Unmet Health Services Needs Among US Children with Developmental Disabilities: Associations with Family Impact and Child Functioning.

The family financial and employment impacts were measured at the same time as unmet need, so the study cannot show whether unmet need caused family impacts or families with impacts could not access services. The child behavioral outcome was assessed only about two years later, a short period for chronic developmental disabilities. All data were parent-reported, and the brief SDQ does not capture the full complexity of behavior in children with developmental disabilities. The sample excluded children younger than 6, children without current autism spectrum disorder, developmental delay, or intellectual disability, and families who could not complete the survey in English. Response rates were 25.5% for the 2009-10 survey and 62% weighted completion for the 2011 follow-up, so families who responded may differ from families who did not. Therapy services were counted as one category that included physical, occupational, and speech and language therapy, so the study cannot tell which type of therapy was unmet. The surveys did not directly assess social and educational services, such as welfare benefits.

The authors reported no conflicts of interest. The publication types list NIH extramural and non-U.S. government research support.

Do not conclude that meeting unmet health service needs will reduce family financial problems or improve child behavior. The family impact association was cross-sectional, so cause and direction cannot be separated, and the child behavioral outcome was not significant.