The Effect of Familial Status on the Attainment and Funding of Services in Children with ASD

Background: Single parents of children with autism spectrum disorder (ASD) report elevated levels of stress related to child care and work responsibilities (Johnson & Simpson, 2013). Additionally, parents face high costs for ASD-related intervention services (Tregnago & Cheak-Samora, 2006). As such, un-partnered parents may have more difficulty obtaining intervention services for their child due to high stress and financial burden. Moreover, familial status may affect funding options or services utilized.

Objectives:  The goal of the current study was to examine how marital status relates to access to intervention services and public vs. private funding for services in families with a child with ASD.

Methods:  Participants included families of 116 children diagnosed with ASD after screening positive on the Modified Checklist for Autism in Toddlers (-Revised), with Follow-Up (M-CHAT(-R)/F) during 18- and 24-month visits at pediatricians’ offices in metro-Atlanta. Families also attended a re-evaluation between 3-4 years of age (M_age=48.47 months, SD=12.32), and provided information about intervention participation and funding of each service received since diagnosis (state/school funded vs. any use of private insurance/pay). Interventions included: speech-language, occupational, physical, developmental, sensory-integration, and behavioral therapies, as well as special education, special (pre)schools, and Babies Can’t Wait early intervention program. Complementary therapies that did not fit these categories were coded into a separate “Other” category. The number of services, type of services, and source of funding for each intervention were examined in relation to family structure (partnered vs. non-partnered).

Results: Overall, 90.2% of children with partnered parents and 87.0% of children with non-partnered parents got some type of intervention service, which was not a significant difference, X²(1, N=115)=.209, p=.45. However, children with partnered parents (M=3.09, SD=1.77) received more types of services than children with non-partnered parents (M=2.30, SD=1.49, t(113)=1.98, p=.034). In particular, children with partnered parents (31.5%) are more likely to use complementary interventions (i.e., “Other”) than children with non-partnered parents (4.3%, X²(1, N=115)=7.05, p=.005). No significant difference across any other intervention type was found. There also was no significant difference between familial status and use of public funding for services for most types of interventions, with the exception of pre-school; more non-partnered parents (86.7%) paid for pre-school with public funding than partnered parents (53.7%, X²(1, N=82)=5.53, p=.021).

Conclusions:  The majority of families received at least one type of intervention service regardless of marital status, suggesting that single-parent households are not at a large disadvantage. However, one-parent households received fewer types of interventions compared to two-parent households. Specifically, children with partnered parents received more nonconventional therapies (i.e. “Other”), such as music therapy and hippotherapy, which is consistent with Hall’s (2012) finding that partnered parents are more likely to utilize complementary/alternative therapies. This suggests single parents may lack resources to enroll their children in alternative services. Future research on the efficacy of specific types and number of interventions is needed to further understand whether children with partnered parents are making greater gains due to increased access to more types of intervention services.