Loss in services precedes high school exit for teens with autism spectrum disorder: A longitudinal study.
Daniel J Laxman, Julie Lounds Taylor, Leann S DaWalt and 2 others
PMID 31033222WHAT IT FOUND
Speech therapy and occupational therapy declined before and at high school exit for young people with autism.
Unmet needs rose at exit. Physical therapy changed little, and service loss differed by intellectual disability status.
Key findings
01Speech therapy, occupational therapy, and respite services declined before and at high school exit for both those with and without intellectual disability.
02Unmet service needs showed essentially no change before exit, a significant jump at exit, and a gradual decline after exit.
03The amount of change in service use upon high school exit and the overall rate of change of service use differed for those with versus without intellectual disability.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The analytic sample was 204 after excluding people without a known high school exit date; those excluded were younger, had lower household incomes, had lower maternal education levels, and their mothers were more often of a racial or ethnic minority group. The study used only two states, Massachusetts and Wisconsin, and state of residence was related to service receipt, so it may not represent other service systems. Service receipt and unmet need were parent-reported, not reported by the adults with ASD or by professionals, and unmet need was only assessed when a service was not received. The study did not measure service quality, intensity, or family satisfaction, so a lower count of services does not show whether needed supports were adequate. The services measured did not include transition services specifically. The sample lacked racial and ethnic diversity. The design was observational, so it cannot show which service changes caused other outcomes or whether service loss reflects unmet need.
Declared interests
The supplied text does not report an author conflict-of-interest statement. Publication types list NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that fewer services after high school exit mean reduced need. The study found unmet needs rose at exit, and the authors say the later decline in reported unmet needs may reflect parents adjusting to limited adult services.