21986
Severity and Latino Ethnicity in Specialty Services for Children with Autism Spectrum Disorder
Children with autism spectrum disorder (ASD) experience a range of severity levels characterized as levels of support they need for everyday functioning. By this definition, greater levels of severity should warrant greater use of services and supports among children with ASD. In previous studies, Latino children with ASD in the USA have been shown to have lower access to diagnosis and treatment services than White children. However, none have examined service use in relation to severity.
Objectives:
In this study, our objective was to examine whether there are ethnic disparities between Latino and White children with ASD in specialty autism-related services, and whether condition severity moderate the relationship between ethnicity and receipt of autism services.
Methods:
We used data from the Survey of Pathways to Diagnosis and Services, a supplement to the National Survey of Children with Special Health Care Needs and analyzed current use of four specialty services commonly used by children with ASD: behavioral interventions, occupational therapy, social skills training, and sensory integration. The analytic sample included non-Latino White (n=1,063) and Latino (n=120) children with any ASD. When weighted, the sample represented 431,525 White children and 85,154 Latino children with any ASD. Logistic and Linear and logistic regressions were used to determine the relationships of ethnicity and severity to the outcome service variables, adjusting for demographic variables. An interaction term of ethnicity and severity was created to test for interaction effects.
Results:
We found that children whose conditions were more severe were twice as likely to receive each of the services as children who were less severe. Being Latino was significantly related to lower total service use. Furthermore, Latino children with ASD who had severe conditions received fewer specialty autism-related services than White children with similarly severe conditions. These disparities were evident despite the fact that the sample of Latino children in this data were more privileged than the general US Latino population given that it was an English speaking and relatively high income sample.
Conclusions:
Future research is needed to investigate factors that contribute to Latino children who have greater severity receiving fewer services than White children. Also, data sets are needed that are more representative of the US Latino population. Assertive policy initiatives are needed to address these disparities and ensure that these highly vulnerable children with severe conditions receive appropriate services and supports.