Unmet Healthcare Needs and Functioning among US Children with Developmental Conditions

This study examined the relationship between unmet health services needs and functioning among a nationally-representative sample of children with autism spectrum disorder, developmental delay, and/or intellectual disability.

Data from the 2009-2010 National Survey of Children with Special Health Care Needs were linked to data from the 2011 Survey of Pathways to Diagnosis and Services. The main independent variable was any unmet need for 14 specific child health services (e.g. specialty or dental care). Dependent variables included child functional status according to if the child’s condition consistently affected daily activities often a great deal, if the child missed 11 or more school days annually, or if wandering behavior occurred. Weighted descriptive statistics and chi-square tests were computed, and weighted multiple logistic regression models adjusted for child sociodemographic factors and functional limitations status were fit. 

An estimated 1 803 112 US school-age children with developmental conditions were represented by the sample of 3518 children. Relative to children with any unmet need for health services, children without unmet needs were less likely to be consistently affected in their daily activities (70.3% vs. 51.0%; AOR:0.55[0.39-0.76]), to miss 11 or more school days annually (26.0% vs. 15.2%; AOR:0.59[0.42-0.83]), or to exhibit wandering behavior (33.7% vs. 22.1%; AOR:0.62[0.44-0.85]). 

Receipt of needed health services was positively associated with functioning among US children with developmental conditions. Efforts to resolve unmet needs via delivery systems for children with developmental conditions remain important.