Special Education
Children With Autism Gao ID: GAO-05-220 January 14, 2005According to the Autism Society of America, about 1.5 million Americans are currently living with some form of autism. This figure includes over 100,000 school-aged children diagnosed with autism served under the Individuals with Disabilities Education Act (IDEA), the primary federal legislation that addresses the educational needs of children with disabilities. As the number of children diagnosed with autism has increased, interest in understanding how children diagnosed with autism are being served under IDEA has grown. In this report we are describing the tend in the number of children diagnosed with autism served under IDEA, the services provided to these children, the estimated per pupil expenditures for educating children with autism, and approaches to their education.
The number of children diagnosed with autism served under IDEA has increased by more than 500 percent in the last decade. In 2002, data collected for the Department of Education indicated that nearly 120,000 children diagnosed with autism were being served under IDEA. This substantial increase may be due to a number of factors, including better diagnoses and a broader definition of autism. The services provided to children with autism depend on the needs of the child. These services may include speech therapy, occupational therapy, and the services of special education teachers. As with other children with disabilities, children with autism are eligible for special education services under IDEA in accordance with their individualized education programs (programs established by a team familiar with the needs of the child). The average per pupil expenditure for educating a child with autism was estimated by SEEP to be over $18,000 in the 1999-2000 school year, the most recent year for which data were available. This estimate was nearly three times the expenditure for a typical regular education student who did not receive special education services and was among the highest per pupil expenditures for school-age children receiving special education services in public schools. Finally, the National Research Council report offered several key features of successful approaches to the education of children with autism, including early intervention soon after the diagnosis of autism, which can generally occur by the age of 3. The report also offered guidelines regarding educational objectives for children with autism, including the development of social skills and expressive and receptive language and communication skills.
GAO-05-220, Special Education: Children With Autism
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Report to the Chairman and Ranking Minority Member, Subcommittee on
Human Rights and Wellness, Committee on Government Reform, House of
Representatives:
United States Government Accountability Office:
GAO:
January 2005:
Special Education:
Children with Autism:
GAO-05-220:
United States Government Accountability Office:
Washington, DC 20548:
January 14, 2005:
The Honorable Dan Burton:
Chairman:
The Honorable Diane E. Watson:
Ranking Minority Member:
Subcommittee on Human Rights and Wellness:
Committee on Government Reform:
House of Representatives:
According to the Autism Society of America, about 1.5 million Americans
are currently living with some form of autism. This figure includes
over 100,000 school-aged children diagnosed with autism served under
the Individuals with Disabilities Education Act (IDEA), the primary
federal legislation that addresses the educational needs of children
with disabilities. As the number of children diagnosed with autism has
increased, interest in understanding how children diagnosed with autism
are being served under IDEA has grown.
You expressed an interest in the education of children with autism, and
in this report we are describing the trend in the number of children
diagnosed with autism served under IDEA, the services provided to these
children, the estimated per pupil expenditures for educating children
with autism, and approaches to their education.
To determine the number of children diagnosed with autism served under
IDEA, we relied on data collected for the Department of Education
(Education). To describe the services provided to children with autism,
we reviewed relevant literature and spoke with Education officials. To
describe the estimates of per pupil expenditures for educating children
with autism, we reviewed data collected and analyzed by the Special
Education Expenditure Project (SEEP), which was funded by Education and
was the only national source of this type of data. We spoke with
Education officials about the proper use and reliability of the data we
used and found them to be sufficiently reliable for the purposes of
this report. However, some weaknesses with the SEEP data exist,
including a low survey response rate, potential response bias, and
limited documentation. Finally, to describe approaches to the education
of children with autism, we reviewed a 2001 report by the National
Research Council on the education of children with autism. We conducted
our work between November and December 2004 in accordance with
generally accepted government auditing standards.
On December 13, 2004, we briefed your staff on the results of our
study. This report formally conveys the information provided during
that briefing. In summary, we found:
The number of children diagnosed with autism served under IDEA has
increased by more than 500 percent in the last decade. In 2002, data
collected for the Department of Education indicated that nearly 120,000
children diagnosed with autism were being served under IDEA. This
substantial increase may be due to a number of factors, including
better diagnoses and a broader definition of autism.
The services provided to children with autism depend on the needs of
the child. These services may include speech therapy, occupational
therapy, and the services of special education teachers. As with other
children with disabilities, children with autism are eligible for
special education services under IDEA in accordance with their
individualized education programs (programs established by a team
familiar with the needs of the child).
The average per pupil expenditure for educating a child with autism was
estimated by SEEP to be over $18,000 in the 1999-2000 school year, the
most recent year for which data were available. This estimate was
nearly three times the expenditure for a typical regular education
student who did not receive special education services and was among
the highest per pupil expenditures for school-age children receiving
special education services in public schools.
Finally, the National Research Council report offered several key
features of successful approaches to the education of children with
autism, including early intervention soon after the diagnosis of
autism, which can generally occur by the age of 3. The report also
offered guidelines regarding educational objectives for children with
autism, including the development of social skills and expressive and
receptive language and communication skills.
We provided a draft of this briefing to officials at Education for
their technical review and incorporated their comments where
appropriate.
Unless you publicly announce its contents earlier, we plan no further
distribution until 30 days after the date of this report. At that time,
we will send copies of this report to the Secretary of Education,
relevant congressional committees, and other interested parties and
will make copies available to others upon request. In addition, the
report will be available at no charge on GAO's Web site at http://
www.gao.gov.
If you or your staff have any questions about this report, please
contact Marnie Shaul or Deborah Edwards at (202) 512-7215. Nagla'a El-
Hodiri and Art Merriam also made key contributions to this report.
Signed by:
Marnie Shaul:
Director, Education, Workforce, and Income Security Issues:
Education of Children with Autism:
Briefing for Staff of Rep. Dan Burton, Chairman and Rep. Diane E.
Watson, Ranking Minority Member:
Subcommittee on Human Rights & Wellness:
Committee on Government Reform:
House of Representatives:
December 13, 2004:
Introduction:
* The Individuals with Disabilities Education Act (IDEA) is the primary
federal legislation that addresses educational needs of children with
disabilities, including autism.
* It is estimated that more than 1.5 million Americans live with some
form of autism, including more than 100,000 children served under IDEA.
* Given the above numbers, there has been growing interest in the
education of children with autism.
Research Questions:
1. What is the trend in numbers of children with autism receiving
services under IDEA?
2. What services are provided in educating these children?
3. What are the estimated per pupil expenditures for educating children
with autism in public schools?
4. What approaches are used in educating children with autism?
Scope and Methodology:
* To determine the trend in the number of children with autism
receiving services under IDEA, we reviewed and analyzed Department of
Education data. We interviewed officials from the Office of Special
Education Programs (OSEP) about the proper use and reliability of the
data.
* To determine the range of services provided to educate children with
autism, we reviewed relevant literature and interviewed OSEP officials.
* To determine the estimated expenditures associated with the education
of children with autism, we reviewed existing Special Education
Expenditure Project (SEEP) reports that analyzed expenditures by
disability. In addition, we interviewed officials from OSEP regarding
the proper use and reliability of the data.
We found the study to be sufficient for informational purposes;
however, the reliability of these data is undetermined for policy
analysis. We are reporting on this study because the number of children
with disabilities covered by the survey is sizeable and the results
provide information about the magnitude of expenditures - a "ballpark
estimate." However, weaknesses in this study exist, including a low
survey response rate, potential response bias, as well as limited
documentation.
* To describe what is known about approaches to educating children with
autism, we reviewed the recent report Educating Children with Autism
(National Research Council) and spoke with Education officials.
* We conducted our work from November to December 2004 in accordance
with generally accepted government auditing standards.
Summary of Results:
* Data collected for the Department of Education indicate that the
number of children ages 6 through 21 diagnosed with autism served under
the IDEA has increased by more than 500 percent in the last decade.
* A variety of services, such as speech therapy and counseling, are
made available to support the education of children with autism, in
accordance with the child's needs.
* The SEEP report estimated that the average per pupil expenditure for
educating a child with autism was more than $18,000 in the 1999-2000
school year. This amount is almost three times the average per pupil
expenditure of educating a child who does not receive any special
education services.
* According to a 2001 National Research Council report, intervention at
an early age is a key feature of successful approaches to educating
children with autism.
Background:
* Autism spectrum disorders (ASD) are complex and include a number of
disorders.
Figure 1: Disorders Included in the Range of ASD:
Autism spectrum disorders:
Asperger's disorder;
Childhood disintegrative disorder;
Rett's disorder;
Pervasive developmental disorder--not otherwise specified (PDD-NOS);
Autistic disorder.
Source: National Institute of Mental Health.
[End of figure]
* Estimates of the prevalence of ASD range from 2 to 6 per 1,000
children.
* Characteristics of ASD are generally present by the age of 3 and
include:
* deficits in social interaction,
* deficits in verbal and nonverbal communication, and * repetitive
behaviors or interests.
* Often children with ASD have unusual responses to sensory stimulation.
* Currently, there is no consensus about the cause of ASD.
* Theories regarding the causes of ASD include genetic components,
environmental components, and some combination of genetics and the
environment.
* While no known cure for ASD exists, the general agreement is that
early diagnosis followed by appropriate treatment can improve outcomes
for later years for most children with ASD.
* IDEA is the primary federal law that addresses the unique needs of
children with disabilities, including autism.
* The act:
- mandates the availability of a free appropriate public education for
all eligible children with disabilities,
- requires an individualized education program (IEP) for eligible
children with disabilities,
- requires the inclusion of students with disabilities in statewide and
districtwide academic assessment programs, and:
- requires the placement of students in the least restrictive
environment.
* SEEP was funded by Education to examine the nation's spending on
special education and related services.
* SEEP reports are based on the analyses of data for the 1999-2000
school year. Data were collected by surveys at the state, district, and
school levels. The databases include a sample of approximately 10,000
students with disabilities.
Research Question 1:
What is the trend in numbers of children with autism receiving services
under IDEA?
Increased Numbers of Children Diagnosed with Autism Receiving Services
under IDEA:
* The number of children ages 6 through 21 diagnosed with autism
receiving services under IDEA has increased more than 500 percent over
the past 10 years, from under 20,000 in 1993 to almost 120,000 in 2002,
according to data collected for the Department of Education.
* Possible reasons for this increase include:
- The advent of better diagnoses.
- A wider range of conditions being categorized as ASD.
- A higher incidence of autism in the general population.
Figure 2: Trend in Number of Children Ages 6 - 21 Diagnosed with Autism
Served under IDEA by Age.
[See PDF for image]
Source: IDEA data collected for the Department of Education.
[End of figure]
* The number of children ages 6 through 21 diagnosed with autism
receiving services under IDEA has grown at a higher rate than the
number of children diagnosed with certain other "low-incidence"
disabilities (see fig. 3).
Figure 3: Trend in the Number of Children Ages 6-21 with Certain Low-
Incidence Disabilities Number of children:
[See PDF for image]
Source: IDEA data collected for the Department of Education.
[End of figure]
Research Question 2:
What services are provided in educating children with autism?
Services Can Vary According to a Child's Needs:
* A wide range of services can be available for children with autism,
including:
- special education teachers/aides,
- speech therapists,
- behavioral therapists,
- occupational therapists,
- physical therapists, and
- counselors/psychologists.
* Children with ASD may demonstrate a variety of manifestations of the
disorder and need services accordingly. For example:
- A child with autistic disorder may have great difficulty
communicating and may need services focused on speech development.
- A child with Asperger's disorder may be more verbal than other
children with autism and may have average or above average
intelligence, yet still be in need of services.
* In addition, services required for an individual child with autism
can change over time.
* Children with autism are generally eligible for services under IDEA,
including early intervention, preschool and school-age programs, and
transitional services.
* IDEA Part C promotes early intervention for children with autism by
funding early intervention services (birth to age 3).
* Early intervention services:
- are administered by a state-designated lead-agency,
- include of a range of allowable services to address developmental
delays,
- can be provided in home and in community settings, and
- provide a transition to preschool.
* IDEA Part B supports the educational needs of children with autism,
ages 3 through 21.
* Preschool and school-age instructional and related services (3
through 21 years):
- are administered by state and local education agencies and:
- include a range of allowable instructional and related services to
address a student's individual educational needs.
* School age postsecondary transition services (generally 14 through 21
years):
- are administered by state and local education agencies,
- provide movement from school to post-school activities, and
- identify the role of agencies in providing and funding transition
services.
Research Question 3:
What are the estimated per pupil expenditures for educating children
with autism in public schools?
SEEP Estimated Per Child Expenditures of Educating Children with Autism:
* According to SEEP, the estimated expenditure per child with autism
was $18,790 in the 1999-2000 school year, the most recent year for
which data are available. For the same school year, per pupil
expenditures for the typical regular education student were $6,556.
* Included in this amount are expenditures associated with:
- Instruction:
* Regular education;
* Special education.
- Administration and support:
* School and district levels;
* Special education program.
- Regular and special transportation services:
- School facilities:
* According to SEEP, the estimated average annual expenditures of
educating a child with autism were generally greater than those of
educating a child with other disabilities in public school settings.
Table 1: Estimated per pupil expenditure by disability in 1999-2000 (in
dollars), rounded to the nearest hundred.
Average special education student;
Average per pupil expenditures: $12,500[A].
Autism;
Average per pupil expenditures: $18,800.
Emotional disorders;
Average per pupil expenditures: $14,100.
Mental retardation;
Average per pupil expenditures: $15,000.
Multiple disabilities;
Average per pupil expenditures: $20,100.
Source: Special Education Expenditure Project.
[A] This figure represents the average expenditures for students with
disabilities including those listed in this table as well as other
disabilities.
Note: Apparent differences may not be statistically significant.
[End of table]
* According to SEEP estimates:
- Approximately 68 percent of total per pupil expenditures for children
with autism in 1999-2000 (an estimated $12,773) was used on instruction
and related services.
- Ninety percent of that amount (an estimated $11,543) was used for
special education services, while the remaining 10 percent (an
estimated $1,230) was used for regular education services.
According to SEEP, expenditures for special education services can be
categorized as follows:
* special education classes - classes designed specifically for
students with disabilities, taught by special education teachers;
* resource specialists - includes special education teachers who either
pull students with disabilities out of regular education classes or go
into regular education classrooms to work with students with
disabilities;
* related services - school psychologists, social workers, school
nurses, speech/language specialists, and physical/occupational and
other therapists; and:
* other special education services - community-based training, extended
time services, and summer school.
* Of the estimated $11,543 spent per pupil on special education
instructional services for children with autism, SEEP estimated that:
* 43% was spent on special education classes,
* 24% was spent on related services,
* 19% was spent on resource specialists, and:
* 14% was spent on other special education services.
Research Question 4:
What approaches are used in educating children with autism?
NRC Identified Intervention at an Early Age as a Key Component in
Successful Approaches:
* The National Research Council (NRC) report provides an overview of
practices and challenges in educating children with autism. Among other
topics, the study focuses on:
* intervention at an early age,
* diagnosis and classification,
* the rights of children with autism under IDEA, and
* assistive technology.
* The report was based on existing research studies, model
interventions, and workshops with researchers, educators, and others.
NRC reported a general consensus that the following features were key
to the education of children with autism across preschool programs:
* Intervention programs as soon as an autism spectrum disorder is
seriously considered.
* Active engagement in intensive instructional programming-a minimum of
a full school day, at least 5 days (25 hours)/week, full year.
* Repeated teaching organized around short intervals with one-to-one
and very small group instructions.
* Inclusion of a family component.
* Mechanisms for ongoing evaluation of program and children's progress,
with adjustments made accordingly.
* Goals for educating children with autism are the same as goals for
educating other children, that is:
* personal independence and
* social responsibility.
* In addition, NRC found that the IEP for children with autism should
include educational objectives that are:
* observable and measurable;
* accomplishable within 1 year; and:
* affect a child's participation in education, community, and family
life.
* Finally, progress should be monitored frequently and objectives
adjusted accordingly.
Educational objectives for children with autism should include the
development of:
* social skills;
* expressive verbal language, receptive language, nonverbal
communications skills;
* a functional symbolic communication system;
* engagement and flexibility in developmentally appropriate tasks and
play;
* fine and gross motor skills;
* cognitive skills (symbolic play and academic skills);
* conventional/appropriate behaviors; and:
* independent organizational skills and skills for success in a regular
classroom.
In addition to sponsoring the NRC report, the Department of Education
supports improving educational experiences of children with autism
through a number of programs. For instance:
* Education reports that they provide information and advocacy for
families ovchildren with ASD through Parent Training and Information
Projects and Community-Parent Resource Centers.
* Education has supported research regarding early identification of
children with autism in order to increase the possibility that such
children will receive services at a younger age.
* To help prepare personnel, Education has funded some professional
development programs focused on the education of children with autism.
* Education participates in the Interagency Autism Coordinating
Committee, established by the Children's Health Act of 2000.
[End of slide presentation]
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