The Relationship between Socioeconomic Status and Use of Interventions in Families of Children with Autism Spectrum Disorder: Results from the ABC-CT Feasibility Study

Background: Prior research indicates significantly reduced utilization of autism-related services in families with lower socioeconomic status (SES). Specifically, research shows that families with lower SES receive fewer hours of autism-related services, and a smaller variety in the types of services they receive. The Autism Biomarkers Consortium for Clinical Trials (ABC-CT) is a multi-site project that aims to investigate biomarkers associated with autism spectrum disorder including their sensitivity to community-based intervention. It provides an opportunity to investigate the relations between SES, total hours of services received, and types of interventions used (evidence-based or complementary and alternative medicine), from data collected at five sites across the United States.

Objectives: To examine the relations between SES and total number of hours of interventions received and to examine patterns between SES and type of interventions received.

Methods: Twenty-five children with ASD and twenty-six typically developing children (M= 8.04 years old, SD= 2.2, range 4-11) participated in the feasibility phase of the ABC-CT project. Two participants did not provide complete data and were not included in analyses. Parents completed a series of questionnaires that included a demographics form and intervention and medication history. Demographics data collected included the participant’s race, race of both biological parents, education level of both biological parents, and annual household income. In addition, parents completed an intervention and medication history log on the participant’s use of medication (type of medicine and daily dose), the types of intervention received (e.g. speech and language therapy, equine therapy) and the total number of hours of intervention received in the previous six weeks.

Results: Poisson regressions examined the relations between socioeconomic status (measured by parental education level and household income), child age, and hours of intervention received (with significance < .05). Specifically, total hours of intervention received, total hours of evidence-based practices (EBPs) and total hours of complementary and alternative medicine (CAMs) were examined. Annual household income was significantly related to total number of hours of interventions received and total number of hours of CAM received. Maternal education level was significantly related to total hours of EBPs received, but unrelated to total hours of intervention received or total hours of CAM received. Paternal education level and participant’s age were significantly related to total hours of interventions received, total hours of EBP received, and total hours of CAM received. Examination of SES by intervention type via Pearson’s Chi-squared showed no differences related to SES level in the proportion of families who accessed EBPs, CAMs, or medication. Finally, no site-related differences were found for use of EBPs, CAMs, or medication.

Conclusions: These results indicate relations between parental education level, income, age, and total hours of intervention received by children with autism. Results indicate these effects were due to differences at higher levels of annual household income and parental education. Although these preliminary findings suggest relations between socioeconomic status and the amount of intervention received by children with autism across the U.S., in order to further explore these relations, they should be replicated in a larger sample.