Rising autism prevalence rates have lent urgency to efforts to improve outcomes for individuals with autism spectrum disorder (ASD). Stakeholders have focused, in particular, on the transition to adulthood that can occur over a range of ages, typically between 18 and 22 years, and often corresponding to when the youth finishes secondary school. This represents a particularly vulnerable time, as the entitlements of the children's service system end and young adults with ASD and their families encounter fragmented and underfunded systems of care. Research across multiple domains-education, vocational training and employment, social support and community involvement, housing and healthcare-reveals poor outcomes for this population during the transition to adulthood, suggesting that the current models of school-based transition planning are not meeting
Objective
Little national data exist regarding service use patterns for
children with autism spectrum disorder (ASD) of varying severity. This study
aimed to assess the relationship between parent-reported severity and use of
educational and health care services.
Method
Data from the 2011 Survey of Pathways to Diagnosis and Services were
used to examine a nationally-representative sample of 1420 US children aged
6–17 years with ASD, with or without developmental delay and
intellectual disability. Weighted multivariable logistic regression assessed
associations of parent-reported ASD severity and child sociodemographic
characteristics with school-based therapy, non-school-based therapy,
behavioral interventions, and specialty provider visits.
Results
Higher parent-reported ASD severity was associated with increased
likelihood of current use of school-based therapy (Adjusted Odds Ratio
[AOR] 4.08, 95% Confidence Interval
1.85–8.98), non-school-based therapy (AOR 3.60
[1.95–6.66]), and behavioral interventions (AOR 2.30
[1.22–4.34]), as well as regular specialty provider
visits (AOR 2.99 [1.38–6.46]). Though rates of
service use were generally highest among children with severe ASD,
non-school-based therapy and behavioral interventions were only used by
about half of children with severe ASD, and about 1 in 4 children with mild
ASD were using none of the therapies asked about.
Conclusion
Parent-reported severity is associated with increased therapy and
specialty provider service use among children with ASD. However, substantial
variability exists in service use across levels of severity.
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