Child and Family Characteristics Influencing Intervention Choices in Autism Spectrum Disorders

Abstract

A myriad of treatment options are available for children with autism, yet little is understood regarding characteristics of parents (e.g., education) and children (e.g., severity of autism symptoms) that influence types and amounts of therapy utilization. Interviews from 70 families were analyzed to determine potential influences on utilization (e.g., start of first services, use of traditional services). Descriptive findings regarding therapy types were similar to national studies. However, only three of the variables predicted utilization of specific therapies: severity of sensory processing problems was associated with earlier initiation of services in general, and higher maternal and paternal education was associated with the use of dietary and/or vitamin therapy as well as with more types of services. No other variables had predictive value; thus, the amount and type of therapies received may be more related to diagnostic practices and/or to the affordances/constraints of service delivery and reimbursement systems at particular ages.

Parent Perceptions About Autism Spectrum Disorder Influence Treatment Choices

“…Higher-than-average socioeconomic status has been identified as a potential bias in other studies related to ASD treatment (Green et al, 2006;Patten et al, 2013;Smith & Antolovich, 2000), including in selecting, implementing, and following-through on treatment. Overall, 76.4% of families in our sample exceeded the national median household income level ($51,914; U.S. Census Bureau, 2010) and also in terms of parent educational attainment (27.9% of the U.S. adult population hold a bachelor's degree or higher; U.S. Census Bureau, 2010).…”

“…Higher parent education level may increase the likelihood of pursuing complementary and alternative medicine (CAM) treatments (Akins, Krakowiak, Angkustsiri, Hertz-Picciotto, & Hansen, 2014), including increased use of special diets and/or vitamin therapy (Patten et al, 2013). Medicaid-eligible children with ASD are much more likely to be treated with psychotropic medications (Mandell et al, 2008).…”

Sensory Response Patterns in Nonverbal Children with ASD

“…Although this is a sample of convenience rather than an epidemiological sample, these findings may reflect disparities in services that are related to demographic variables. For example, in an analysis of service utilization, in which the sample largely overlapped that in the current study, higher parental education was related to more intervention services obtained [55]. …”

Using latent class analysis to identify treatment‐use subgroups among parents of children with autism spectrum disorder

“…Given the myriad of treatments available, it is not surprising that many families use multiple treatments [Bowker, D'Angelo, Hicks, & Wells, ; Green et al, ], implement them simultaneously [Goin‐Kochel, Myers, & Mackintosh, ], and start and stop various treatments throughout their child's life [Bowker et al, ]. Factors associated with parents' treatment selection include symptom presentation and child's age [Goin‐Kochel et al, ; Mire, Raff, Brewton, & Goin‐Kochel, ], parental education level and income [Patten, Baranek, Watson, & Schultz, ], geographic location [Murphy & Ruble, ; Mire, Hughes, Manis, & Goin‐Kochel, ], and parents' perceptions of treatment and ASD [Dardennes et al, ; Mire, Gealy, Kubiszyn, Backscheider‐Burridge, & Goin‐Kochel, ]. However, there are many unknowns about factors that influence parents' decisions to employ some treatments over others [Matson & Williams, ].…”

“…Importantly, some factors that influence treatment use may be difficult to change or may be outside of the family's control, including the accessibility and availability of treatments in one's community (i.e., geographic location), as well as family income and insurance coverage [Patten et al, ; Chiri & Warfield, ]. Access to specialized ASD services, including both diagnostic and treatment services, is affected by family income [Durkin et al, ; Liptak et al, ; Zuckerman et al, ].…”