Patna: For many middle-class families of autistic children in Bihar, therapy comes with a heavy financial burden. What begins as a search for answers after diagnosis often turns into a years-long struggle involving therapy expenses, travel costs, relocation and the challenge of finding trained professionals.As awareness and diagnoses rise, families across Bihar say they are spending thousands of rupees every month, with limited support available through public healthcare systems.When Roma Kumari’s six-year-old son Jatin struggled with toilet training and developmental milestones during the Covid-19 lockdown, she was unaware of autism. A resident of Bahari Dhawalpura in Patna City, she spent months visiting different doctors before understanding her son’s condition.The next challenge was accessing treatment.Private therapy sessions cost around Rs800 each, taking her monthly expenses close to Rs15,000. For a farming family, sustaining the cost was difficult. Roma initially sought help at a govt hospital in Pahari, but after seeing limited improvement, she was referred to private therapists.“I had to sell a piece of my land to continue Jatin’s treatment,” she says.Even after receiving discounted rates, speech and occupational therapy, along with travel expenses, cost the family nearly Rs1,000 a day.For Nivriti Singh, the challenge has also meant relocating. A resident of Bhagalpur, she has been living in Patna’s Phulwarisharif area for nearly three years so that her seven-year-old son, Keshav, can access therapy.Her husband, a govt school teacher, is the family’s sole earning member. The family spends around Rs10,000 a month on rent and more than Rs30,000 on therapy and related expenses.“It has been a physical, mental and financial crisis for me,” she says. “I cannot leave him alone even for a minute. People make comments and call him ‘pagal’,” she laments.The financial strain is similar for Amrendra Kumar Puri, whose six-year-old son Abhiraj is undergoing multiple therapies. Originally from Muzaffarpur, the family shifted to Patna and pays Rs11,000 a month in rent to remain close to treatment facilities.“It is very difficult for a middle-class family to afford,” Puri says, adding, “We had to borrow money from friends to start therapy. We have severely cut down on our lifestyle to manage the expenses.”“The govt should open more affordable therapy centres and special schools so that lower and middle-income families are not left behind,” he says.Experts say such financial challenges are common among families seeking autism care. Dr Shams Alam, consultant occupational therapist in Patna, said the biggest challenge for many families is not only receiving a diagnosis but sustaining long-term intervention.“Occupational therapy, speech therapy, behavioural therapy, special education, transportation and regular follow-ups create a cumulative financial burden that can overwhelm many families,” he says.He called for govt-supported early intervention centres, insurance coverage for therapy services, financial assistance for low-income families and stronger support systems within schools.
