Predicting intervention use in autistic children: Demographic and autism-specific characteristics

Abstract

Autism is a heterogeneous diagnosis with symptoms that present in different ways. There is a large variety of interventions for autistic individuals. However, little is known about who chooses which specific interventions. We aimed to explore intervention prevalence and predict intervention use, based on demographic and autism-specific characteristics. This study used data on autistic children ( N = 1464, aged 1–17 years) from the Netherlands Autism Register. Most children (88%) had received therapies, and about half had received medication. Intervention use was mostly related to additional factors (lower IQ, special education and co-occurring diagnoses). Children with a lower IQ received less therapies, children attending special education or with a co-occurring diagnosis received more therapies. Children in special education or with a co-occurring diagnosis were more likely to receive several types of therapy and medication. Older age, higher IQ and being female were related to more guideline (autism-specific) or mainstream (targeting co-occurring problems) therapy use. Lower parental education was related to more mainstream medication use. More severe sensory issues increased the chance of other medication use. Other autism-specific characteristics (autism severity, social skills, repetitive and restrictive behaviours) were not related to intervention use. More transdiagnostic interventions should be available for children with autism who have additional difficulties. Lay abstract Autism is a condition that is characterised by social communication difficulties and restrictive and repetitive behaviours or interests. Autism can present in many different ways and various interventions are available. Some interventions are conventional, and they are recommended to be used for children with autism (guideline therapies) or for other disorders such as anxiety or attention-deficit hyperactivity disorder (mainstream therapies or medication), while others are less conventional (other therapies or medication, they are discouraged, unknown or alternative). Little is known about who chooses which intervention. This study found that most autistic children use some kind of intervention. Children who attend special education or have an additional diagnosis (other than autism) tend to receive more therapies, while children with a lower IQ receive fewer therapies. Older children, children with a higher IQ and girls are more likely to use conventional (mainstream or guideline) therapies. Children whose parents have a lower educational level are more likely to have used conventional medication. Whereas, children with more sensory issues (e.g. sensitivity to sound, smell or movement) were more likely to have used unconventional medication. This study found that other autism-related characteristics such as the number of autism symptoms, social skills and repetitive and restrictive behaviours were not related to the interventions used. More treatments focussed on multiple problems should be available for children with autism who have additional difficulties.

Alternative treatments for autism: Prevalence and predictors

“…Medication can be used to treat co-occurring problems like aggression and irritability (Mayes et al, 2020). Conventional treatments for autism are described in several guidelines (see the Dutch Youth Institute (Nederlands Jeugd Instituut NJI, 2017), the Dutch mental health care quality standards (GGZ Standaarden, 2020), the European society of child and adolescent psychiatry (ESCAP; Fuentes et al, 2020), the British National Institute for Health and Care Excellence (National Institute for Health and Care Excellence (NICE), 2013) and the Centers for Disease Control and Prevention (Centers for Disease Control and Prevention (CDC), 2019); also see Jonkman et al, 2022), their advice is based on scientific evidence, general practice and the theoretical framework underlying the treatment approach.…”

Community perspectives on the appropriateness and importance of support goals for young autistic children

“…Finally, the mean priority scores were calculated across all items within each goal domain. In line with previous research, mean scores were not calculated in instances where participants had not completed or had responded ‘no opinion/not sure’ to at least one item within a particular domain ( Jonkman et al, 2023 ). Thus, this score was missing for these participants in all relevant analyses.…”

Achter de Spiegel: Het spectrum van autisme

“…Een recente studie naar behandelingen liet zien dan 90% van de autistische kinderen behandelingen volgt 59 . In Nederland zien we overigens dat die intensieve vroege behandelingen slechts in 5% genoemd worden.…”