Abstract
Background: Although Medicaid coverage of treatment for children with autism spectrum disorder (ASD) is expanding, we know little about when children receive speech‐language, occupational, and/or physical therapy. The objective of this study was to examine the relationships between predisposing, enabling and need characteristics and utilization of speech‐language, occupational, and physical therapy by diagnosis of autism spectrum disorder (ASD).
Methods: We integrated administrative, Medicaid, and Census data using a large sample of children with ASD who enrolled in a 1915(c) Home and Community Based Medicaid waiver in a Southeastern state (N=1968) to explore: 1) the percent of treatment utilization by ASD diagnosis; 2) the type of therapy utilized; and 3) the predisposing, enabling, and need characteristics associated with utilization.
Results: The percent of utilization was 71%; 65.8% utilized SLT, 33.4% utilized OT, and 18.4% utilized PT. Enabling (i.e., urbanicity, age of diagnosis, early intervention program enrollment) and need (i.e., Intellectual Disability) characteristics were associated with utilization while predisposing social characteristics (i.e., sex and child race‐ethnicity, and neighborhood racial composition, poverty, and affluence) were not associated with utilization.
Conclusions: Findings highlight the value in monitoring when children begin treatment. As governments in the U.S. and globally work to maximize children’s potential, additional research that can inform efforts to facilitate earlier utilization will be key to promoting optimal outcomes.