Service Use in Adolescents and Adults in Latin America. Results from a Multisite Study

Background: Individuals with ASD are users of different type of educational and medical services. There is increasing evidence that recognizes ASD as a lifelong disorder; however, studies about type and frequency of services used by adolescents and adults within the spectrum is scarce.

Objectives: This study aimed to explore perceptions about the use of services of caregivers of adolescents and adults with Autism Spectrum Disorders in Latin America.

Methods: This study was carried in 6 different countries in South America: Argentina, Brazil, Chile, Dominican Republic, Uruguay, and Venezuela. A sample of convenience was drawn from each country. The total sample was made up by 592 caregivers from Argentina, Brazil, Chile, Dominican Republic, Uruguay, and Venezuela. 49.83% (n=295) were adolescents (13-18 years-old), and 50.17% (n=297) were adults (>18 years-old). Caregivers completed a survey either by an interview, by phone, or online, either assisted by a clinician or not. The survey contains four sections: family demographics, affected individual characteristics, service encounters and parent/caregiver perceptions.

Results:

The most prevalent diagnosis among adolescent’s sample was Asperger Syndrome (33.22%) followed by ASD (26.10%). For the adults, Asperger was the most common diagnosis as well (35.69%), followed by Autism (28.62%). 11.85% of the adolescents and 21.54% of the adults had at least one medical comorbidity. For both age groups, Epilepsy was the most frequent comorbidity. The most common type of service used was medication (41.02% in adolescents, and 48.48% in adults); followed by physical therapy (26.77% in adolescents, 24.93% in adults), and Behavior Therapy/Behavior Modification (24.41% in adolescents, 24.93 in adults). The least commonly reported services were psychodynamic therapy (16.94% in adolescents, 15.15% in adults), biomedical treatments (0.68 in adolescents and 8.08% in adults), and relational therapy (floor time and sonrise) (0.34% in adolescents, 2.02% in adults). There was statistical significance between the two age groups for the frequency of use of medication (x²=139.954, α=0.001) biomedical treatments (x²=25.313,α=0.001), and relational services (x²=15.868,α =0.14).

Conclusions: Although exploratory data from caregivers in Latin America results from our sample suggest a decrease in the use of services from adolescence to adulthood. Only medication, psychodynamic therapy, and biomedical treatment were more frequent in adults than adolescents. It could be a function of the scarce availability of services for this population in Latin American countries. It could also describe a more medical oriented approach or conceptualization of ASD in this culture. With a representation of 6 countries, results have clear implications for public health and educational policies and practices