Lindly Olivia J, Sinche Brianna K, Zuckerman Katharine E
College of Public Health and Human Sciences, Oregon State University, Corvallis, Ore; Division of General Pediatrics, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, Ore.
Division of General Pediatrics, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, Ore.
Acad Pediatr. 2015 Sep-Oct;15(5):534-43. doi: 10.1016/j.acap.2015.04.001.
To examine the relationship between ease of access to needed community-based services (ease of access) and educational services receipt, and variation in educational services receipt by sociodemographic and need factors among a nationally representative sample of children with autism spectrum disorder (ASD), developmental delay (DD), and/or intellectual disability (ID).
Data from the 2009-2010 National Survey of Children with Special Health Care Needs were linked to the 2011 Survey of Pathways to Diagnosis and Services on a sample of 3502 US children aged 6 to 17 years with ASD, DD, and/or ID. Descriptive statistics, chi-square tests, and multivariable logistic regression models were used to determine associations of educational services receipt with ease of access and sociodemographic and need factors.
Among children with developmental conditions, nearly half (49.7%) lacked easy access to services, and 16.9% did not have an individualized education program (IEP). Among children with an IEP, those with ease of access were more likely to have an IEP that addressed parent concerns about the child's development and education than those unable to easily access services (adjusted odds ratio 2.77; 95% confidence interval 1.71-4.49). Need factors, including functional limitations status, care coordination need, developmental condition type, and early intervention receipt, were significantly associated with educational services receipt.
Cross-systems initiatives facilitating service access remain important to ensuring the developmental needs of children with ASD, DD, and/or ID are met. Increased interprofessional collaboration promoting quality educational services receipt for children diagnosed with developmental conditions may further reduce disparities.
在全国具有代表性的患有自闭症谱系障碍(ASD)、发育迟缓(DD)和/或智力残疾(ID)的儿童样本中,研究获得所需社区服务的便利性(服务可及性)与接受教育服务之间的关系,以及社会人口统计学和需求因素对接受教育服务情况的影响。
将2009 - 2010年全国特殊医疗需求儿童调查的数据与2011年诊断和服务途径调查相链接,样本为3502名6至17岁患有ASD、DD和/或ID的美国儿童。使用描述性统计、卡方检验和多变量逻辑回归模型来确定接受教育服务与服务可及性、社会人口统计学和需求因素之间的关联。
在患有发育障碍的儿童中,近一半(49.7%)难以获得服务,16.9%没有个性化教育计划(IEP)。在有IEP的儿童中,与难以获得服务的儿童相比,服务可及性高的儿童更有可能拥有一个解决家长对孩子发展和教育担忧的IEP(调整后的优势比为2.77;95%置信区间为1.71 - 4.49)。需求因素,包括功能受限状况、护理协调需求、发育障碍类型和接受早期干预情况,与接受教育服务显著相关。
促进服务可及性的跨系统举措对于确保满足ASD、DD和/或ID儿童的发展需求仍然很重要。加强跨专业合作以促进被诊断患有发育障碍的儿童获得高质量教育服务,可能会进一步减少差距。