Autism: Comorbidities and Treatment Patterns in the Real World, a Retrospective Cohort Study Among Children, Adolescents and Adults Newly Diagnosed with Autism.
Azza Shoaib, M Soledad Cepeda, Gayle Murray and 1 others
PMID 34623581WHAT IT FOUND
Among 36,000 newly diagnosed autistic patients, behavioral therapy was the most common treatment, received by over 70%.
Comorbidities were frequent, with ADHD affecting about half. Treatment patterns varied widely, with many patients switching or combining therapies over three years.
Key findings
01ADHD was the most common comorbidity, present in 50.09% of Medicaid patients and 44.16% of commercial insurance patients.
02Behavioral therapy was the most common treatment, received by 74.64% of Medicaid patients and 71.97% of commercial insurance patients.
03Combination therapy became more common as treatment lines advanced, occurring in 75% of Medicaid patients and 64.38% of commercial insurance patients by the fourth line.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Patients were identified using diagnosis codes, which are not perfect, though a validated algorithm was used to improve accuracy. The study did not examine the average time patients actively received each treatment or the duration of gaps between treatments. Prescription claims do not include diagnoses, so it is impossible to link specific medications to specific comorbidities or symptoms. Requiring three years of continuous observation likely excluded some patients with ASD. The databases do not capture the severity of autism, which could explain some variation in treatment. Group-level behavioral interventions mediated by schools or community organizations may not have been fully captured.
Declared interests
The authors declare no conflicts of interest. The study used de-identified data from IBM MarketScan and Optum databases.
The easy way to misread this
Do not interpret the high prevalence of behavioral therapy or specific medications as evidence of their efficacy for core ASD symptoms. This is a descriptive study of real-world usage patterns, not a trial testing treatment outcomes.