Racial and Ethnic Differences in Occupational Therapy Service Access in the Initial Five Years Following Autism...

Children diagnosed with autism spectrum disorder (ASD) require timely access to occupational therapy (OT) to support their developmental and functional needs, yet children of minority races and ethnicities may experience barriers to accessing care. This study aimed to assess racial and ethnic differences in OT access during the initial five years post-ASD diagnosis.

This retrospective study utilized electronic health records from a large pediatric health system encompassing 13 outpatient sites in the Northeastern United States. Data on OT access from 2014 to 2019 (the most recent five-year period uninterrupted by the COVID-19 pandemic), comorbid diagnoses, and social determinants of health were collected.

The sample comprised 1181 children diagnosed with ASD in 2014 (diagnosis age: M = 5.0 years, SD = 3.2). No differences in odds of OT receipt were found between racial/ethnic groups. However, children of minority race/ethnicity had lower OT intensity, with Hispanic, Black, and Asian and Pacific Islander children receiving 0.6 (95% CI = [0.44, 0.82]), 0.54 [0.36, 0.81], and 0.55 [0.32, 0.96] times the number of OT visits received by non-Hispanic White children over five years post-diagnosis.

Children of minority race/ethnicity may receive lower OT intensity, suggesting potential barriers in continued access to therapy following ASD diagnosis.