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.