Parent-reported severity and health/educational services use among US children with autism: Results from a national survey

Katharine E. Zuckerman, Nora D.B. Friedman, Alison E. Chavez, Amy M. Shui, Karen A. Kuhlthau

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Objective: Little national data exist regarding service use patterns for children with autismspectrum disorder (ASD) of varying severity. This study aimed to assess the relationship between parent-reported severity and use of educational and health care services. Methods: Data from the 2011 Survey of Pathways to Diagnosis and Services were used to examine a nationally representative sample of 1420 US children aged 6 to 17 years with ASD, with or without developmental delay and intellectual disability. Weighted multivariable logistic regression assessed associations of parent-reported ASD severity and child sociodemographic characteristics with school-based therapy, non-school-based therapy, behavioral interventions, and specialty provider visits. Results: Higher parent-reported ASD severity was associated with increased likelihood of current use of school-based therapy (adjusted odds ratio [AOR] 5 4.08, 95% confidence interval 51.85-8.98), non-school-based therapy (AOR 5 3.60 [1.95-6.66]), and behavioral interventions (AOR 5 2.30 [1.22-4.34]), as well as regular specialty provider visits (AOR 5 2.99 [1.38-6.46]). Although rates of service use were generally highest among children with severe ASD, non-school-based therapy and behavioral interventions were only used by about half of children with severe ASD, and about 1 in 4 children with mild ASD were using none of the therapies asked about. Conclusion: Parent-reported severity is associated with increased therapy and specialty provider service use among children with ASD. However, substantial variability exists in service use across levels of severity.

Original languageEnglish (US)
Pages (from-to)260-268
Number of pages9
JournalJournal of Developmental and Behavioral Pediatrics
Issue number4
StatePublished - May 1 2017


  • Autism spectrum disorder
  • Severity
  • Site of care
  • Specialty provider visit
  • Therapy service

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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