the human capital development, as well as systematic use of professional competencies of society representatives. As a result, the concept of formation and development of the human capital, as well as its investment support and state regulation regarding sustainable growth of the labor productivity and reproduction of the human capital in accordance with modern requirements, in particular, globalization, Industry 4.0, digitalization, socialization is reconsidered. The modern structure of investments in human capital includes the following types of investments: the cost of education (the cost of general and special education, formal and informal education, the cost of training in the workplace), the cost of health care (physical and mental health), information search, migration, mobility, motivation, R&D, informatization, intellectual innovation, ecology and healthy lifestyles, culture and recreation. In this case, the availability of information to private investors or the population about promising areas of investment in the human capital is accompanied by a systematic receipt of profit, which maintains their interest for a certain period of time.

Exploring the Impact of Quality Early Child Education on Special Education

This article examines the research literature to determine whether the provision of quality early childhood education (ECE) lowers the risk of a child developing special education needs (SEN) and mediates the intensity of support for children with an identified exceptionality. Schools play a crucial role in reducing developmental gaps assessed at school entry, but their success comes with great expense in special education and related costs. Research indicates that ECE could narrow these gaps and better prepare children for success in school, and this realization is slowly being reflected in public policy. Based on our literature review, we describe the benefits of quality ECE in lowering special education expenses. Specific play-based learning pedagogical strategies support all children in optimizing academic progress, language development, social skills, and emotional-behavioural regulation. Professional learning for early childhood educators can build capacity to embed effective pedagogy into daily practice. The provision of quality ECE that makes a difference depends on the knowledge and skills of this workforce.

The Economic Costs of Autism Spectrum Disorder: A Literature Review.

Autism is associated with a range of costs. This paper reviews the literature on estimating the economic costs of autism spectrum disorder (ASD). More or less 50 papers covering multiple countries (US, UK, Australia, Canada, Sweden, the Netherlands, etc.) were analysed. Six types of costs are discussed in depth: (i) medical and healthcare service costs, (ii) therapeutic costs, (iii) (special) education costs, (iv) costs of production loss for adults with ASD, (v) costs of informal care and lost productivity for family/caregivers, and (vi) costs of accommodation, respite care, and out-of-pocket expenses. A general finding is that individuals with ASD and families with children with ASD have higher costs. Education costs appear to be a major cost component for parents with children with ASD.

The economic burden of child sexual abuse in the United States

The present study provides an estimate of the U.S. economic impact of child sexual abuse (CSA). Costs of CSA were measured from the societal perspective and include health care costs, productivity losses, child welfare costs, violence/crime costs, special education costs, and suicide death costs. We separately estimated quality-adjusted life year (QALY) losses. For each category, we used the best available secondary data to develop cost per case estimates. All costs were estimated in U.S. dollars and adjusted to the reference year 2015. Estimating 20 new cases of fatal and 40,387 new substantiated cases of nonfatal CSA that occurred in 2015, the lifetime economic burden of CSA is approximately $9.3 billion, the lifetime cost for victims of fatal CSA per female and male victim is on average $1,128,334 and $1,482,933, respectively, and the average lifetime cost for victims of nonfatal CSA is of $282,734 per female victim. For male victims of nonfatal CSA, there was insufficient information on productivity losses, contributing to a lower average estimated lifetime cost of $74,691 per male victim. If we included QALYs, these costs would increase by approximately $40,000 per victim. With the exception of male productivity losses, all estimates were based on robust, replicable incidence-based costing methods. The availability of accurate, up-to-date estimates should contribute to policy analysis, facilitate comparisons with other public health problems, and support future economic evaluations of CSA-specific policy and practice. In particular, we hope the availability of credible and contemporary estimates will support increased attention to primary prevention of CSA.

Child Abuse and Neglect and its Psycho-Physical and Social Consequences: A Review of the Literature.

Child maltreatment is a complex life experience occurs when a parent or caregiver does an intentional or potential damage to a child, including acts of commission and omission. Child abuse is not an uncommon event, but it is not always recognized. Identifying the real number of maltreated children is a challenge because of the large variability in reported prevalence data across studies. Unfortunately, in the United States, it affects 1 in 8 children, by the age of 18 years, annually. Paediatricians may encounter a variety of forms of maltreatment such as neglect, emotional, physical and sexual abuse. These aspects should be recognised, examined and evaluated by employing a systematic approach and focusing on basic needs of children that may not be met. Child maltreatment is a global problem with serious life-long physical and psychological or psychiatric outcomes. It is associated with important economic and social costs (such as physical and mental health, productivity losses, child welfare, criminal justice and special education costs) due to its high prevalence and its long-term and short-term consequences. In the United States, the average cost of nonfatal maltreatment is $210,012 per children and the cost of fatal maltreatment is $1,272,900. General Practitioners are quite prepared to face the problem of child maltreatment: since they have the opportunity to meet several members of the same family, they can detect stressors that put children at risk of maltreatment. All health professionals have the responsibility to protect children from abuse and neglect.

Special education costs in New Zealand: What are direct family members paying?

Special education costs in New Zealand: What are direct family members paying?

Special Education of Children with Fetal Alcohol Spectrum Disorder

The current study aimed to estimate the cost associated with special education among children (5 to 14 years) with Fetal Alcohol Spectrum Disorder (FASD) in elementary and middle school by sex, age group, and province and territory in Canada. It was estimated that there were 6,520 students with FASD receiving special education in Canada in 2011–2012. The cost of special education among these students was 53.5 million Canadian dollars. Implications for decision- and policymakers, educational systems and school staff are discussed.

Funding Special Education by Total District Enrollment: Advantages, Disadvantages, and Policy Considerations

Several states and the federal government distribute aid for special education programs based primarily on total district enrollment and a fixed aid amount per student, a method called census funding. In this policy brief, we address three questions to help policy makers, educators, and researchers better understand census-funding models and special education finance policies in general. The first question is, what are the key advantages and disadvantages of census-funding models? The second and third questions relate to aspects of policy implementation, in the event a state legislature should choose to adopt the approach. First, we examine what options are available to mitigate concerns about the equity of funding under a census funding model. Second, we examine what other options exist for helping states and districts to contain special education costs while maintaining a high level of quality.

The economic burden of child maltreatment in the United States and implications for prevention

ObjectivesTo present new estimates of the average lifetime costs per child maltreatment victim and aggregate lifetime costs for all new child maltreatment cases incurred in 2008 using an incidence-based approach. MethodsThis study used the best available secondary data to develop cost per case estimates. For each cost category, the paper used attributable costs whenever possible. For those categories that attributable cost data were not available, costs were estimated as the product of incremental effect of child maltreatment on a specific outcome multiplied by the estimated cost associated with that outcome. The estimate of the aggregate lifetime cost of child maltreatment in 2008 was obtained by multiplying per-victim lifetime cost estimates by the estimated cases of new child maltreatment in 2008. ResultsThe estimated average lifetime cost per victim of nonfatal child maltreatment is $210,012 in 2010 dollars, including $32,648 in childhood health care costs; $10,530 in adult medical costs; $144,360 in productivity losses; $7,728 in child welfare costs; $6,747 in criminal justice costs; and $7,999 in special education costs. The estimated average lifetime cost per death is $1,272,900, including $14,100 in medical costs and $1,258,800 in productivity losses. The total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the United States in 2008 is approximately $124 billion. In sensitivity analysis, the total burden is estimated to be as large as $585 billion. ConclusionsCompared with other health problems, the burden of child maltreatment is substantial, indicating the importance of prevention efforts to address the high prevalence of child maltreatment.

Congress to Consider IDEA Full Funding

You have accessThe ASHA LeaderPolicy Analysis1 Oct 2009Congress to Consider IDEA Full Funding Neil Snyder Neil Snyder Google Scholar More articles by this author https://doi.org/10.1044/leader.PA2.14132009.1 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In Legislation that calls for the federal government to meet its commitment to fund 40% of the cost of implementing the Individuals with Disabilities Education Act (IDEA), the 1975 law that requires states to provide an appropriate education for students with special needs, has been re-introduced in both chambers of the U.S. Congress. In early September, Sens. Tom Harkin (D-Iowa) and Pat Roberts (R-Kan.) introduced bipartisan legislation in the Senate; Rep. Chris Van Hollen (D-Md.) introduced a similar bill in the House. The American Recovery and Reinvestment Act (ARRA), the economic stimulus package passed in the spring, increased funding for IDEA grants to states to $22.8 billion this year, or 34% of the cost of providing special education programs. However, ARRA is a one-time investment that addresses an immediate crisis; without it, IDEA grants are funded in fiscal year 2009 at about 17%. Federal IDEA funding has never exceeded 18%, leaving state governments and local school districts to pick up the tab, often at the expense of other programs such as remedial classes, after-school tutoring, and summer school. “Congress made a promise to our schools and our children to share the cost of special education,” Roberts said. “It’s time for Congress to relieve our state and local governments of the financial burden they have been forced to shoulder, especially in these tough economic times.” The IDEA Full Funding Act authorizes increasing amounts of mandatory funding in six-year increments that, in addition to the discretionary funding allocated through the Appropriations Committee, finally will meet the federal government’s commitment to educating children with special needs. These new resources will ensure that all children with disabilities receive a free, appropriate public education. The increased federal funding also would allow states to re-direct funds being used to meet IDEA requirements to other education priorities, such as teacher salaries, school construction, and technology improvements. “This is a win-win-win bill,” Harkin said. “With these appropriations, students with disabilities will get the public education they have a right to and school districts will be able to provide services without cutting into their general education budgets.” Author Notes Neil Snyder, director of federal advocacy, can be reached at [email protected]. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 14Issue 13October 2009 Get Permissions Add to your Mendeley library History Published in print: Oct 1, 2009 Metrics Downloaded 98 times Topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2009 American Speech-Language-Hearing AssociationLoading ...

A Lucrative Investment: Controlling Lead Paint Yields Big Dividends

Fewer children today have the high blood lead levels seen in kids a few decades ago, when gasoline and paint still came fully leaded. But a surprising number of children still have blood lead levels that may place them at risk for a variety of cognitive, emotional, and behavioral problems. The good news is that boosting current efforts to protect U.S. children from one major source of lead—the house paint used prior to a 1978 ban, which still appears in many homes—may pay for itself many times over [EHP 117:1162–1167; Gould]. According to National Health and Nutritional Examination Survey data from 2003 to 2006, an estimated 25% of the 28 million U.S. children aged 6 years and younger have blood lead levels between 2 and 10 μg/dL, a range in which persistent cognitive damage is known to occur. Another 200,000 children are estimated to have levels over 10 μg/dL. Using data from published studies, the author performed a cost–benefit analysis of the effects of controlling children’s exposure to lead paint. She calculated that controlling lead paint in the approximately 1 million worst-case housing units would cost between $1.2 billion and $11 billion, depending on many factors including local costs of lead abatement. But the benefits to be derived from controlling lead hazards could range from $181 billion to $269 billion. For example, abatement could save $11–53 billion in immediate medical treatment and $30–146 million in special education costs. Reducing the incidence of attention deficit/hyperactivity disorder (ADHD) related to lead paint exposure might save $267 million; and because both ADHD and lead exposure have been associated with criminal behavior, crime-related costs could shrink by $1.7 billion with efforts to eliminate and contain lead-laden paint. The author concludes that every dollar spent to limit U.S. children’s exposure to lead paint—such as through paint stripping, replacement, and covering with a special encapsulant coating—could net $17–221. By comparison, vaccination against the most common childhood diseases is estimated to save $5.30–16.50 for every dollar spent on immunizations. The author noted that the cost savings from better lead mitigation could be even higher than estimated in the current study. For one thing, the calculations of potential benefit pertain only to children under age 6. Yet getting rid of lead paint would benefit other segments of the population as well. Also, the analysis excluded many potential costs of lead exposure, including future health care expenses and the indirect costs of criminal activity. U.S. public health and housing policies have been slow to address the lingering problems related to lead paint, the author asserts. Given the huge projected savings and income in terms of health care, crime prevention, education, lifetime earnings, and tax revenues, she writes, the time for proactive and universal lead control has never been better.

Costs of congenital rubella syndrome (CRS) in Oman: Evidence based on long-term follow-up of 43 children

As part of the national plan for elimination of rubella and congenital rubella syndrome (CRS), Oman established a national registry of CRS cases. As of May 2005, the registry included 43 surviving CRS cases, with a mean age of 11.9 years. Clinical examinations found that 84% had ocular defects, 84% had auditory/speech defects, 70% had neurological manifestations, and 42% had cardiac defects. Lifetime medical, special education, and rehabilitation costs were assessed. Using a discount rate of 3%, the average direct lifetime cost per surviving CRS patient was estimated at US$ 18,644. When including predicted lost productivity due to CRS, the average discounted direct and indirect lifetime costs per surviving CRS patient amounted to US$ 98,734.

Response to Tough Teaching: The 2% Solution

From its inception in 1975, modern special education seems to have forced us to concentrate on percentages, and not always for clearly useful purposes. For example, when Congress was considering Public Law 94-142 thirty years ago, lawmakers naturally wanted to know the number of students with disabilities. Congress cared mostly about cost, and to estimate cost, it needed to know the percentages. So the history of public policy in special education that followed reflects guesses about prevalence and has never reflected much about incidence, or how many new kids with disabilities will appear each year and, more important, why. For example, professionals and researchers once suggested that about 6% or 7% of all students had serious emotional disturbance (SED). Congress thought about the cost, and then thought otherwise. As a result, Congress created a 2% solution, and then wrote the law in a way that discouraged identification of students with SED. Schools must obviously also have seen the fiscal wisdom in fewer identifications of such expensive students because they have never identified as many as 2% of all students as SED. This 2% solution pops up repeatedly in special education. In 1975, most professionals also figured that the prevalence of students with mental retardation was about 2%. Again, we glossed over the difference between counting and accounting for the percentage of students with disabilities. In this case, we wanted to know the percentage of students from various ethnic minority groups who should or should not be identified as having disabilities and, therefore, receive special education. That is, how proportional (or disproportional) to population percentages minority students should be as a percentage of special education enrollments. On one hand, we want to acknowledge the effects of poverty and disadvantage and developmental risk but, on the other hand, we want to think that distribution of disabilities should be inherently just. The argument cannot be resolved without making some heroic assumptions about the etiology and epidemiology of disabilities. We have managed to think up various creative ways of measuring proportion, though, and the students of concern in this debate tend not to do very well in school, which means that teachers tend to find them difficult to teach effectively. Congress also heard few reliable predictions of the percentage of students with learning disabilities in 1975. Ultimately, the opinion that prevailed assumed that perhaps 1%-2% of students had specific learning disabilities. Imagine everyone's surprise in the early 1980s when that prevalence estimate looked more like 5%. Schools, many argued, must be identifying them incorrectly, or didn't understand how to do it, or else were, for some inexplicable reason, subverting the law, despite the obvious irrationality of such behavior in that schools end up paying the lion's share of special education costs. It's worth mentioning in passing that large-scale efforts to implement multitiered instruction as an alternative approach to identifying students with learning difficulties have found a residual of non-responsive students very close to 5% of the population, even after expending an average 150 hours of instruction. …

What School Administrators Should Know About Inclusion and Its Costs

The author suggests that for many administrators, the questions “Does inclusion work?” and “Does it cost more than our traditional approach to special education?” remain unanswered. The purpose of the paper is to present answers to the above questions. The author believes that the key to successful inclusion is collaboration and that the most successful models are characterized by the use of full-time collaborative teams and a commitment to adopting strategies that improve the quality of instruction for both special needs students and general education students. He subsequently presents research suggesting that the responsible implementation of collaborative inclusive models will require additional spending and may not be affordable for many school districts under current funding systems. Generalizations are offered based on a cost analysis of a school district’s expenditures for instructional personnel, facility space, and transportation. Cost comparisons are made between the resource requirements of two inclusive models derived from the professional literature and a school district’s traditional model. The author’s computer driven cost analysis, rooted in an ingredients (Levin, 1983) or Resource Cost Model approach (Chambers, 1999), shows reduced per-student special education costs with both inclusion models overshadowed by increased expenditures for all general education students served in the inclusive settings. While costs for facility space would vary based on local needs and circumstances, transportation costs would be reduced by the degree to which districts eliminate their use of out-of-district special education placements with the inclusion models.

Bus Passes, Budgets, and Turnover

The only alternative Mr. Lalley sees to self-imposed criticism and self-induced improvement is self-destruction. And there's an awesome power for progress that is unleashed when everyone helps willingly and contributes in large ways and small to the noble mission of our schools. EVERY morning when my district's 270 kindergartners and first-graders arrive at school, about 60 of them are carrying a note from a parent or caretaker. After school my child is going somewhere other than the usual place, the note will say. It could be to a friend's house or to Brownies or to a birthday party or to day care. Perhaps a grandparent or a neighbor is coming to get the child. In some instances, a court order bars certain people from having contact with a child, and the burden of enforcement during the school day and at dismissal time falls on school personnel. In the past, one office assistant took care of all these important messages, and bus passes alone took two hours a day to process. When the assistant's job was eliminated in 1991, the responsibility for bus passes shifted to the school secretary, who already had a full workload. The old procedure was still working, and children still ended up where they were supposed to be. But with one person fewer on the job, we needed a system that was more efficient, but no less effective. There is no room for error or laxity when the safety of small children is at stake. How could we solve our problem? To resolve the bus pass issue, I sat down with the secretary and asked her to describe the current process, so we could both understand how it worked. Then I asked some simple questions, derived from the literature on quality management: How did she think this process could be improved? What might be done differently to save time and even improve service? If the system were computerized, she suggested, it might save precious minutes; so we brainstormed how such a computer system might work. All the students would be in an easily accessible database, all the essential bus schedule and contact information for each student would be readily available, and the system would flag any special situation such as a court order. Such a system would not only run faster, we imagined, but would be more reliable as well. The computer could print passes for the bus driver that included the date, student's name, telephone number, bus number, and destination. Meanwhile, the classroom assistants, doubling as bus aides and armed with a daily adult pickup list, also generated by the computer, could ensure that children were released to the right person. Neither of us knew much about computers, but with the help of a volunteer programmer, we soon had our system up and running. After several subsequent enhancements, the bus pass system serves more students, takes one-third the time, and offers better-quality service than ever. The bus pass issue was not an emergency, but it typifies many of the problems I have faced during my years as the superintendent of three school districts in two New Hampshire towns. The problems that present themselves are generally not crises, but instead involve finding ways to become more productive, to stretch limited resources. It's great to be able to anticipate and prevent problems before they happen, but, of course, it doesn't always work that way, as I learned from a hard and embarrassing lesson. A couple of years ago, one of our school districts unexpectedly ran short of special education funds in the last few months of the school year. Like many districts, we base our special education budgets on the students we expect to serve in our district programs and in out-of-district placements. We know special education costs are difficult to predict and can change dramatically when students move into or out of the district or when students' educational needs change. This uncertainty may explain the problem, but it doesn't solve it. …