Medical home primary care components and current educational service use in children and youth on the autism spectrum
IntroductionChildren and youth on the autism spectrum and their families use health and educational services to address their complex needs. They use primary health care services in the medical home, as endorsed by the American Academy of Pediatrics (AAP). They can also use educational services for...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Education |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/feduc.2023.1125929/full |
| _version_ | 1797824124178923520 |
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| author | Sabrin Rizk Sabrin Rizk Teal W. Benevides Chengshi Amory Shiu Kristin L. Berg Mary A. Khetani Mary A. Khetani |
| author_facet | Sabrin Rizk Sabrin Rizk Teal W. Benevides Chengshi Amory Shiu Kristin L. Berg Mary A. Khetani Mary A. Khetani |
| author_sort | Sabrin Rizk |
| collection | DOAJ |
| description | IntroductionChildren and youth on the autism spectrum and their families use health and educational services to address their complex needs. They use primary health care services in the medical home, as endorsed by the American Academy of Pediatrics (AAP). They can also use educational services for their cognitive, social, and adaptive skill development, beginning in early intervention and through their transition to postsecondary or vocational roles. Medical and educational services are organized and delivered in separate systems, thereby placing the primary responsibility for coordinating these services on their families.MethodsPooled data from 2016 through 2019 National Survey of Children's Health were used to measure the association between current educational service use and six medical home primary care components, controlling for select sociodemographic and clinical factors in children and youth on the autism spectrum (n = 1,922).ResultsAfter controlling for select sociodemographic and clinical factors, difficulty getting referrals [aOR = 2.93, 95% CI (1.33, 6.41), P = 0.007] and no shared decision-making in the medical home [aOR = 2.93, 95% CI (1.21, 7.06), P = 0.016] resulted in higher likelihood of current educational service use. Older children had a lower likelihood of current educational service use [aOR = 0.91, 95% CI (0.85, 0.97), P = 0.003], whereas higher autism severity increased the likelihood of current educational service use [aOR = 1.80, 95% CI (1.10, 2.95), P = 0.019].ConclusionChildren and youth on the autism spectrum, especially those with moderate or severe autism, had a higher likelihood of education service use, unless they were older, had difficulty getting referrals, and no shared decision-making. Results suggest that the way services are currently provided between health and educational systems separates medical and educational professionals, therefore increasing the demands on caregivers and educational systems to facilitate current educational service use. Further study is needed for improving the medical home referral or shared decision-making pathways and to identify caregiver strategies for navigating educational systems. |
| first_indexed | 2024-03-13T10:34:20Z |
| format | Article |
| id | doaj.art-c418054f782546be8f5c62f82e552203 |
| institution | Directory Open Access Journal |
| issn | 2504-284X |
| language | English |
| last_indexed | 2024-03-13T10:34:20Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Education |
| spelling | doaj.art-c418054f782546be8f5c62f82e5522032023-05-18T08:11:24ZengFrontiers Media S.A.Frontiers in Education2504-284X2023-05-01810.3389/feduc.2023.11259291125929Medical home primary care components and current educational service use in children and youth on the autism spectrumSabrin Rizk0Sabrin Rizk1Teal W. Benevides2Chengshi Amory Shiu3Kristin L. Berg4Mary A. Khetani5Mary A. Khetani6Occupational Therapy, University of Illinois Chicago, Chicago, IL, United StatesChildren's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United StatesInstitute of Public and Preventative Health, Augusta University, Augusta, GA, United StatesSchool of Nursing, University of California, Los Angeles, Los Angeles, CA, United StatesDisability and Human Development, University of Illinois Chicago, Chicago, IL, United StatesOccupational Therapy, University of Illinois Chicago, Chicago, IL, United StatesChildren's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United StatesIntroductionChildren and youth on the autism spectrum and their families use health and educational services to address their complex needs. They use primary health care services in the medical home, as endorsed by the American Academy of Pediatrics (AAP). They can also use educational services for their cognitive, social, and adaptive skill development, beginning in early intervention and through their transition to postsecondary or vocational roles. Medical and educational services are organized and delivered in separate systems, thereby placing the primary responsibility for coordinating these services on their families.MethodsPooled data from 2016 through 2019 National Survey of Children's Health were used to measure the association between current educational service use and six medical home primary care components, controlling for select sociodemographic and clinical factors in children and youth on the autism spectrum (n = 1,922).ResultsAfter controlling for select sociodemographic and clinical factors, difficulty getting referrals [aOR = 2.93, 95% CI (1.33, 6.41), P = 0.007] and no shared decision-making in the medical home [aOR = 2.93, 95% CI (1.21, 7.06), P = 0.016] resulted in higher likelihood of current educational service use. Older children had a lower likelihood of current educational service use [aOR = 0.91, 95% CI (0.85, 0.97), P = 0.003], whereas higher autism severity increased the likelihood of current educational service use [aOR = 1.80, 95% CI (1.10, 2.95), P = 0.019].ConclusionChildren and youth on the autism spectrum, especially those with moderate or severe autism, had a higher likelihood of education service use, unless they were older, had difficulty getting referrals, and no shared decision-making. Results suggest that the way services are currently provided between health and educational systems separates medical and educational professionals, therefore increasing the demands on caregivers and educational systems to facilitate current educational service use. Further study is needed for improving the medical home referral or shared decision-making pathways and to identify caregiver strategies for navigating educational systems.https://www.frontiersin.org/articles/10.3389/feduc.2023.1125929/fullreferral and consultationdecision-makingsharedautism spectrumearly interventioneducational |
| spellingShingle | Sabrin Rizk Sabrin Rizk Teal W. Benevides Chengshi Amory Shiu Kristin L. Berg Mary A. Khetani Mary A. Khetani Medical home primary care components and current educational service use in children and youth on the autism spectrum Frontiers in Education referral and consultation decision-making shared autism spectrum early intervention educational |
| title | Medical home primary care components and current educational service use in children and youth on the autism spectrum |
| title_full | Medical home primary care components and current educational service use in children and youth on the autism spectrum |
| title_fullStr | Medical home primary care components and current educational service use in children and youth on the autism spectrum |
| title_full_unstemmed | Medical home primary care components and current educational service use in children and youth on the autism spectrum |
| title_short | Medical home primary care components and current educational service use in children and youth on the autism spectrum |
| title_sort | medical home primary care components and current educational service use in children and youth on the autism spectrum |
| topic | referral and consultation decision-making shared autism spectrum early intervention educational |
| url | https://www.frontiersin.org/articles/10.3389/feduc.2023.1125929/full |
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