Economic Burden of Rehabilitation Services Among Parents of Childrenwith Autism Spectrum Disorder in Pakistan: A Cross-Sectional Study

Abstract

Background: This study quantifies the economic burden of rehabilitation services on families of children with autism spectrum disorder (ASD) in Karachi, Pakistan, and identifies associated socioeconomic factors.

Methods: A cross-sectional study was conducted with 30 parents of children (aged 3-14 years) diagnosed with ASD. Data were collected through structured interviews assessing sociodemographic characteristics, direct rehabilitation costs (physiotherapy, occupational therapy, speech therapy, special education), indirect costs (transportation, assistive devices, caregiver support), and perceived financial stress. Data were analyzed using SPSS version 26.0.

Results: The average monthly total cost was PKR 37,900 ± 10,600, with direct service costs averaging PKR 28,500 ± 8,200 and indirect expenses PKR 9,400 ± 4,600. Seventy percent of parents reported moderate to high financial stress. Monthly household income significantly predicted financial burden (p = 0.01), with lower-income families experiencing disproportionate strain. Nearly all costs were paid out-of-pocket due to minimal public funding.

Conclusion: This study provides critical baseline evidence on ASD rehabilitation costs in Pakistan, where such data are scarce. Findings highlight significant socioeconomic inequities and support policy recommendations for subsidized therapy programs and financial assistance mechanisms.