Eric Rubenstein1, Lisa Croen2, Li-Ching Lee3, Eric Moody4, Laura A Schieve5, Gnakub N Soke5, Kathleen Thomas6, Lisa Wiggins5, Julie Daniels7. 1. University of Wisconsin Madison, Waisman Center, 1500 Highland Ave, Madison WI, 53705. 2. Division of Research, Kaiser Permanente of Northern California, 2000 Broadway, Oakland, CA 94612. 3. Bloomberg School of Public Health, Johns Hopkins University, 315 N Wolfe St, Baltimore, MD 21231. 4. Wyoming Institute of Disabilities, University of Wyoming, 1000 E. University Ave. Laramie, WY 82071. 5. Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, 1600 Clifton Road, Atlanta, GA 30329. 6. Cecil G. Sheps Center for Health Services Research, University of North Carolina Chapel Hill, 725 Martin Luther King Jr. Blvd. Chapel Hill, NC 27599-7590. 7. University of North Carolina Gillings School of Global Public Health, Department of Biostatistics, 137 East Franklin Street Room 6702 CB# 8030 Chapel Hill, NC 27514.
Abstract
BACKGROUND: ASD-related services can improve outcomes for children, but less is known about service outside of school settings during preschool age. We aimed to describe amount and category of community-based service use among 3-5-year-old children with ASD and examine differences by health insurance. METHODS: We used cross-sectional data on 792 children with ASD diagnoses in the Study to Explore Early Development, a community-based study of neurodevelopment with enrollment between 2012-2016. Mothers reported current child service use and insurance status at study entry. We used log-Poisson and logistic regression to compare service use by insurance group. RESULTS: Nearly 40% of children were not receiving community-based services at study entry. Children with public insurance had fewer total services than children with private or both insurances. After adjustment for sociodemographic confounders, insurance status was not associated with types of different categories of community-based services. However, children with public insurance alone were least likely to receive community-based behavioral therapy and most likely to receive psychotropic medication compared to other insurances. CONCLUSION: Many preschool-aged children do not receive community-based services, with receipt associated with insurance type. Increasing access and availability for evidence-based service, especially for beneficiaries of public insurance, may improve service use and outcomes.
BACKGROUND: ASD-related services can improve outcomes for children, but less is known about service outside of school settings during preschool age. We aimed to describe amount and category of community-based service use among 3-5-year-old children with ASD and examine differences by health insurance. METHODS: We used cross-sectional data on 792 children with ASD diagnoses in the Study to Explore Early Development, a community-based study of neurodevelopment with enrollment between 2012-2016. Mothers reported current child service use and insurance status at study entry. We used log-Poisson and logistic regression to compare service use by insurance group. RESULTS: Nearly 40% of children were not receiving community-based services at study entry. Children with public insurance had fewer total services than children with private or both insurances. After adjustment for sociodemographic confounders, insurance status was not associated with types of different categories of community-based services. However, children with public insurance alone were least likely to receive community-based behavioral therapy and most likely to receive psychotropic medication compared to other insurances. CONCLUSION: Many preschool-aged children do not receive community-based services, with receipt associated with insurance type. Increasing access and availability for evidence-based service, especially for beneficiaries of public insurance, may improve service use and outcomes.
Authors: Jon Baio; Lisa Wiggins; Deborah L Christensen; Matthew J Maenner; Julie Daniels; Zachary Warren; Margaret Kurzius-Spencer; Walter Zahorodny; Cordelia Robinson Rosenberg; Tiffany White; Maureen S Durkin; Pamela Imm; Loizos Nikolaou; Marshalyn Yeargin-Allsopp; Li-Ching Lee; Rebecca Harrington; Maya Lopez; Robert T Fitzgerald; Amy Hewitt; Sydney Pettygrove; John N Constantino; Alison Vehorn; Josephine Shenouda; Jennifer Hall-Lande; Kim Van Naarden Braun; Nicole F Dowling Journal: MMWR Surveill Summ Date: 2018-04-27