The relationship between school characteristics and the availability of mental health and related health services in middle and high schools in the United States

Slade, Eric P.

doi:10.1007/bf02287426

Cited by 54 publications

(36 citation statements)

References 29 publications

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“…Although similar rates of ASD prevalence are reported in both rural (0.9%) and urban (1.0%) areas (Mohamed et al, 2016), individuals in rural communities, report limited access to the types of resources required for timely and appropriate identification and intervention services (Cohen and Hesselbart, 1993; Slade, 2003; Green et al, 2013; Gona et al, 2016). There are specific factors which contribute to barriers in diagnosis and services for affected individuals and families in rural settings.…”

Section: Introductionmentioning

confidence: 78%

“…In general, poor availability and implementation of mental health services for children has been reported for rural areas (Cohen and Hesselbart, 1993; Slade, 2003; Green et al, 2013; Cummings et al, 2015), however, there is little research examining the specific barriers that prevent children with ASD and their families from benefitting fully from services available in rural settings. In this section, we outline recently identified barriers to implementation, and we suggest specific solutions that may increase the availability of effective screening and intervention strategies.…”

Section: Implementation Of Asd Services In Rural Settingsmentioning

confidence: 99%

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Rural Trends in Diagnosis and Services for Autism Spectrum Disorder

et al. 2017

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Rural communities face significant challenges regarding the adequate availability of diagnostic-, treatment-, and support-services for individuals with autism spectrum disorder (ASD). Specifically, a variety of factors, including geographic distance between families and service providers, low reliance on health care professionals, and cultural characteristics, contribute to the diminished availability and utilization of services. Together, these factors lead to risks for delayed ASD screening and diagnosis, yielding lower educational and functional outcomes. The purpose of this review is to outline the specific diagnosis and treatment barriers that affect individuals with ASD and their families in rural settings. Telehealth feasibility and efficacy research is also reviewed, suggesting that telecommunication services may offer an inroad for addressing the specific service barriers faced by rural communities. Together, the current review identifies specific needs for both research and support services that address the specific access barriers characteristic of rural settings.

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Section: Introductionmentioning

confidence: 78%

Section: Implementation Of Asd Services In Rural Settingsmentioning

confidence: 99%

Rural Trends in Diagnosis and Services for Autism Spectrum Disorder

et al. 2017

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“…[39][40][41][42] A number of studies have found that children in rural areas have less access to regular and specialty care. 43,44 It may also be that a critical mass of children with ASD, which is more likely found in densely populated areas, may increase physicians' and families' familiarity with the disorder.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Age of Diagnosis Among Children With Autism Spectrum Disorders

2005

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Objective-Early diagnosis of children with autism spectrum disorders (ASD) is critical but often delayed until school age. Few studies have identified factors that may delay diagnosis. This study attempted to identify these factors among a community sample of children with ASD.Methods-Survey data were collected in Pennsylvania from 969 caregivers of children who had ASD and were younger than 21 years regarding their service experiences. Linear regression was used to identify clinical and demographic characteristics associated with age of diagnosis.Results-The average age of diagnosis was 3.1 years for children with autistic disorder, 3.9 years for pervasive developmental disorder not otherwise specified, and 7.2 years for Asperger's disorder. The average age of diagnosis increased 0.2 years for each year of age. Rural children received a diagnosis 0.4 years later than urban children. Near-poor children received a diagnosis 0.9 years later than those with incomes >100% above the poverty level. Children with severe language deficits received a diagnosis an average of 1.2 years earlier than other children. Hand flapping, toe walking, and sustained odd play were associated with a decrease in the age of diagnosis, whereas oversensitivity to pain and hearing impairment were associated with an increase. Children who had 4 or more primary care physicians before diagnosis received a diagnosis 0.5 years later than other children, whereas those whose pediatricians referred them to a specialist received a diagnosis 0.3 years sooner.Conclusion-These findings suggest improvements over time in decreasing the age at which children with ASD, especially higher functioning children, receive a diagnosis. They also suggest a lack of resources in rural areas and for near-poor families and the importance of continuous pediatric care and specialty referrals. That only certain ASD-related behaviors, some of which are not required to satisfy diagnostic criteria, decreased the age of diagnosis suggests the importance of continued physician education.Early diagnosis of autism spectrum disorders (ASD) is critical for a number of reasons, 1, 2 perhaps most important because interventions to improve the functioning of children with ASD may be more effective with younger children.3 -6 Evidence suggests that early treatment optimizes long-term prognosis, 7 and treatment yields diminishing returns as children get older. 8 Several studies have estimated that the gains in functioning associated with early treatment will result in considerable cost savings to both families of children with ASD and the systems in which they are served. [9][10][11]

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“…6 Public schools have become the main provider of behavioral health services to children in the United States (US) and are responsible for approximately 70–80% of all behavioral health services delivered to children. 11–14 Schools provide convenient access to behavioral health services and significantly reduce barriers to treatment seen in traditional outpatient settings, particularly in ethnic minority groups 15–17 …”

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confidence: 99%

Ethnic Disparities in School‐Based Behavioral Health Service Use for Children With Psychiatric Disorders

Locke

Kang-Yi

Pellecchia

et al. 2016

Journal of School Health

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BACKGROUND We examined racial/ethnic disparities in school-based behavioral health service use for children with psychiatric disorders. METHODS Medicaid claims data were used to compare the behavioral healthcare service use of 23,601 children aged 5–17 years by psychiatric disorder (autism, attention deficit hyperactivity disorder (ADHD), conduct/oppositional defiant disorder, and “other”) and by race/ethnicity (African-American, Hispanic, white, and other). Logistic and generalized linear regression analyses were used. RESULTS Differences in service use by racial/ethnic group were identified within and across diagnostic groups, both for in-school service use and out-of-school service use. For all disorders, Hispanic children had significantly lower use of in-school services than white children. Among children with ADHD, African-American children were less likely to receive in-school services than white children; however, there were no differences in adjusted annual mean Medicaid expenditures for in-school services by race/ethnicity or psychiatric disorders. Statistically significant differences by race/ethnicity were found for out-of-school service use for children with ADHD and other psychiatric disorders. There were significant differences by race/ethnicity in out-of-school service use for each diagnostic group. CONCLUSIONS Differences in the use of school-based behavioral health services by racial and ethnic groups suggest the need for culturally appropriate outreach and tailoring of services to improve service utilization.

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The relationship between school characteristics and the availability of mental health and related health services in middle and high schools in the United States

Cited by 54 publications

References 29 publications

Rural Trends in Diagnosis and Services for Autism Spectrum Disorder

Rural Trends in Diagnosis and Services for Autism Spectrum Disorder

Factors Associated With Age of Diagnosis Among Children With Autism Spectrum Disorders

Ethnic Disparities in School‐Based Behavioral Health Service Use for Children With Psychiatric Disorders

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