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Published on: July 31, 2017
Patterns of Intervention Utilization Among School-Aged Children with Autism Spectrum Disorder: Findings from a
Aksheya Sridhar1, Jocelyn Kuhn2, Susan Faja1
1Boston Children's Hospital/Harvard Medical School, Boston, MA, USA.
Insights
Understanding autism intervention patterns is key for clinical trials. Factors like symptom severity, age, and location influence service use, impacting research design for children on the autism spectrum.
Area of Science:
- Pediatric clinical trials
- Autism Spectrum Disorder (ASD) interventions
- Healthcare service utilization
Background:
- Clinical trials for autism spectrum disorder (ASD) treatments are complicated by concurrent interventions.
- Understanding standard of care intervention patterns is crucial for trial design and interpretation.
- Factors influencing service utilization in children with ASD require further investigation.
Purpose of the Study:
- To examine the types and hours of interventions received by school-aged children with ASD.
- To identify child, family, and geographic factors associated with intervention patterns.
- To inform the design of clinical trials for ASD treatments.
Main Methods:
- Multi-site study involving 280 caregivers of 6-to-11-year-old children with ASD.
- Interviews collected data on intervention types and weekly hours over 6 weeks.
- Interventions categorized as 'evidence-based practice' or 'other interventions'.
Main Results:
- Children received diverse interventions (0-79.3 hours/week) with varying empirical support.
- Higher autism symptom levels, specific state residency, and non-Hispanic ethnicity correlated with more evidence-based intervention hours.
- Younger age, lower cognitive ability, and higher symptom severity were linked to a greater variety of interventions.
Conclusions:
- Clinical trial designs for ASD should consider autism symptom levels, age, cognitive ability, ethnicity, parental education, and geographic location.
- Further research is needed on ethnic, racial, and socioeconomic influences on intervention services for school-aged children.
- Standard of care intervention patterns significantly vary among children with ASD.
Abstract:
When designing and interpreting results from clinical trials evaluating treatments for children on the autism spectrum, a complicating factor is that most children receive a range of concurrent treatments. Thus, it is important to better understand the types and hours of interventions that participants typically receive as part of standard of care, as well as to understand the child, family, and geographic factors that are associated with different patterns of service utilization. In this multi-site study, we interviewed 280 caregivers of 6-to-11-year-old school-aged children on the autism spectrum about the types and amounts of interventions their children received in the prior 6 weeks. Reported interventions were coded as "evidence-based practice" or "other interventions," reflecting the level of empirical support. Results indicated that children received a variety of interventions with varying levels of empirical evidence and a wide range of hours (0 to 79.3 hours/week). Children with higher autism symptom levels, living in particular states, and who identified as non-Hispanic received more evidence-based intervention hours. Higher parental education level related to more hours of other interventions. Children who were younger, had lower cognitive ability, and with higher autism symptom levels received a greater variety of interventions overall. Thus, based on our findings, it would seem prudent when designing clinical trials to take into consideration a variety of factors including autism symptom levels, age, cognitive ability, ethnicity, parent education and geographic location. Future research should continue to investigate the ethnic, racial, and socioeconomic influences on school-aged intervention services.
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