Sévérité déclarée par les parents et services de santé/éducatifs utilisés pour les enfants US avec un diagnostic d'autisme: résultats d'une enquête nationale

Aperçu: G.M.

Il existe peu de données nationales concernant les modèles d'utilisation des services pour les enfants avec un diagnostic de trouble du spectre de l'autisme (TSA ) de gravité variable. Cette étude visait à évaluer la relation entre la gravité rapportée par les parents et l'utilisation des services d'éducation et de soins de santé.

Une plus grande gravité du TSA déclarée par les parents était associée à une probabilité accrue d'utilisation actuelle de la thérapie scolaire, de la thérapie non scolaire et des interventions comportementales, ainsi que des visites régulières de prestataires spécialisés.

Bien que les taux d'utilisation des services soient généralement les plus élevés parmi les enfants avec un TSA sévère, la thérapie non scolaire et les interventions comportementales ont été utilisées uniquement par environ la moitié de ces enfants et environ 1 enfant sur 4 avec un TSA léger n'utilisaient aucune des thérapies. 

J Dev Behav Pediatr. 2017 Apr 12. doi: 10.1097/DBP.0000000000000437.

Parent-Reported Severity and Health/Educational Services Use Among US Children with Autism: Results from a National Survey

Zuckerman KE¹, Friedman NDB, Chavez AE, Shui AM, Kuhlthau KA.

Author information

1

*Division of General Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR; †Portland State University School of Public Health, Portland, Oregon; ‡Lurie Center for Autism, Massachusetts General Hospital for Children, Boston, MA; §Biostatistics Center, Massachusetts General Hospital, Boston, MA; ∥Division of General Pediatrics, Massachusetts General Hospital for Children, Boston, MA; ¶Department of Pediatrics, Harvard Medical School, Boston, MA.

Abstract

OBJECTIVE:

Little national data exist regarding service use patterns for children with autism spectrum disorder (ASD) of varying severity. This study aimed to assess the relationship between parent-reported severity and use of educational and health care services.

METHODS:

Data from the 2011 Survey of Pathways to Diagnosis and Services were used to examine a nationally representative sample of 1420 US children aged 6 to 17 years with ASD, with or without developmental delay and intellectual disability. Weighted multivariable logistic regression assessed associations of parent-reported ASD severity and child sociodemographic characteristics with school-based therapy, non-school-based therapy, behavioral interventions, and specialty provider visits.

RESULTS:

Higher parent-reported ASD severity was associated with increased likelihood of current use of school-based therapy (adjusted odds ratio [AOR] = 4.08, 95% confidence interval =1.85-8.98), non-school-based therapy (AOR = 3.60 [1.95-6.66]), and behavioral interventions (AOR = 2.30 [1.22-4.34]), as well as regular specialty provider visits (AOR = 2.99 [1.38-6.46]). Although rates of service use were generally highest among children with severe ASD, non-school-based therapy and behavioral interventions were only used by about half of children with severe ASD, and about 1 in 4 children with mild ASD were using none of the therapies asked about.

CONCLUSION:

Parent-reported severity is associated with increased therapy and specialty provider service use among children with ASD. However, substantial variability exists in service use across levels of severity.

PMID: 28410256

DOI: 10.1097/DBP.0000000000000437