Benevides Teal W, Carretta Henry J, Mandell David S
Department of Occupational Therapy, College of Health Professions, Thomas Jefferson University, Philadelphia, Pennsylvania;
Florida State University, Department of Family Medicine & Rural Health Division of Health Affairs, College of Medicine, Tallahassee, Florida; and.
Pediatrics. 2016 Feb;137 Suppl 2:S176-85. doi: 10.1542/peds.2015-2851P.
Identifying racial and ethnic differences in perceived need for treatment among families of children with autism spectrum disorder (ASD) will improve understanding of disparities in care seeking. We described racial and ethnic differences in perceived need for services that children with ASD and their families frequently use.
We conducted bivariate analyses of racial and ethnic categories and perceived need for 6 common services used by children with ASD as found in the 2005 to 2006 (n = 2123) and the 2009 to 2010 (n = 3055) National Survey of Children With Special Health Care Needs data sets. Multivariate logistic regressions within concatenated data sets were conducted to examine associations between racial and ethnic category and perceived service needs while controlling for predisposing, enabling, and child factors.
Compared with caregivers of white non-Hispanic children with ASD, caregivers of Hispanic children reported less need for prescription medications in adjusted multivariate analyses. Caregivers of black non-Hispanic children with ASD reported less need for prescription medications and for child and family mental health services than caregivers of white non-Hispanic children. Both English-speaking Hispanic caregivers and black non-Hispanic caregivers reported greater need for occupational, speech, and physical therapy than white non-Hispanic caregivers. No racial or ethnic differences were found in perceived need for specialty medical care or respite care.
Caregivers of children with ASD from different racial and ethnic backgrounds may differentially perceive need for different types of care. Their perceptions may in turn affect how they prioritize and seek care, independent of their child's specific needs.
识别自闭症谱系障碍（ASD）儿童家庭中在感知治疗需求方面的种族和族裔差异，将有助于增进对寻求治疗方面差异的理解。我们描述了ASD儿童及其家庭经常使用的服务在感知需求方面的种族和族裔差异。
我们对2005年至2006年（n = 2123）和2009年至2010年（n = 3055）全国特殊医疗需求儿童调查数据集里的种族和族裔类别以及ASD儿童使用的6种常见服务的感知需求进行了双变量分析。在合并的数据集中进行多变量逻辑回归，以检验种族和族裔类别与感知服务需求之间的关联，同时控制 predisposing、促成因素和儿童因素。
在调整后的多变量分析中，与非西班牙裔白人ASD儿童的照料者相比，西班牙裔儿童的照料者表示对处方药的需求较少。患有ASD的非西班牙裔黑人儿童的照料者表示，与非西班牙裔白人儿童的照料者相比，对处方药以及儿童和家庭心理健康服务的需求较少。说英语的西班牙裔照料者和非西班牙裔黑人照料者都表示，与非西班牙裔白人照料者相比，对职业、言语和物理治疗的需求更大。在对专科医疗护理或喘息服务的感知需求方面未发现种族或族裔差异。
来自不同种族和族裔背景的ASD儿童照料者可能对不同类型护理的需求有不同的感知。他们的感知可能反过来影响他们如何确定护理的优先级和寻求护理，而与孩子的具体需求无关。
