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CDC reports on kids with special care needs, ASD

Friday May 25, 2012
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A new report from the U.S. Centers for Disease Control and Prevention examined the diagnostic history and treatment of school-aged children with autism spectrum disorder and special healthcare needs.

The authors noted that "early identification is an important first step toward making sure that children with ASD and their families are able to access and benefit from early intervention, which has been associated with positive developmental outcomes." But among school-aged children with both special healthcare needs and ASD, a majority were age 5 or older when they were first identified as having ASD, while only one in five was diagnosed by age 3.

A wide range of healthcare providers, including general and specialist physicians, mental health specialists and others, were the first professionals to identify children with special healthcare needs as having ASD, according to the survey. A majority of children with special healthcare needs diagnosed with ASD at age 5 or older were identified by psychologists and psychiatrists, whereas no single type of healthcare provider identified more than 20% of children with special healthcare needs as having ASD before age 5.

Most families use a combination of services to address the developmental needs of their children with special healthcare needs and ASD, according to the survey. Social skills training and speech or language therapy are the most commonly used, followed by occupational therapy.

Meanwhile, 12% of children with special healthcare needs and ASD do not use any of the eight services included in the survey: behavioral intervention or modification services, sensory integration therapy, cognitive-based therapy, school-based or other occupational therapy, school-based or other physical therapy, school-based or other social skills training, school-based or other speech or language therapy, and alternative healthcare or treatment.

Fewer than half of children with special healthcare needs use behavioral interventions or modification services, which the authors cited as the most well-established and efficacious intervention for ASD. Younger children with special healthcare needs and ASD are more likely to use any services and multiple services, in part because they are more likely to use occupational therapy and speech or language therapy to meet their developmental needs.

More than half of school-aged children with special healthcare needs and ASD use at least one psychotropic medication, most commonly stimulants. Medication use spans a variety of medication classes, perhaps reflecting treatment of co-occurring symptoms or absence of clear practice guidelines for psychotropic medication use in children with ASD, according to the researchers.

For purposes of the study, researchers defined children with special healthcare needs using criteria from the National Survey of Children with Special Healthcare Needs. The Maternal and Child Health Bureau has defined these children as "those who have or are at increased risk for a chronic physical, developmental, behavioral or emotional condition and who require health and related services of a type or amount beyond that required by children generally."

The report appeared May 24 as a Data Brief of the CDCís National Center for Health Statistics. To read it, visit http://1.usa.gov/JfETPi.


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