Service Use Classes Among School-aged Children From the Autism Treatment Network Registry

Abstract

BACKGROUND AND OBJECTIVES: Use of specific services may help to optimize health for children with autism spectrum disorder (ASD); however, little is known about their service use patterns. We aimed to (1) define service use groups and (2) determine associations of sociodemographic, developmental, behavioral, and health characteristics with service use groups among schoolaged children with ASD. METHODS: We analyzed cross-sectional data on 1378 children aged 6 to 18 years with an ASD diagnosis from the Autism Speaks Autism Treatment Network registry for 2008-2015, which included 16 US sites and 2 Canadian sites. Thirteen service use indicators spanning behavioral and medical treatments (eg, developmental therapy, psychotropic medications, and special diets) were examined. Latent class analysis was used to identify groups of children with similar service use patterns. RESULTS: By using latent class analysis, school-aged children with ASD were placed into 4 service use classes: limited services (12.0%), multimodal services (36.4%), predominantly educational and/or behavioral services (42.6%), or predominantly special diets and/or natural products (9.0%). Multivariable analysis results revealed that compared with children in the educational and/or behavioral services class, those in the multimodal services class had greater ASD severity and more externalizing behavior problems, those in the limited services class were older and had less ASD severity, and those in the special diets and/or natural products class had higher income and poorer quality of life. CONCLUSIONS: In this study, we identified 4 service use groups among school-aged children with ASD that may be related to certain sociodemographic, developmental, behavioral, and health characteristics. Study findings may be used to better support providers and families in decision-making about ASD services. WHAT'S KNOWN ON THIS SUBJECT: Myriad services exist for children with autism spectrum disorder (ASD). Some researchers have examined the use of individual services, the number of services used, and weekly treatment hours among children with ASD. Little is known, however, about service use patterns among children with ASD. WHAT THIS STUDY ADDS: In this study, we identified 4 distinctive service use classes among a large sample of school-aged children with ASD across North America. Service use classes included limited services, multimodal services, predominantly educational and/or behavioral services, and predominantly special diets and/or natural products.

Universal child health and early education service use from birth through Kindergarten and developmental vulnerability in the Preparatory Year (age 5 years) in Tasmania, Australia

“…LCA is a model‐based technique that provides fit statistics. This is useful when there are no a priori recommended thresholds of service use (Lindly et al, 2020; Petersen et al, 2019). LCA was used to reduce the heterogeneity of service use patterns to a meaningful number of different patterns.…”

Characterizing the physical and mental health profile of children, adolescents and adults with autism spectrum disorder in Spain

“…Despite this evidence, most health problems beyond ASD-related symptoms have been overlooked for decades. Only a few studies have systematically addressed them in the last years ( 22 , 26 , 36 ), and fewer still have included adult individuals ( 24 , 30 , 33 , 37 ). Thus, the lack of research on health outcomes is a significant barrier to promoting the QoL of people on the autism spectrum.…”

Editors’ Note and Prologue

“…Ultimately, the optimization of health of children and youth with ASD is dependent not only on the availability of evidence-based interventions but access to and use of such services. Lindly and colleagues 26 examined the presence of distinct service use groups and the association with developmental and health characteristics and sociodemographic factors. They report 4 different classes of service use, with the majority of children receiving multimodal therapies or primarily educational services, but still, onefifth of the population received limited services or primarily nutritional or special diet treatments.…”