Service Use Classes Among School-Aged Children from the Autism Treatment Network Registry

Background: Use of specific services may help to optimize health for children with autism spectrum disorder (ASD); yet, little is known about their service utilization patterns.

Objectives: We, therefore, aimed to (1) define service use groups and (2) determine associations of sociodemographic, developmental, behavioral, and health characteristics with service use groups among school-aged children with ASD.

Methods: We analyzed cross-sectional data on 1,378 children aged 6-18 years with an ASD diagnosis who were enrolled in the Autism Speaks Autism Treatment Network Registry, from years 2008-2015 across 18 sites in North America. We used data from the first follow-up visit (9-15 months post baseline) on 13 service use indicators spanning behavioral and medical therapies (e.g., behavioral interventions, psychotropic medications, special diets). Latent class analysis was used to identify groups of children with similar service use patterns. Bivariate and multivariable analysis was then used to determine associations of sociodemographic, developmental, behavioral, and health factors with services use groups.

Results: Latent class analysis placed school-aged children with ASD into 4 services use classes: limited services [LS] [12%], multimodal services [MS] [36%], predominantly educational and/or behavioral services [EBS] [43%], and predominantly special diets and/or natural products [SDNP] [9%] (Figure 1). Multivariable analysis results showed children in the LS class were significantly older and had significantly less severe ASD than those in the EBS class. Children in the MS class had significantly more externalizing behavior problems than those in the EBS class, and children in the SDNP class had significantly higher income and significantly poorer quality of life compared to those in the EBS class (Table 1).

Conclusions: Results suggest distinct service use groups exist among school-aged children with ASD following diagnosis and may be related to certain sociodemographic, developmental, behavioral, and health characteristics. Together, these findings may be used by health professionals to better support families in decision-making about service use for their child with ASD following diagnosis.