Unmet Need for Therapy Among Children with Autism Spectrum Disorder: Results from the 2005-2006 and 2009-2010 National Survey of Children with Special Health Care Needs
Unmet Need for Therapy Among Children with Autism Spectrum Disorder: Results from the 2005-2006 and 2009-2010 National Survey of Children with Special Health Care Needs
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DOI：
10.1007/s10995-015-1876-x
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发表时间：
2016-04-01
影响因子：
2.3
通讯作者：
Lane, Shelly J.
中科院分区：
文献类型：
--
作者：
Benevides, Teal W.;Carretta, Henry J.;Lane, Shelly J.
目的：我们研究了自闭症谱系障碍（ASD）儿童与其他有特殊医疗需求的儿童（CSHCN）相比，治疗服务需求未得到满足的人群趋势，并确定了与治疗需求未得到满足相关的因素。方法采用2005-2006年和2009-2010年全国特殊卫生保健需求儿童调查（NS-CSHCN）的汇总横断面比较。使用加权双变量分析比较3-17岁ASD儿童（n = 5113）与其他CSHCN儿童（n = 71，294）对治疗服务的未满足需求。调查加权多变量模型被用来检查与未满足的需求相关的儿童，家庭和背景特征。结果在两次调查中，ASD儿童需要治疗的比例高于其他CSHCN儿童。在报告有需求的儿童中，ASD儿童报告未满足治疗需求的可能性是其他CSHCN儿童的1.4倍（OR 1.42，95% CI 1.18-1.71）。与未满足的治疗服务需求显著相关的变量包括过去一年未接受健康儿童访视（OR 5.81，CI 3.83-8.81），2009年调查（OR 1.42，CI 1.18-1.71）、儿童为女性（OR 1.27，CI 1.05-1.53）、无保险（OR 1.72，CI 1.15-2.56）、功能受限较大（OR 2.44，CI 1.80-3.34）。实践结论ASD儿童需要支持性服务，如职业，物理和语言治疗，但不太可能比其他CSHCN接受此类服务。在过去的一年里，接受良好的儿童访问与接受所需的治疗服务密切相关。
Objectives We examined population-based trends in unmet need for therapy service in children with autism spectrum disorder (ASD) compared to other children with special health care needs (CSHCN), and identified factors associated with unmet need for therapy. Methods A pooled cross-sectional comparison of the 2005-2006 and 2009-2010 waves of the National Survey for Children with Special Health Care Needs (NS-CSHCN) was used. Weighted bivariate analyses were used to compare children ages 3-17 years with ASD (n = 5113) to other CSHCN (n = 71,294) on unmet need for therapy services. Survey weighted multivariate models were used to examine child, family, and contextual characteristics associated with unmet need. Results A greater percentage of children with ASD across both surveys were reported to need therapy than other children with CSHCN. Among children with a reported need, children with ASD were 1.4 times more likely to report an unmet need for therapy compared to other CSHCN (OR 1.42, 95 % CI 1.18-1.71). Variables significantly associated with unmet need for therapy services included not receiving a well-child visit in the past year (OR 5.81, CI 3.83-8.81), surveyed in 2009 (OR 1.42, CI 1.18-1.71), child being female (OR 1.27, CI 1.05-1.53), uninsured (OR 1.72, CI 1.15-2.56), and having greater functional limitation (OR 2.44, CI 1.80-3.34). Conclusions for Practice Children with ASD require supportive services such as occupational, physical, and speech therapy but are less likely to receive such services than other CSHCN. Receiving a well-child visit in the past year was strongly associated with receipt of needed therapy services.