Service use by youth with autism within a system-driven implementation of evidence-based practices in children's mental health services.
Nicole A Stadnick, Anna S Lau, Kelsey S Dickson and 3 others
PMID 32686469WHAT IT FOUND
Youth with autism in public mental health services received more total claims and longer care than matched peers.
They received less psychotherapy but more case management, medication, and crisis services. Behavioral parent training was their most common primary evidence-based practice.
Key findings
01Youth with autism had significantly higher volume of claims and received care for a significantly longer duration compared to matched controls.
02Compared to peers, youth with autism received a smaller percentage of psychotherapy services but significantly greater percentages of case management, medication management, and crisis services.
03Significantly more youth with autism received Behavioral Parent Training practices as their primary treatment type, while matched controls more often received Trauma practices.
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 relied solely on administrative claims data, which lack rich contextual information about the actual content of services provided. Diagnoses and practices reported in claims were not validated, and providers may not have documented all co-occurring conditions. It is possible that some control group youth actually had ASD but it was not documented as a primary or secondary diagnosis on claims. The study did not account for mental health services youth with ASD may have received under other funding sources outside the Prevention and Early Intervention initiative.
Declared interests
The paper reports no specific conflicts of interest for the authors. The study was supported by an N.I.H. grant.
The easy way to misread this
Do not assume that the higher volume of services and longer duration of care for youth with ASD indicates better outcomes or higher quality of treatment. The data reflect utilization patterns within a specific system-driven implementation where interventions were not designed specifically for ASD, and claims data do not validate whether these services were effective or appropriately tailored.