Access to Autism Behavioral Therapy Services: An Analysis of 2022-2023 National Survey of Children's Health Data

Children with autism spectrum disorder (ASD) frequently face barriers to accessing care. While prior research has explored general disparities in healthcare utilization, few studies have specifically examined barriers to behavioral therapy, a key recommended intervention for ASD. This study aimed to identify factors associated with access to behavioral therapy for children with ASD.

We analyzed data from the 2022-2023 National Survey of Children's Health. Our outcome was reported access to behavioral therapy among children with ASD, which we explored across child age, sex, race/ethnicity, poverty level, rurality, insurance type, parent household language, and parent education level. Descriptive statistics and chi-square tests were initially used to assess associations between these variables and therapy access. We then fit a logistic regression model to estimate independent predictors.

Rural residence and having a caregiver with less than a high school education were both significantly associated with lower rates of behavioral therapy use. Insurance status was also crucial: children with public insurance or both public and private coverage had over three times the odds of accessing therapy compared to uninsured children.

Disparities in behavioral therapy access persist for children with ASD, particularly in rural and lower-education households. Strategies such as expanding telehealth delivery, increasing insurance outreach, and funding family navigation services may help reduce these gaps, requiring collaboration between policymakers and providers.