Kent School of Social Work, University of Louisville, Louisville, Kentucky (Yingling); College of Social Work, Hamilton College, University of South Carolina, Columbia (Bell, Hock).
Psychiatr Serv. 2019 Nov 1;70(11):1034-1039. doi: 10.1176/appi.ps.201800479. Epub 2019 Aug 5.
This study investigated equity in enrollment in a Medicaid waiver program for early intensive behavioral intervention for children with autism spectrum disorder (ASD).
State administrative, Medicaid, and U.S. Census data for children enrolled in the waiver program between 2007 and 2015 (N=2,111) were integrated. Multivariate and bivariate analyses were used to compare enrollees' neighborhood demographic characteristics with those of the state's general population, with controls for enrollees' age, sex, and race-ethnicity.
Findings indicate that in general, enrollment was equitable. During the years in which there were inequities, children who lived in neighborhoods of privilege were favored. These neighborhoods had higher median incomes, lower poverty levels, and fewer female-headed households and were located in urban areas.
As states work to provide equitable treatment to children with ASD and their families, it is important to track potential inequities between children who do and do not enroll in services and to use this information to inform outreach efforts. States may turn to South Carolina for insight on how to ensure equity.
本研究调查了在针对自闭症谱系障碍（ASD）儿童的早期强化行为干预的 Medicaid 豁免计划中，入学机会是否公平。
整合了 2007 年至 2015 年期间参加豁免计划的儿童的州行政、医疗补助和美国人口普查数据（N=2111）。使用多变量和双变量分析来比较参与者所在社区的人口统计学特征与该州总人口的特征，同时控制参与者的年龄、性别和种族-民族。
研究结果表明，总体而言，入学机会是公平的。在存在不平等的年份，居住在特权社区的儿童更受青睐。这些社区的收入中位数较高，贫困水平较低，女性户主家庭较少，并且位于城市地区。
随着各州努力为 ASD 儿童及其家庭提供公平待遇，重要的是要跟踪未参加服务的儿童与参加服务的儿童之间的潜在不平等，并利用这些信息来指导外展工作。各州可能会借鉴南卡罗来纳州的经验，了解如何确保公平性。
