18825
Children with Autism Spectrum Disorder Accessing Early Intervention in the Autism and Developmental Disabilities Monitoring (ADDM) Network
Objectives: To describe the socioeconomic/demographic and diagnostic characteristics of children with ASD in two Early ADDM sites, comparing children who did and did not participate in EI services.
Methods: In surveillance year 2010, NJ and UT Early ADDM sites identified 4-year-old children with ASD using validated population-based, multi-source record review methods. Characteristics of children with ASD served by EI were compared with children with ASD not served by EI using chi-square and t-tests. Variables included sex, race/ethnicity, socioeconomic status (SES) indicators (parental ages and education duration at child’s birth), presence of co-occurring intellectual disability (ID), attention deficit with hyperactivity disorder (ADHD), or seizures, regression history, previous ASD diagnosis by a qualified professional, and age at first ASD evaluation.
Results: NJ and UT Early ADDM sites identified 484 4-year-olds with ASD; 45% (N=218) participated in EI. A greater proportion of parents of children served by EI were >34 years old and had >13 years of education as compared with parents of children not served by EI (Table 1). Although no significant differences in race/ethnicity were detected between the two groups, a smaller proportion of children served by EI were White, non-Hispanic (36%) than those not served by EI (47%). No differences were detected in the frequency of co-occurring ID, ADHD, or seizures between children accessing and children not accessing EI. Children accessing EI were younger at first ASD evaluation (22.8 vs. 34.1 months, p<0.0001) and diagnosis (30.2 vs. 36.3 months, p<0.0001). Children served in EI were significantly more likely to have a final case status of autism (p<0.001).
Conclusions: Study findings suggest a link between higher SES and EI use; however, there appears to be some indication that the role of race and ethnicity should be further explored. Children accessing EI were not more likely to acquire a community-based ASD diagnosis by age four; however, as expected, they were more likely to have an evaluation and diagnosis at a significantly younger age than children without documented EI access. Toddlers with earlier evaluations and diagnoses have more time to qualify for and participate in birth-to-three EI programs. Although not a perfect severity metric, the co-occurrence of ID, ADHD, or seizures was not associated with EI participation. Additional exploration of the role of SES and other demographic factors in accessing universally-available EI programs for children with ASD is warranted.
See more of: Interventions - Non-pharmacologic - Preschool