Department of Health Sciences, Northern Arizona University, Flagstaff, Arizona;
Biostatistics Center.
Pediatrics. 2020 Apr;145(Suppl 1):S140-S150. doi: 10.1542/peds.2019-1895Q.
Use of specific services may help to optimize health for children with autism spectrum disorder (ASD); however, little is known about their service use patterns. We aimed to (1) define service use groups and (2) determine associations of sociodemographic, developmental, behavioral, and health characteristics with service use groups among school-aged children with ASD.
We analyzed cross-sectional data on 1378 children aged 6 to 18 years with an ASD diagnosis from the Autism Speaks Autism Treatment Network registry for 2008-2015, which included 16 US sites and 2 Canadian sites. Thirteen service use indicators spanning behavioral and medical treatments (eg, developmental therapy, psychotropic medications, and special diets) were examined. Latent class analysis was used to identify groups of children with similar service use patterns.
By using latent class analysis, school-aged children with ASD were placed into 4 service use classes: limited services (12.0%), multimodal services (36.4%), predominantly educational and/or behavioral services (42.6%), or predominantly special diets and/or natural products (9.0%). Multivariable analysis results revealed that compared with children in the educational and/or behavioral services class, those in the multimodal services class had greater ASD severity and more externalizing behavior problems, those in the limited services class were older and had less ASD severity, and those in the special diets and/or natural products class had higher income and poorer quality of life.
In this study, we identified 4 service use groups among school-aged children with ASD that may be related to certain sociodemographic, developmental, behavioral, and health characteristics. Study findings may be used to better support providers and families in decision-making about ASD services.
使用特定的服务可能有助于优化自闭症谱系障碍（ASD）儿童的健康；然而，对于他们的服务使用模式知之甚少。我们的目的是：（1）定义服务使用群体；（2）确定社会人口学、发育、行为和健康特征与 ASD 学龄儿童服务使用群体之间的关联。
我们分析了 2008-2015 年自闭症之声自闭症治疗网络注册中心的 1378 名 6 至 18 岁 ASD 诊断儿童的横断面数据，该注册中心包括 16 个美国站点和 2 个加拿大站点。共检查了 13 个服务使用指标，涵盖行为和医疗治疗（如发育疗法、精神药物和特殊饮食）。使用潜在类别分析来识别具有相似服务使用模式的儿童群体。
通过使用潜在类别分析，将 ASD 学龄儿童分为 4 种服务使用群体：有限服务（12.0%）、综合服务（36.4%）、主要教育和/或行为服务（42.6%）或主要特殊饮食和/或天然产品（9.0%）。多变量分析结果显示，与教育和/或行为服务组的儿童相比，综合服务组的儿童 ASD 严重程度更高，外化行为问题更多；有限服务组的儿童年龄更大，ASD 严重程度更低；特殊饮食和/或天然产品组的儿童收入更高，生活质量更差。
在这项研究中，我们在 ASD 学龄儿童中确定了 4 种服务使用群体，这些群体可能与某些社会人口学、发育、行为和健康特征有关。研究结果可用于更好地为提供者和家庭提供 ASD 服务决策提供支持。
