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Service Use Among Transition-Age Youth with Autism Spectrum Disorder.

Karen J Ishler1, David E Biegel2, Fei Wang2

  • 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106-7164, USA. kji@case.edu.

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Summary

Service use in transition-age youth with Autism Spectrum Disorder is influenced by caregiver education, marital status, Medicaid waiver, high school enrollment, and adaptive functioning. Many youth need more services than they currently receive.

Keywords:
Autism spectrum disorderFamilyPredictorsService useTransition age

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Area of Science:

  • Health Services Research
  • Developmental Psychology
  • Autism Spectrum Disorder Research

Background:

  • Transition-age youth with Autism Spectrum Disorder (ASD) face unique challenges accessing services.
  • The "service cliff" describes the potential reduction in support as youth age out of child-focused systems.
  • Understanding service utilization predictors is crucial for effective support.

Purpose of the Study:

  • To identify predictors of service use in transition-age youth with ASD.
  • To apply Andersen's healthcare utilization model to this population.
  • To examine factors associated with current service use and unmet needs.

Main Methods:

  • Cross-sectional study of 174 transition-age youth (16-30 years) with ASD.
  • Data collected via caregiver interviews regarding service use over the past 6 months.
  • Andersen's behavioral model of healthcare utilization guided the analysis.

Main Results:

  • Youth used an average of 6.1 services, with a need for 3.2 additional services.
  • Higher service use linked to caregiver college education, caregiver not married/partnered, youth Medicaid waiver, youth in high school, and lower adaptive functioning.
  • Specific service use strongly associated with Medicaid waiver, high school status, lower adaptive functioning, and comorbid mental health diagnoses.

Conclusions:

  • Predisposing, enabling, and need factors influence service use in transition-age youth with ASD.
  • Significant unmet service needs highlight the "service cliff" phenomenon.
  • Further research is needed to address service gaps for this population.