Cost-utility analysis of Social Stories��� for children with autism spectrum disorder in mainstream primary schools: results from a randomised controlled trial.
Han-I Wang, Kerry Bell, Jane Blackwell, Charlie Welch, Laura Mandefield, Judith Watson, Emma Standley, Dean McMillan, Simon Gilbody, Barry Wright, Catherine Hewitt, Steve Parrott
Author Information
Han-I Wang: Department of Health Sciences, University of York, UK; and York Trial Unit, Department of Health Sciences, University of York, UK. ORCID
Kerry Bell: Department of Health Sciences, University of York, UK; and York Trial Unit, Department of Health Sciences, University of York, UK.
Jane Blackwell: Department of Health Sciences, University of York, UK; and York Trial Unit, Department of Health Sciences, University of York, UK.
Charlie Welch: Department of Health Sciences, University of York, UK; and York Trial Unit, Department of Health Sciences, University of York, UK. ORCID
Laura Mandefield: Department of Health Sciences, University of York, UK; and York Trial Unit, Department of Health Sciences, University of York, UK.
Judith Watson: Department of Health Sciences, University of York, UK; and York Trial Unit, Department of Health Sciences, University of York, UK.
Emma Standley: Department of Health Sciences, University of York, UK; and York Trial Unit, Department of Health Sciences, University of York, UK.
Dean McMillan: Department of Health Sciences, University of York, UK; and Hull York Medical School, University of York, UK.
Simon Gilbody: Department of Health Sciences, University of York, UK; and Hull York Medical School, University of York, UK. ORCID
Barry Wright: Department of Health Sciences, University of York, UK; Hull York Medical School, University of York, UK; and Child Oriented Mental Health Intervention Centre (COMIC), Leeds and York Partnership NHS Foundation Trust, York, UK.
Catherine Hewitt: Department of Health Sciences, University of York, UK; and York Trial Unit, Department of Health Sciences, University of York, UK.
Steve Parrott: Department of Health Sciences, University of York, UK; and York Trial Unit, Department of Health Sciences, University of York, UK.
BACKGROUND: One in 57 children are diagnosed with autism in the UK, and the estimated cost for supporting these children in education is substantial. Social Stories��� is a promising and widely used intervention for supporting children with autism in schools and families. It is believed that Social Stories��� can provide meaningful social information to children that can improve social understanding and may reduce anxiety. However, no economic evaluation of Social Stories has been conducted. AIMS: To assess the cost-effectiveness of Social Stories through Autism Spectrum Social Stories in Schools Trial 2, a multi-site, pragmatic, cluster-randomised controlled trial. METHOD: Children with autism who were aged 4-11 years were recruited and randomised ( = 249). Costs measured from the societal perspective and quality-adjusted life-years (QALYs) measured by the EQ-5D-Y-3L proxy were collected at baseline and at 6-month follow-up for primary analysis. The incremental cost-effectiveness ratio was calculated, and the uncertainty around incremental cost-effectiveness ratios was captured by non-parametric bootstrapping. Sensitivity analyses were performed to evaluate the robustness of the primary findings. RESULTS: Social Stories is likely to result in a small cost savings (-��191 per child, 95% CI -767.7 to 337.7) and maintain similar QALY improvements compared with usual care. The probability of Social Stories being a preferred option is 75% if society is willing to pay ��20 000 per QALY gained. The sensitivity analysis results aligned with the main study outcomes. CONCLUSIONS: Compared with usual care, Social Stories did not lead to an increase in costs and maintained similar QALY improvements for primary-aged children with autism.
