Comparison of unmet health care needs in children with intellectual disability, autism spectrum disorder and both disorders combined.
K Haller, A Stolfi, J Duby
PMID 35357055WHAT IT FOUND
Children with intellectual disability alone had more unmet medical, hearing and mental health care needs than children with autism, and more gaps in insurance coverage; children with both diagnoses had more general unmet needs but fewer unmet medical needs.
Key findings
01Children with intellectual disability alone had 3.79 times the odds of not receiving needed medical care compared with children with autism, while children with both diagnoses had 0.19 times the odds.
02Children with intellectual disability alone had a gap in insurance coverage in 13.2% of cases, compared with 6.0% of children with autism and 4.9% of children with both diagnoses.
03Children with both diagnoses had 1.79 times the odds of any unmet health care need compared with children with autism; 16.2% of children with both diagnoses had unmet needs versus 10.0% of children with autism.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is a cross-sectional survey, so it can show associations but cannot prove that a diagnosis or insurance gap caused unmet needs. Diagnoses of intellectual disability and autism were based on parent report, not confirmed clinical records. Parents may not report all unmet needs, and the survey question did not name barriers such as cost or access. Children with both diagnoses may be undercounted if parents do not know or report intellectual disability alongside autism. The survey did not ask about parental employment, which may influence insurance type. Changes to the survey before the 2016 to 2017 cycle mean results cannot be compared with earlier years. Missing responses were excluded, and the timing of data collection may not represent the whole national population.
Declared interests
Wright State University enabled open access funding. The authors declared no conflicts of interest.
The easy way to misread this
Do not read these odds ratios as proof that an autism diagnosis improves access to care. The study is a cross-sectional survey of parent-reported diagnoses and unmet needs, so it cannot show that diagnosis caused the differences.