Parent-Reported Severity and Health/Educational Services Use Among US Children with Autism: Results from a National Survey.
Katharine E Zuckerman, Nora D B Friedman, Alison E Chavez and 2 others
PMID 28410256WHAT IT FOUND
Higher parent-reported autism severity was linked with more therapy and specialist visits.
School-based speech and social-skills therapy were common; behavioral intervention was less common. Ask what services a child actually receives.
Key findings
01After accounting for child and family factors, higher parent-reported ASD severity was significantly associated with receiving behavioral intervention, any regular school-based therapy, any regular non-school-based therapy, and any regular provider visit.
02School-based therapies were the most common therapy group; speech or language therapy was used by 54.1% and social-skills training by 48.9%, while non-school-based therapy use was 35.7%.
03Overall, 17.2% of children were reported to use no therapy services, and 31.1% had no regular visits with any specialty provider asked about.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is cross-sectional, so it cannot show that severity causes service use or that services were appropriate; service use could also influence parents' severity ratings. ASD diagnosis, severity, therapy receipt, and provider visits were all parent-reported and not verified, so misclassification is possible. Behavioral intervention setting was not captured, so school-based versus non-school-based behavioral intervention use cannot be distinguished. The survey did not assess all therapies a child with ASD might need or use. Data are from 2011, and insurance coverage has expanded since, so current service receipt may be higher than reported. The sample was English-only, had low response and completion, and was more white and affluent than the US population; residual bias may remain. Some outcomes may have been under-powered despite the large sample.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not read higher service use with greater severity as proof that more therapy is needed or that the therapies used are effective. This survey is cross-sectional and parent-reported, and it did not verify whether services were appropriate for each child.