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Published on: October 3, 2018
Urbanicity-related variation in help-seeking and services utilization among preschool-age children with autism in
Chuan-Yu Chen1, Chieh-Yu Liu, Wen-Chuan Su
1Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Fl. 5, Campus 2, No. 309, Sung-Te Rd, Taipei 110, Taiwan. cychen@nhri.org.tw
Insights
Children with autism in suburban and rural areas face longer diagnosis times. Early diagnosis and psychiatric specialty care improve access to autism services.
Area of Science:
- Pediatric neurology
- Developmental pediatrics
- Public health
Background:
- Autism spectrum disorder (ASD) diagnosis and service utilization can be influenced by geographic factors.
- Understanding urbanicity-related disparities in healthcare access is crucial for equitable intervention.
Purpose of the Study:
- To examine urbanicity-related differences in the autism diagnosis process for preschool children.
- To identify factors predicting the use of autism-specific services within one year of diagnosis.
Main Methods:
- Retrospective analysis of the National Health Insurance Research Database (NHIRD) in Taiwan (1997-2004).
- Inclusion of 3495 children diagnosed with autism and 13964 matched controls.
- Statistical analysis to compare diagnosis timelines and service utilization based on urbanicity.
Main Results:
- Children with autism in suburban and rural areas were diagnosed at older ages and experienced longer diagnostic processes compared to urban children.
- Male gender, younger age at diagnosis, and diagnosis by a psychiatric specialty were significant predictors of higher autism service utilization.
- Significant disparities in diagnosis and service access were observed based on geographic location.
Conclusions:
- Healthcare policies should prioritize early detection and intervention for children with autism in rural and underserved areas.
- Addressing geographic and socioeconomic barriers is essential to ensure timely and equitable access to autism-related services.
- Psychiatric specialty diagnosis is a key factor in facilitating early access to crucial autism support services.
Abstract:
The present study examines urbanicity-related differences in help-seeking process among preschool children with autism and investigates the factors associated with utilization of autism-related services within the year of diagnosis. Using the 1997-2004 National Health Insurance Research Database (NHIRD) in Taiwan, we identified a total of 3495 autistic children born in 1997-1999 and 13964 matched controls. Results indicate that suburban and rural autism tended to receive the diagnosis at an older age and to have a longer diagnosis process as compared with urban counterparts. Male gender, a younger age of diagnosis, and being diagnosed by psychiatric specialty strongly predict subsequent greater utilization of autism-specific services (all p < 0.05). Health policy makers and other service providers should address the needs of children with early-onset neurodevelopmental disorders in rural areas, particularly those from disadvantaged families.
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