Classifying children with ASD by service utilization and treatment type: A cluster analysis of a nationally representative United States survey
Background: If there are patterns of the distribution of services and treatments across the population of people with ASD, these patterns should be based along clinical characteristics or other service needs and not sociodemographic characteristics unrelated to evidence-based care. We examined how i...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | Acta Psychologica |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0001691822003158 |
| _version_ | 1797955401925263360 |
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| author | Anne E. Brisendine Sarah E. O'Kelley Bisakha Sen Julie Preskitt Martha S. Wingate |
| author_facet | Anne E. Brisendine Sarah E. O'Kelley Bisakha Sen Julie Preskitt Martha S. Wingate |
| author_sort | Anne E. Brisendine |
| collection | DOAJ |
| description | Background: If there are patterns of the distribution of services and treatments across the population of people with ASD, these patterns should be based along clinical characteristics or other service needs and not sociodemographic characteristics unrelated to evidence-based care. We examined how individuals in a broad, nationally representative sample “grouped together” based on service utilization and services needed but not covered by insurance. By understanding various treatment patterns, clinicians, researchers, policymakers, and self-advocates and their families can better advocate for high-quality, evidence-based services to be provided equitably. Methods: Using the 2011 Survey of Pathways to Diagnosis and Services, a cluster analysis was performed to explore patterns in this population based on medication use, private services use, school-based service use, and services not covered by insurance. Differences in clusters were then explored through multinomial logistic regression. Results: Six clusters emerged, showing differences in the level of service/medication usage and insurance coverage. Differences across clusters were associated with the level of functional limitation and age at ASD diagnosis. Disparities by insurance type, functional limitation, and age at diagnosis exist among patterns of ASD service provision. Conclusions: Our analysis showed that intervention for children with ASD can be across several scales – high and low users of services (both private and school-based), high and low users of medications, and high and low levels of reported non-covered services. The differences were clustered in multiple ways. Further research should incorporate longitudinal and nationally representative data to explore these relationships further. |
| first_indexed | 2024-04-10T23:33:41Z |
| format | Article |
| id | doaj.art-2c43d073af2d4ec8829309500f131067 |
| institution | Directory Open Access Journal |
| issn | 0001-6918 |
| language | English |
| last_indexed | 2024-04-10T23:33:41Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Acta Psychologica |
| spelling | doaj.art-2c43d073af2d4ec8829309500f1310672023-01-12T04:18:10ZengElsevierActa Psychologica0001-69182023-02-01232103800Classifying children with ASD by service utilization and treatment type: A cluster analysis of a nationally representative United States surveyAnne E. Brisendine0Sarah E. O'Kelley1Bisakha Sen2Julie Preskitt3Martha S. Wingate4Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, 1720 2nd Avenue South, RPHB 320, Birmingham, AL 35294-0022, United States of America; Corresponding author.Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, 1720 2nd Avenue South, CH19 307, Birmingham, AL 35294-0022, United States of AmericaDepartment of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, 1720 2nd Avenue South, RPHB 320, Birmingham, AL 35294-0022, United States of AmericaDepartment of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, 1720 2nd Avenue South, RPHB 320, Birmingham, AL 35294-0022, United States of AmericaDepartment of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, 1720 2nd Avenue South, RPHB 320, Birmingham, AL 35294-0022, United States of AmericaBackground: If there are patterns of the distribution of services and treatments across the population of people with ASD, these patterns should be based along clinical characteristics or other service needs and not sociodemographic characteristics unrelated to evidence-based care. We examined how individuals in a broad, nationally representative sample “grouped together” based on service utilization and services needed but not covered by insurance. By understanding various treatment patterns, clinicians, researchers, policymakers, and self-advocates and their families can better advocate for high-quality, evidence-based services to be provided equitably. Methods: Using the 2011 Survey of Pathways to Diagnosis and Services, a cluster analysis was performed to explore patterns in this population based on medication use, private services use, school-based service use, and services not covered by insurance. Differences in clusters were then explored through multinomial logistic regression. Results: Six clusters emerged, showing differences in the level of service/medication usage and insurance coverage. Differences across clusters were associated with the level of functional limitation and age at ASD diagnosis. Disparities by insurance type, functional limitation, and age at diagnosis exist among patterns of ASD service provision. Conclusions: Our analysis showed that intervention for children with ASD can be across several scales – high and low users of services (both private and school-based), high and low users of medications, and high and low levels of reported non-covered services. The differences were clustered in multiple ways. Further research should incorporate longitudinal and nationally representative data to explore these relationships further.http://www.sciencedirect.com/science/article/pii/S0001691822003158Autism spectrum disorderHealth servicesCluster analysisAccess to careSurvey of pathways to diagnosis and services |
| spellingShingle | Anne E. Brisendine Sarah E. O'Kelley Bisakha Sen Julie Preskitt Martha S. Wingate Classifying children with ASD by service utilization and treatment type: A cluster analysis of a nationally representative United States survey Acta Psychologica Autism spectrum disorder Health services Cluster analysis Access to care Survey of pathways to diagnosis and services |
| title | Classifying children with ASD by service utilization and treatment type: A cluster analysis of a nationally representative United States survey |
| title_full | Classifying children with ASD by service utilization and treatment type: A cluster analysis of a nationally representative United States survey |
| title_fullStr | Classifying children with ASD by service utilization and treatment type: A cluster analysis of a nationally representative United States survey |
| title_full_unstemmed | Classifying children with ASD by service utilization and treatment type: A cluster analysis of a nationally representative United States survey |
| title_short | Classifying children with ASD by service utilization and treatment type: A cluster analysis of a nationally representative United States survey |
| title_sort | classifying children with asd by service utilization and treatment type a cluster analysis of a nationally representative united states survey |
| topic | Autism spectrum disorder Health services Cluster analysis Access to care Survey of pathways to diagnosis and services |
| url | http://www.sciencedirect.com/science/article/pii/S0001691822003158 |
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