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Impact of Social and Relational Adversity on Access to Services among US Children with Autism Spectrum Disorder

Sarah D Ronis1,2, Eunice Lee2, Carrie Cuffman3

  • 1Center for Child Health and Policy, UH Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, MS 6036, Cleveland, OH 44106, USA.

Children (Basel, Switzerland)
|December 24, 2021
PubMed

Insights

Children with autism spectrum disorder (ASD) face more social and relational adversities. Relational adversity is linked to increased medication use for ASD, highlighting the need for adversity screening in care.

Area of Science:

  • Pediatric Health
  • Neurodevelopmental Disorders
  • Social Determinants of Health

Background:

  • Children with autism spectrum disorder (ASD) experience significant social and relational adversities.
  • Understanding the impact of these adversities on healthcare access is crucial for effective intervention.

Purpose of the Study:

  • To investigate the association between social and relational adversity and access to key health services for US children with ASD.
  • To determine if demographic characteristics, medical needs, or adversities influence service utilization in children with ASD.

Main Methods:

  • Cross-sectional analysis of the 2016-2019 National Survey of Children's Health.
  • Assessed health service use in children with ASD, controlling for demographic factors, medical needs, and reported adversities.
  • Utilized multivariable models to identify significant associations between adversities and service use.

Main Results:

  • Children with ASD were over twice as likely to report multiple social adversities and over three times as likely to report multiple relational adversities compared to peers without ASD.
  • Relational adversities were significantly associated with increased odds of medication use for ASD (OR 1.50).
  • Social adversities showed no significant association with behavioral therapy receipt or ASD medication prescription.

Conclusions:

  • Screening for social and relational adversities in youth with ASD is critical, as even single adverse experiences can impact care.
  • The nature of the adversity influences its effect on healthcare access for children with ASD.
  • Further research is needed to explore the role of childhood adversity in physical and mental health outcomes within the ASD population.

Keywords:
adverse childhood experiencesautism spectrum disorderhealth disparitieshealth servicessocial determinants of health

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