Measuring the Social Return on Investment from Progression Support for Autistic Adults – Lessons and Results from Case Studies.

Background: Autism is a lifelong condition experienced by a significant and possibly increasing proportion of the population. The direct financial cost of supporting autistic people and their families is significant. Outcomes for autistic people in adulthood are on average worse than for the rest of the population. Hence the wider economic and social benefits to society of providing support which leads to improved outcomes are also likely to be significant. Applying a Social Return On Investment (SROI) approach to interventions for autistic adults is a potentially informative way of understanding the balance of costs and benefits to society.

Objectives: The project’s objectives are to assess (1) the applicability of SROI concepts to services for autistic adults (2) identification of autism specific issues necessitating modification of the SROI approach (3) the practicality of collecting longitudinal SROI data in a frontline service setting (4) the value and insights which the autistic adults, service managers, commissioners and other stakeholders derived from the resultant SROI estimates.

Methods: This project takes place within three geographically separate services operated by a leading nationwide autism charity. Each service was chosen because its focus is to support autistic adults in achieving progression towards a life course goal – for example successful transition into adulthood, or progression towards sustained, unsupported employment. A review of SROI approaches in government and the third sector was undertaken. A longitudinal dataset of service fees was constructed to quantify financial costs and identify individuals with apparently changing support needs. With individuals’ consent, input data and contextual information was collected via interviews and case notes.

Results: Autism professionals, autistic people and their families generally agreed with the validity and relevance of the SROI approach. When case studies are completed, feedback will be sought from stakeholders on the insights they bring. Significant changes over time in individuals’ service fees were less common than expected, suggesting that achievement of life course goals is rare, though further investigation may identify other factors that explain this finding. Autistic adults in receipt of these services often had a poor employment history, accessed health and social care frequently, and some were in contact with the criminal justice system. This suggests there is high potential SROI which can be realised if services prove effective for at least some individuals up to a ‘break even’ point which the project will attempt to estimate.

Conclusions: The SROI approach appears to be applicable to services for autistic adults and of value to stakeholders. There are some challenges including the difficulty autistic people may have with recall or intrusive questioning; the often slow and uneven progress achieved towards outcomes; and the complexity of SROI calculations for untrained service managers. These challenges can potentially be overcome if a professional analyst is engaged, processes are co-produced with autistic people, and periodic data collection is built into the support planning and reviewing process.