Canadian Services for Young Children with Autism Spectrum Disorder (ASD): A Preliminary Overview

Background: Anecdotal descriptions suggest that type and intensity of service provision vary radically from one Canadian province to another for children diagnosed with ASD, but empirical data have been lacking.    

Objectives:  To provide an overview of type and amount of services provided to young children with ASD in five Canadian urban sites (Halifax, Montreal, Hamilton, Edmonton, and Vancouver).  We examined: (1) the percentage of children who received each of 10 types of service; (2) the percentage of children who did not receive any service; and (3) the intensity of services received  We also examined variation in service use by site and by time (across four assessments, T1-T4).

Methods: Parents completed a questionnaire about the type and amount of service provided to their children at each assessment (i.e., within one month of the child’s diagnosis at age 2 to 4, at 6 and 12 months following diagnosis, and at age 6).  Using the Pathways Autism Services Log (PASL), parents’ responses were coded into 10 types of service with four possible levels of intensity for each.  Teams of two researchers at each of the five sites coded data from their sites according to criteria developed by the whole group.  Inter-rater reliability was 91%.   

Results: Data were collected from 377 families. Across all sites, the highest percentages of children received “language and communication services” at T1 (64%) and T2 (54%) (i.e., within six months of diagnosis), but by T3 (i.e., within a year), 63% of the children were receiving “behavioural/structured therapy”.  Proportions of children receiving each type of service varied across sites and assessments. For example, at T1, four sites reported “language and communication services” as the service type received by the highest percentages of children, (ranging from 100% to 34%), while another site reported “supported mainstream group-based activities” as the service received by the highest proportion (54%).  However, by T2, two sites reported “behavioural/structured therapy” (100%, 73%), two cited “language and communication” (61%, 57%), and one reported “supported group activity” (33%) as received by the greatest percentage of children. Proportions of children not receiving any service also varied.  At T1, 23% of families reported that their child was not receiving any service, but this decreased to 3% by T4.  Service intensity also varied across assessments. For example, at T1, the highest proportion of children received “behavioural/structured therapy” for 6-10 hours per week versus 11-20 hours per week at T3. 

Conclusions: Preliminary descriptive analysis using the PASL revealed both similarities and differences in service provision from province to province and over time. Overall, “behavioural/structured therapy” and “language and communication services” were the service types received by the largest percentages of children. In addition, services appeared to become more available over time. Detailed discussion of variation across sites and assessment times will be presented.