International Meeting for Autism Research: Changes in Educational Placements for Children with Autism Spectrum Disorders (ASDs) in a Population-Based Sample in a US Metropolitan Area

Changes in Educational Placements for Children with Autism Spectrum Disorders (ASDs) in a Population-Based Sample in a US Metropolitan Area

Friday, May 21, 2010: 2:45 PM
Grand Ballroom AB Level 5 (Philadelphia Marriott Downtown)
1:15 PM
M. J. Morrier , Department of Psychiatry and Behavioral Sciences, Emory Autism Center, Emory University School of Medicine, Atlanta, GA
C. E. Rice , Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA
J. Baio , Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA
S. J. Wagner , Department of Psychiatry and Behavioral Sciences, Emory Autism Center, Emory University School of Medicine, Atlanta, GA
J. Nicholas , Medicine, Medical University of South Carolina, Charleston, SC
Background: ASDs affect about 1% of children (CDC, 2009) which challenges school systems to meet these students’ educational needs. Federal mandates require students with disabilities to be educated in the least restrictive environment to the maximum extent possible (IDEA, 2004).
Objectives: To document changes in educational placements for students with an ASD over four time periods from a population-based ASD surveillance system.
Methods: Children with ASD were identified through record abstraction at multiple health and education sources within a US metropolitan area. Case status based on the DSMIVTR criteria was determined by clinician reviewers. Educational placement was obtained from the child’s Individualized Educational Plan (IEP) at age eight, while intellectual level was based on the most recent IQ score on record. Socioeconomic status was coded from Census 2000 indicators based on the child’s residence.
Results: A total of 1,497 8-year-old children with an ASD were identified for the study years 2000, 2002, 2004, or 2006. Of these, 141 had no IEP on record and were presumed to be in general education (GenEd). The remaining 1356 children were receiving special education services; however, 50 (3.3%) children with an unknown educational placement were excluded from the analysis. Placements were categorized as (a) Less Restrictive, comprised of 141 (9.7%) in GenEd and 195 (13.5%) outside GenEd < 21% of the time; or (b) More Restrictive, comprised of 214 (14.8%) children outside GenEd 21-60% of the time, 882 (61%) outside GenEd > 60% of the time, and 15 (1%) in separate facilities.
During all four years combined, 336 (23.2%) students with ASD were educated in Less Restrictive environments while 1111 (76.8%) had More Restrictive placements. The proportion of children in Less Restrictive environments increased each year from 2000 to 2006, with children in 2006 significantly more likely to be in Less Restrictive placements (OR = 1.3, 95% CI = 1.0-1.7; p = .03). Overall, children with IQ >70 were significantly more likely to be in Less Restrictive placements (OR = 5.4, 95% CI = 3.8-7.6; p < .001). Children in the lowest SES tertile were significantly more likely to be in More Restrictive placements than those from the middle and higher SES tertiles (OR = 2.5, 95% CI = 1.6-3.8; p < .001). White non-Hispanic race was associated with placement in a Less Restrictive environment (p < .001).
Conclusions: The majority of special education students with ASD were being educated outside of GenEd, and this appears to be decreasing slightly over time. However, some children with mild ASD may not have been identified by the case identification process.  Placements were primarily influenced by IQ level. Race/ethnicity and SES were also associated with placement in more restrictive setting, however, an interaction was observed between these factors. Although educational mandates emphasize the least restrictive environment, educational placement in the GenEd is not common for students with ASD.
The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
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