Variation in Educational Services Receipt Among US Children With Developmental Conditions

Abstract

Objective: 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).

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: autism spectrum disorder; children with special health care needs; developmental conditions; developmental delay; ease of access; individualized education program; intellectual disability; school-based therapy.

Figure 1

Weighted Percentage and 95% Confidence Interval of US Children Aged 6–17 Years Who Were Able to Easily Access Needed Community-Based Services, Overall and by Developmental Condition ***Indicates the proportion was significantly different from the proportion for the rest of the sample at the P< .001 level.

Figure 2

Weighted Percentages with 95% Confidence Intervals of Educational Services Receipt^a Among US Children Aged 6–17 Years, Overall and by Developmental Condition ***Indicates the proportion was significantly different from the proportion for the rest of the sample at the P < .001 level, **P < .01 level, or *P < .05 level. ^aThe denominators for measures of having an IEP that addressed parent concerns about the child's development and education as well as receipt of ≥1 school-based therapy include all children in the study sample in order to show the proportion of children who could have potentially received such services regardless of whether they had an IEP. Source: 2011 Survey of Pathways to Diagnosis and Services