Treatment patterns in children with autism in the United States

摘要

Children with autism receive different types of non‐drug treatments. We aimed to describe caregiver‐reported pattern of care and its variability by geography and healthcare coverage in a US‐wide sample of children aged 3–17 years. We recruited caregivers from the Simons Foundation Powering Autism Research for Knowledge (SPARK) cohort. Two online questionnaires (non‐drug treatment, Autism Impact Measure) were completed in September/October 2017. Primary outcome measures were caregiver‐reported types and intensities of treatments (behavioral, developmental/relationship, speech and language (SLT), occupational, psychological, “other”; parent/caregiver training) in the previous 12 months. Main explanatory variables were geography and type of healthcare coverage. We investigated associations between the type/intensity of treatments and geography (metropolitanonmetropolitan) or coverage (Medicaid vs privately insured by employer) using regression analysis. Caregivers (n = 5,122) were mainly mothers (92.1%) with mean (SD) age of 39.0 (7.3) years. Mean child age was 9.1 (3.9) years; mostly males (80.0%). Almost all children received at least one intervention (96.0%). Eighty percent received SLT or occupational therapy, while 52.0% received both. Behavioral therapy and SLT were significantly more frequent and more intense in metropolitan than in nonmetropolitan areas. No consistently significant associations were seen between healthcare coverage and frequency or intensity of interventions. At least one barrier such as “waiting list” and “no coverage” was reported by 44.8%. In conclusion, in children sampled from SPARK, we observed differences between metropolitan and nonmetropolitan areas, while we did not find significant differences between those privately insured versus Medicaid. >Autism Res 2019, 12: 517–526 © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc.