Material hardship and sources of support for autistic adolescents and their families.
Kristy A Anderson, Melissa Radey, Lauren Bishop and 3 others
PMID 39704010WHAT IT FOUND
Families of autistic teens face high material hardship, but income alone misses the problem.
Many middle-income families struggle with costs and lack safety net access. Therapists should screen for financial strain and asset loss, not just poverty, as these families often have insurance but still face food insecurity and bankruptcy risks.
Key findings
01Material hardship affected 46.4% of families with autistic adolescents, a rate higher than the 29.8% living in income poverty.
02Families with autistic adolescents were over twice as likely to forego medical care due to cost compared to non-autistic families, despite similar healthcare access.
03Nearly half (48.5%) of middle- to high-income families with autistic adolescents did not receive any formal safety net support, despite many experiencing material hardship.
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 study is cross-sectional, so it cannot determine if financial hardship causes caregiver depression or vice versa. The sample was drawn from a dataset that oversampled unmarried parents, making it more socioeconomically disadvantaged than the general population. Autism status was based on parent report of a diagnosis, not clinical verification. The sample was predominantly male (81%), limiting generalizability to autistic girls. Material hardship was measured as a composite, which may obscure specific types of financial strain.
Declared interests
The authors declared no potential conflicts of interest. The study was supported by NIH and US Government funds.
The easy way to misread this
Do not assume that families with higher incomes are financially secure. Many middle- to high-income families with autistic adolescents experienced material hardship and had no savings, yet were disconnected from formal safety nets because they did not meet income-based eligibility criteria.