Treatment is expensive; indirect costs are more so. A U.S. study estimated an average cost of $3.2 million in 2003 U.S. dollars for someone born in 2000, with about 10% medical care, 30% extra education and other care, and 60% lost economic productivity.^[1] Publicly supported programs are often inadequate or inappropriate for a given child, and unreimbursed out-of-pocket medical or therapy expenses are associated with likelihood of family financial problems;^[2] a 2008 U.S. study found a 14% average loss of annual income in families of children with ASD.^[3] After childhood, key treatment issues include residential care, job training and placement, sexuality, social skills, and estate planning.^[4]