Early Intervention Program Participation By Preschool Children with Autism Spectrum Disorder

Background:   Early Intervention Programs (EIP) are critical to the overall outcome of children with Autism Spectrum Disorder (ASD). Through early intervention, children make gains in cognitive ability, social functioning and even in the core symptoms of ASD.  The efficacy of EIP is also increased when at-risk children are placed early.          

Objectives:  

This study endeavored to investigate the number, proportion and demographic distribution of preschool age children with ASD receiving services through Early Intervention Programs (EIP) in a large, metropolitan, population-based, sample and analyzed demographic differences among children receiving EIP services. 

Methods:  

Data were from the New Jersey Autism Study (NJAS), a population-based ASD surveillance investigation carried out in Essex and Union Counties. The current findings represent 4-year olds (2006-born) with surveillance-defined ASD, in 2010.  ASD ascertainment was by an active, retrospective, multiple-source, Centers for Disease Control and Prevention (CDC)-designed case-finding method, based on review and analysis of information contained in health and education records.  Demographic variables and case-specific data, including information on use of EIP services, were analyzed. Chi-square tests were used to test associations. 

Results:  

We identified 352 four-year-old children with ASD in 2010.  Of those, 211 ASD children (60%) received EIP services.  Overall, sex, race/ethnicity and SES were not associated with receipt of EIP services.  We found no variation EIP service by cognitive impairment.   Children with a mild degree of impairment due to ASD were less likely to receive EIP services (p<.05).  Children with the Autistic Disorder pattern were more likely to receive EIP services than children with the PDD-NOS pattern (92% vs. 8%, p<.001, respectively).  Children with ASD receiving EIP services were more likely to be diagnosed with ASD before school age (64% vs. 35%, p<.01).  Our findings showed that the average age of ASD diagnosis of preschool children with ASD receiving EIP services was 30 months, while the average age for children not receiving EIP services was 38 months (p<.001).  Also, children with ASD receiving EIP services had their first evaluation at 23 months, while children not receiving EIP services had their first evaluation by 36 months (p<.001).

Conclusions:  

Our findings show that a significant minority of children with ASD (40%) do not receive Early Intervention Program services.  Our findings also indicate that children with ASD receiving EIP services are likely to have a higher degree of impairment than other ASD children.