The Impacts of the COVID-19 Pandemic on Therapy Utilization Among Racially/Ethnically and Socio-Economically Diverse Autistic Children.
Cassin W Gonzales, Jennifer R Simonell, Mark H C Lai and 2 others
PMID 36757541WHAT IT FOUND
ABA therapy hours for autistic children fell sharply in early 2020 and had not fully recovered a year later.
School district funded children lost hours fastest. Asian children recovered hours more slowly than white children. These disruptions likely affected treatment progress.
Key findings
01Hours of ABA therapy dropped significantly during the pandemic crisis phase (March-May 2020) and, while they increased during the mitigation phase, they did not fully recover to pre-pandemic levels after one year.
02Children whose primary funding source was their school district experienced a sharper decrease in therapy hours during the crisis phase compared to children with private insurance.
03During the recovery (mitigation) phase, Asian children saw a significantly smaller monthly increase in therapy hours compared to white children.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study only looked at hours of therapy, not the quality of therapy or clinical outcomes, so it is unclear if the lost hours resulted in lost skills. The sample came from a single agency in California, which may not represent broader populations. Race and ethnicity data were missing for 22% of participants, and broad categories were used (e.g., grouping Black, Latinx, and Other together), which may have masked specific disparities. The study excluded children who ended therapy before March 2020, potentially biasing the sample toward those with continuous care.
Declared interests
The study was funded by the University of Southern California. The authors declared no other conflicts of interest.
The easy way to misread this
Do not interpret the lack of significant racial differences in the crisis phase drop as evidence that all minority groups were treated equally. The 'Other' category grouped Black, Latinx, and mixed-race children together, and the small sample size for Black children may have masked true disparities. The slower recovery for Asian children was a specific finding within this grouping.