Food insecurity in the households of children with autism spectrum disorders and intellectual disabilities in the United States: Analysis of the National Survey of Children’s Health Data 2016–2018

Abstract

Individuals with autism spectrum disorder and co-occurring intellectual disabilities experience substantial challenges in accessing needed supports. This research aimed to understand the prevalence and factors associated with food insecurity among families of children with autism spectrum disorder and co-occurring intellectual disabilities. Utilizing the National Survey of Children’s Health (2016–2018) data, this article illustrated that the households of children with autism spectrum disorder and co-occurring intellectual disabilities were about two times more likely to be food insecure than the households of children without disabilities. Furthermore, the households of children with autism spectrum disorder were 1.5 times more likely, and those with other disabilities were 1.3 times more likely to be food insecure than the households of children without disabilities. Implications of these findings in the context of the COVID-19 pandemic are discussed. Lay abstract Families of children with autism spectrum disorder are more likely to experience financial strain and resulting food insecurity due to additional cost of care, disparate access to needed services, and loss of income resulting from parental job loss. Utilizing nationally representative data, this analysis indicates that the families of children with autism spectrum disorder and co-occurring intellectual disabilities are twice as likely to experience food insecurity than families of children without disabilities after adjusting for various factors. Several factors, ranging from state-level policies such as Medicaid expansion to individual-level factors such as higher utilization of emergency room services, were associated with the higher prevalence of food insecurity in families of children with autism spectrum disorder and co-occurring intellectual disabilities. Implications of these findings on programs and policies supporting families in the COVID-19 pandemic are discussed.

Food insecurity in households of children with ASD in COVID-19 pandemic: A comparative analysis with the Household Pulse Survey data using stabilized inverse probability treatment weights

“…Prior research based on the analyses of the NSCH data by the authors identified various factors at individual-, family-, and community-levels contributed in predicting higher levels of food insecurity in households of children on the autism spectrum. 5 For example, children on the autism spectrum were more likely to use emergency room services, missed several days of school, and were more likely to be exposed to adverse childhood experiences. These variables also strongly predicted food insecurity in the multivariate regression models.…”

“…Additionally, the [Author’s organization] respondents consisted of a self-selected sample of parents/caregivers of children on autism spectrum. In comparing the distribution of race/ethnicity characteristics of parents/caregivers of children on autism spectrum in the National Survey of Children’s Health data, 38 the [Author’s organization] respondents had higher proportion of NHW and a lower proportion of families that identified themselves as Hispanic. These differences result from self-selection of the survey participants, and the study design limitations make it difficult to compute selection probabilities due to lack of access to respondent background characteristics who got the survey links.…”

“…Based on the analysis of the National Survey of Children’s Health (NSCH), children on the autism spectrum and children on the autism spectrum with intellectual disabilities had the highest likelihood of experiencing food insecurity (odds ratio (OR) =1.5 and OR=1.9 respectively), compared to households without children without disabilities before the pandemic. 5 The COVID-19 pandemic could negatively impact the food security status of households of children on the autism spectrum by exacerbating existing social, economic, behavioral health vulnerabilities. 6 …”

Financial Impacts and Community Resources Utilization of Children with Feeding Difficulties

“…Additional costs of care, disparate access to needed services, and reduced income from job loss are likely contributing to food insecurity in this population [27]. Children who experience food insu ciency have limited or uncertain ability to acquire acceptable foods [28] suggesting that these children may not always have access to various textures and avors to support developmentally appropriate feeding skills.…”

Maternal Mental Health and Parenting Stress and Their Relationships to Characteristics of the Child With Fragile X Syndrome

“…Moreover, these parents are often engaged in high levels of advocacy on behalf of their children from birth [or receipt of diagnosis; ( 10 )] and persists through adulthood as they advocate for job placements and more ( 11 ). These parents often shoulder additional financial demands surrounding the cost of specialized therapies and health care for their children ( 12 ). Parents of children with neurodevelopmental disabilities may also be required to deal with child challenging behaviors, such as aggression and hyperarousal ( 13 , 14 ), limitations in child adaptive functioning ( 15 – 17 ), as well as social ( 18 , 19 ) and academic challenges ( 20 , 21 ), all of which can further contribute to higher caregiver burden and stress.…”