Barriers to treatment in autism spectrum disorders

Background: Autism spectrum disorders (ASD) are a group of neurological disorders that influence the normal development of the brain and impact social interaction, communication skills, and cognitive function. Families of children with ASD face barriers in obtaining health care for their children. The aim of this study is to identify whether core outcomes as defined by the Maternal and Child Health Bureau (MCHB) differ based on: race of the child, severity of ASD, and status of autism mandate in the state. The secondary aim was to determine other predictors of MCHB outcomes in children with ASD.

Method: A retrospective data analysis was conducted in SAS 9.3 utilizing data from the National Survey of Children with Special Healthcare Needs 2009-2010. The data was collected by the National Center for Health Statistics.

Results: MCHB outcomes were found to be different among children based on the severity of ASD. As compared to children with mild autism, children with severe autism were 33% less likely to receive necessary services to help transition into adulthood, 47% less likely to have a medical home, and 70% less likely to meet all six core outcomes of MCHB. The outcomes did not differ by the status of the autism mandate in the state.

Conclusion: Despite several federal and state initiatives to provide adequate coverage for services necessary to treat ASD, a large percentage of children with ASD do not have adequate insurance. Future policies with a more patient centered approach may help alleviate this issue.