Treatment patterns in children with autism in the United States.
Brigitta U Monz, Richard Houghton, Kiely Law and 1 others
PMID 30629336WHAT IT FOUND
Most US children with autism received several non-drug therapies, with speech therapy the most common and usually school-based.
Rural residence was linked to less therapy and lower intensity; insurance type was not consistently linked to therapy.
Key findings
0196.0% of children received at least one non-drug therapy, and speech-language therapy was the most common at 71.4%.
02Metropolitan residence was associated with higher odds of receiving any therapy, behavioral therapy, and speech-language therapy than nonmetropolitan residence (odds ratios 1.71, 1.54, and 1.41).
03Speech-language therapy was provided in public school for 76.5% of children, and occupational therapy for 63.6%.
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 sample came from an online autism research cohort, so it likely overrepresents motivated, English-speaking, higher-educated families and may understate rural access problems. Treatment data were caregiver-reported over the previous 12 months, so recall and classification of therapy types may be imperfect. The study was cross-sectional, so it cannot show that geography or insurance caused treatment differences. The insurance analysis was limited to Medicaid-only versus private employer insurance and had a smaller sample, so null findings may reflect limited statistical power. Physical therapy and many other therapies were grouped under 'other' and were not analyzed separately.
Declared interests
Three authors are employees of F. Hoffmann-La Roche, a company with autism drugs under development; one holds stock options in that company. One author is a research consultant with the Simons Foundation Autism Research Initiative, which funds and operates SPARK.
The easy way to misread this
Do not read these patterns as evidence that any therapy improves autism symptoms or that insurance type caused differences. The study reports caregiver-reported treatment patterns and cannot show effectiveness or causation.