Sociodemographic Disparities in Intervention Service Utilization in Families of Children with Autism Spectrum Disorder.
Cathina T Nguyen, Paula Krakowiak, Robin Hansen and 2 others
PMID 27639855WHAT IT FOUND
Families using public insurance received fewer weekly hours of individual therapy than those with private insurance.
Non-English speaking families also received fewer hours. Children of Black mothers entered classroom services earlier than White children, though this may reflect differences in prior diagnoses or childcare needs rather than superior access.
Key findings
01Children of mothers with public insurance were 37% more likely to receive fewer than 15 hours of individual services per week compared to those with private insurance.
02Families whose primary home language was not English were more likely to receive fewer than 15 hours of individual services per week, though this association was marginal.
03Children of Black mothers entered classroom-based services approximately half a year earlier than children of White mothers.
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 did not capture the age at which children started individual services, using classroom entry as a proxy which may distort findings. Data on service hours and entry age were reported by parents and not verified, introducing potential recall bias. The sample was limited to children aged 2-5 years who had already received an ASD diagnosis, excluding families who faced the greatest barriers to initial identification. Missing data for service hours and entry age was disproportionately higher in Hispanic, non-English speaking, and public insurance families, which may have introduced bias. Insurance type at birth was used as a proxy for socioeconomic status, which may not reflect current financial circumstances.
Declared interests
The authors declare no conflict of interest.
The easy way to misread this
Do not interpret the earlier entry of Black children into classroom services as evidence of better overall access. The study did not measure when these children started individual therapies, so this finding may reflect a shift in service type rather than a reduction in barriers to comprehensive care.