Abstract
Objectives We examined population-based trends in unmet need for therapy service in children with autism spectrum disorder (ASD) compared to other children with special health care needs (CSHCN), and identified factors associated with unmet need for therapy. Methods A pooled cross-sectional comparison of the 2005–2006 and 2009–2010 waves of the National Survey for Children with Special Health Care Needs (NS-CSHCN) was used. Weighted bivariate analyses were used to compare children ages 3–17 years with ASD (n = 5113) to other CSHCN (n = 71,294) on unmet need for therapy services. Survey weighted multivariate models were used to examine child, family, and contextual characteristics associated with unmet need. Results A greater percentage of children with ASD across both surveys were reported to need therapy than other children with CSHCN. Among children with a reported need, children with ASD were 1.4 times more likely to report an unmet need for therapy compared to other CSHCN (OR 1.42, 95 % CI 1.18–1.71). Variables significantly associated with unmet need for therapy services included not receiving a well-child visit in the past year (OR 5.81, CI 3.83–8.81), surveyed in 2009 (OR 1.42, CI 1.18–1.71), child being female (OR 1.27, CI 1.05–1.53), uninsured (OR 1.72, CI 1.15–2.56), and having greater functional limitation (OR 2.44, CI 1.80–3.34). Conclusions for Practice Children with ASD require supportive services such as occupational, physical, and speech therapy but are less likely to receive such services than other CSHCN. Receiving a well-child visit in the past year was strongly associated with receipt of needed therapy services.
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Acknowledgments
This study was supported by Grant R40MC26194-01-02 from the Maternal and Child Health Research Program, Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services.
Role of the Sponsor
The sponsor did not play a role in the design, implementation, analysis, or interpretation of the data; nor the preparation, review, or approval of the manuscript for submission for publication.
Additional Contributions
Katie Moran, OTS, Alexandra Wolfgang-Price, MS, OTR/L and James Cassel, OTS participated in administrative preparation of the manuscript for publication and all received federal work study compensation as graduate research assistants for their work.
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Benevides, T.W., Carretta, H.J. & Lane, S.J. Unmet Need for Therapy Among Children with Autism Spectrum Disorder: Results from the 2005–2006 and 2009–2010 National Survey of Children with Special Health Care Needs. Matern Child Health J 20, 878–888 (2016). https://doi.org/10.1007/s10995-015-1876-x
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DOI: https://doi.org/10.1007/s10995-015-1876-x