The Effect of Childhood Autism on Parental Employment

Background: The care of children with autism imposes direct care costs on families, as well as indirect costs resulting from loss of earnings due to increased caregiving responsibilities. Previous research on the cost of autism has been restricted primarily to studying medical costs incurred by the healthcare service system. A more comprehensive view of costs must include the financial impact on families and go beyond the costs of medical care. By examining parental employment consequences of childhood autism, this study will provide new insight on indirect costs to families. Having a child with autism imposes additional time and financial constraints for family members. Added time constraints would imply reduced employment, whereas additional financial constraints may lead to increased employment. The net effect on parental employment is an empirical question.

Objectives: to 1) estimate the effect of caring for a child with autism on parents’ labor force participation and hours of market work; 2) examine how this estimated effect varies as a function of child’s individual, family characteristics and community factors.

Methods: We will use the Medical Expenditure Panel Survey (MEPS) from the years 2002-2007. The MEPS is an annual survey that collects detailed information on healthcare use, costs, health insurance, health status, socio-economic, demographic and employment characteristics for nationally representative samples of U.S. households. We will identify children with autism using Medical Condition files that provide information on household-reported medical conditions. Using the parent identifier, we will match children with their parents. We will conduct the analysis separately for mothers and fathers. The main independent variable will be an indicator of whether the child has autism. State-of-the-art econometric techniques will be used to estimate the effect of childhood autism on mothers’ and fathers’ likelihoods of employment and hours of work.

Results: Analyses are ongoing. There were 47942 children living with their mothers, 147 of whom were diagnosed with autism. 62% of mothers of children with autism were employed, compared with 71% of mothers of other children. Average weekly work hours of mothers of children with autism were 34 (sd=12), compared with 35 (sd=11) for mothers of other children. There were 34937 children whose fathers were present in the household. Of these, 113 were diagnosed with autism. 91% of fathers of children with autism were employed, compared with 95% of other fathers. The average weekly work hours of fathers of children with autism were 46 (sd=11), compared with 44 (sd=10) for fathers of other children.

Conclusions: Our preliminary results suggest a negative effect of childhood autism on parental employment. To date, much of the discussion regarding the financial impact of autism has focused on system-level direct care costs. This results in a one-sided argument that favors insurance companies regarding the impact of different strategies for financing services for individuals with autism. This study will provide the most comprehensive estimate of a major source of family costs. This information is essential in designing healthcare and workplace policies that recognize the full impact of autism and appropriately target resources to alleviate its effects.