Dawn Magnusson1, Mari Palta2, Beth McManus3, Ruth E Benedict4, Maureen S Durkin5. 1. Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wis. Electronic address: dmagnus1@jhmi.edu. 2. Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wis; Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis. 3. Department of Health Systems, Management and Policy, Colorado School of Public Health, Aurora, Colo. 4. Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wis; Department of Kinesiology, Occupational Therapy Program, School of Education, University of Wisconsin-Madison, Madison, Wis. 5. Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wis; Department of Pediatrics, University of Wisconsin-Madison, Madison, Wis; School of Medicine and Public Health, Waisman Center, University of Wisconsin-Madison, Madison, Wis.
Abstract
OBJECTIVE: Estimates of unmet therapy need based on parent report overlook the unmet needs of children with developmental delay (DD) whose parents do not first recognize a need for therapy. Using national survey, data we: 1) identified children with DD who likely need physical, occupational, or speech therapy services; 2) estimated the prevalence of overall unmet therapy need; and 3) examined factors associated with unrecognized therapy need and parent-reported unmet therapy need. METHODS: Criteria for DD were applied to children aged 0 to 4 years using the 2009-2010 National Survey of Children With Special Health Care Needs (NS-CSHCN). Multivariate logistic regression was used to identify factors associated with unrecognized or parent-reported unmet therapy need. RESULTS: Among 5349 children with special health care needs aged 0 to 4 years, 50.2% met our inclusion criteria for DD, 21.6% had overall unmet therapy need, 15.4% had unrecognized therapy needs, and 6.2% had parent-reported unmet therapy need. The adjusted odds of unrecognized therapy need were higher among black and Hispanic children, and children from other racial or ethnic groups than among white children (adjusted odds ratio 1.78 [95% confidence interval 1.23-2.57]). The odds of parent-reported unmet therapy need were higher for children lacking special education services. CONCLUSIONS: Relying on parent-reported unmet therapy need, without considering children with DD whose therapy needs go unrecognized, likely underestimates overall unmet therapy need among children with DD. Exploring the mechanisms underlying racial, ethnic, and socioeconomic disparities in overall unmet therapy need should facilitate the development of effective interventions aimed at improving therapy access for children with DD.
OBJECTIVE: Estimates of unmet therapy need based on parent report overlook the unmet needs of children with developmental delay (DD) whose parents do not first recognize a need for therapy. Using national survey, data we: 1) identified children with DD who likely need physical, occupational, or speech therapy services; 2) estimated the prevalence of overall unmet therapy need; and 3) examined factors associated with unrecognized therapy need and parent-reported unmet therapy need. METHODS: Criteria for DD were applied to children aged 0 to 4 years using the 2009-2010 National Survey of Children With Special Health Care Needs (NS-CSHCN). Multivariate logistic regression was used to identify factors associated with unrecognized or parent-reported unmet therapy need. RESULTS: Among 5349 children with special health care needs aged 0 to 4 years, 50.2% met our inclusion criteria for DD, 21.6% had overall unmet therapy need, 15.4% had unrecognized therapy needs, and 6.2% had parent-reported unmet therapy need. The adjusted odds of unrecognized therapy need were higher among black and Hispanic children, and children from other racial or ethnic groups than among white children (adjusted odds ratio 1.78 [95% confidence interval 1.23-2.57]). The odds of parent-reported unmet therapy need were higher for children lacking special education services. CONCLUSIONS: Relying on parent-reported unmet therapy need, without considering children with DD whose therapy needs go unrecognized, likely underestimates overall unmet therapy need among children with DD. Exploring the mechanisms underlying racial, ethnic, and socioeconomic disparities in overall unmet therapy need should facilitate the development of effective interventions aimed at improving therapy access for children with DD.
Authors: Stacey C Dusing; Jennifer C Burnsed; Shaaron E Brown; Amy D Harper; Karen D Hendricks-Munoz; Richard D Stevenson; Leroy R Thacker; Rebecca M Molinini Journal: Phys Ther Date: 2020-08-12
Authors: Matthew L Romo; Katharine H McVeigh; Phoebe Jordan; Jeanette A Stingone; Pui Ying Chan; George L Askew Journal: J Public Health (Oxf) Date: 2020-11-23 Impact factor: 2.341
Authors: Chantal Camden; Léa Héguy; Megan Casoli; Mathieu Roy; Lisa Rivard; Jade Berbari; Mélanie Couture Journal: Int J Environ Res Public Health Date: 2020-04-07 Impact factor: 3.390
Authors: Brian P Kelley; Lauren E Franzblau; Kevin C Chung; Noelle Carlozzi; Jennifer F Waljee Journal: Plast Reconstr Surg Date: 2016-07 Impact factor: 5.169