# Access and cost of services for autistic children and adults in Italy: a carers’ perspective

## TL;DR

This study explores the access to and costs of services for autistic individuals in Italy from the perspective of their carers.

## Contribution

It provides new insights into the challenges faced by carers in accessing and affording autism-related services in Italy.

## Key findings

- Carers spend significant time and money on autism-related services, often paying for professionals like psychologists and speech therapists.
- Educational support is frequently provided by support teachers, but many carers face high out-of-pocket costs.
- Autistic adults often face unemployment despite wanting to work, and carers frequently reduce their own work hours to provide care.

## Abstract

Limited information exists on autistic service access and costs in Italy.

This study aims to investigate access to educational, healthcare, social, and related services for autistic individuals in Italy as part of the Autism Spectrum Disorder in the European Union (ASDEU) project.

Italian carers of autistic individuals completed an online survey regarding services and costs in the 6 months before completion.

Three hundred and three carers of autistic people participated in the survey. The majority of those receiving care were children, males, and lived at home with their parents. Autistic adults were often students (17%) or unemployed but willing to work (17%). Employed carers (49%) worked on average 32.23 ± 9.27 hours per week. A significant portion (82%) took work or school absences to care for autistic individuals, averaging 15.56 ± 14.70 days. On average, carers spent 58.84 ± 48.36 hours per week on caregiving duties. Fifty-five of the autistic individuals received some form of support, 5% utilized residential care, and 6% were hospitalized. Thirty-four percent received outpatient hospital care, and 20% underwent some form of autism-related psychopharmacological therapy. School support was primarily provided by support teachers (18.16 ± 7.02 hours/week). Educational psychologists (80.73%), psychomotor therapists/physiotherapists (53.85%), and speech therapists (50.91%) were frequently paid by carers who paid more per hour. Autistic children received support from educators (73.96 hours/week), group therapy (32.36 hours/week), and speech therapists (31.19 hours/week). Psychologists (76.00%) and counseling/individual therapists (89.13%) were often paid by carers. Carers reported high costs for psychiatrists and psychologists, with frequent use of psychiatric services (8 ± 8 times in 6 months).

Carers’ perspectives on the access and costs of services for autistic individuals in Italy can provide insights into areas for improvement in the delivery of autism services.