Abstract
We measured which medical home care components were associated with the likelihood of current educational service use, controlling for select social and clinical factors, in children and youth on the autism spectrum.
Primary Author and Speaker: Sabrin Rizk
Contributing Authors: Teal Benevides, Chengshi Amory Shiu, Kristin L. Berg, Mary Alunkal Khetani
To examine the medical home care components associated with the likelihood of current educational service use, controlling for social and clinical factors, in children and youth on the autism spectrum. We used cross-sectional data from the combined 2016 through 2019 National Survey of Children’s Health (NSCH). Current educational service use was assessed under an individualized family service plan (IFSP) or an individualized education program (IEP). Six medical home care components were evaluated: personal doctor or nurse, usual source of sick care, family centered care, referral difficulty, effective care coordination, and shared decision-making. Weighted multivariate analyses were used to estimate the likelihood of current educational service use for children and youth on the autism spectrum (n=1,922). Adjusted odds ratios and 95% confidence intervals (CI) are reported. Referral difficulty (aOR= 2.93, CI: 1.33-6.41, p=.007) and lack of shared decision-making (aOR= 2.93, CI: 1.10-3.44, p=.016) were associated with higher likelihood of current educational service use. Older child age was associated with a lower likelihood of current educational service use (aOR= 0.91, CI: 0.85-0.97, p=.003), whereas higher autism severity was associated with a higher likelihood of current educational service use (aOR=1.80, CI: 1.10-2.95, p=.019). Two medical home care components, referral difficulty and lack of shared decision-making, were associated with higher likelihood of current educational service use, attenuated by older child age, but intensified by higher condition severity. Findings suggest easing referral or shared decision-making pathways in medical home care and identifying caregiver strategies for acquiring educational services. Children and youth on the autism spectrum benefit from OT, as a part of the set of services in their educational programs and examining referral or shared decision-making pathways are needed to promote cross sector care.
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