Department of Research, Children's Institute, 271 N Goodman St, Suite D103, Rochester, NY 14607, USA.
Pediatrics. 2009 Dec;124 Suppl 4:S407-13. doi: 10.1542/peds.2009-1255L.
Our objective was to compare access to and satisfaction with school and community health resources among families with a child with an autism spectrum disorder (ASD) and families of other children with special health care needs (CSHCN).
Parents of 40,256 children aged 0 to 17 were surveyed by the 2005-2006 National Survey of Children With Special Health Care Needs. Autism was defined by the question, "To the best of your knowledge, does (child) currently have autism or autism spectrum disorder, that is, ASD?" We used chi(2) and multivariate regression analyses to compare access to and satisfaction with services for parents of children with ASDs and parents of other CSHCN.
Children with ASDs (n = 2123) comprise 5.4% of the CSHCN. More parents of children with ASDs reported difficulty using school and community services (27.6% vs 9.7%) and dissatisfaction (19.8% vs 7.9%) than parents of other CSHCN. Multivariate models determined that parents of children with ASDs were 3.39 times more likely to experience difficulty in obtaining services and 2.65 times more likely to be dissatisfied with services received than parents of other CSHCN, after controlling for household demographics and insurance status. Parents of children with ASDs reported a lack of available services and skilled providers.
Parents of children with ASDs reported less access to and more dissatisfaction with school and community health services than parents of other CSHCN. An increased supply of appropriate services with qualified providers for children with ASDs is needed in the United States.
本研究旨在比较患有自闭症谱系障碍(ASD)儿童的家庭和其他有特殊医疗需求儿童(CSHCN)家庭对学校和社区卫生资源的可及性和满意度。
2005-2006 年,通过全国儿童特殊健康需求调查对 40256 名 0-17 岁儿童的家长进行了调查。自闭症是通过以下问题来定义的:“据你所知,(孩子)目前是否患有自闭症或自闭症谱系障碍,即 ASD?”我们使用卡方检验和多元回归分析比较了 ASD 儿童和其他 CSHCN 儿童家长对服务的可及性和满意度。
患有 ASD 的儿童(n=2123)占 CSHCN 的 5.4%。更多的 ASD 儿童家长报告在使用学校和社区服务方面存在困难(27.6%比 9.7%)和不满(19.8%比 7.9%),而其他 CSHCN 儿童家长则没有。多元模型确定,在控制家庭人口统计学和保险状况后,ASD 儿童的父母获得服务困难的可能性是其他 CSHCN 父母的 3.39 倍,对服务不满意的可能性是其他 CSHCN 父母的 2.65 倍。ASD 儿童的家长报告缺乏可用的服务和熟练的提供者。
与其他 CSHCN 儿童的家长相比,ASD 儿童的家长报告说他们对学校和社区卫生服务的可及性较低,对服务的满意度也较低。美国需要为 ASD 儿童提供更多的、有合格提供者的适当服务。