Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Sep-Oct;19(7):740-747.
doi: 10.1016/j.acap.2019.02.013. Epub 2019 Mar 8.

Geographic Disparities in Treatment for Children with Autism Spectrum Disorder

Benjamin Zablotsky  1 , Matthew J Maenner  2 , Stephen J Blumberg  3
Affiliations

Geographic Disparities in Treatment for Children with Autism Spectrum Disorder

Benjamin Zablotsky et al. Acad Pediatr. 2019 Sep-Oct.

Abstract

Objective: Geographic differences may provide insight into what factors influence the likelihood that a child is diagnosed with autism spectrum disorder (ASD) in the United States; yet, there have been few nationally representative surveys that have explored this topic. The current study expands the limited literature by analyzing regional differences in ASD prevalence, service utilization, and the presence of unmet needs within a nationally representative sample of children.

Methods: Data were drawn from the 2014-2016 National Health Interview Survey (NHIS), a nationally representative household survey of the noninstitutionalized US population. Children 3 to 17 years of age were included in the analytic sample. Prevalence estimates accounted for the complex survey design of the NHIS, and differences between geographic regions were compared using logistic/linear regressions with and without adjustment for child/family characteristics.

Results: The prevalence of ASD was highest in the Northeast (3.0%), followed by the Midwest (2.4%), South (2.4%), and West (2.3%). A significant difference was found between the Northeast and West (P < .05); however, after accounting for child and family characteristics, this difference was no longer significant. Children with ASD in the Northeast were the most likely to have seen a specialist in the past year. Approximately 1 in 8 children with ASD experienced at least 1 unmet need, but there were no differences found by geographic region.

Conclusions: Although differences in prevalence were not significant after adjustment, service utilization differences remained. It appears that children with ASD in the Northeast utilize the greatest number of specialty services when compared to children with ASD from other parts of the country.

Keywords: autism spectrum disorder; children; national survey; prevalence; treatment.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest and Source of Funding: The authors have no financial relationships relevant to this article to disclose. The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.. Number of type of specialists seen in the past year among children with autism spectrum disorder, by geographic region
a Significantly different from children in Northeast after adjustment for child and family characteristics (p<0.05)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013.
    1. Baio J, Wiggins L, Christensen DL, et al. Prevalence of autism spectrum disorder among children aged 8 years—Autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Morb Mortal Wkly Rep. 2018;67:1–23. - PMC - PubMed
    1. Christensen DL, Baio J, Braun KVN, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2012. MMWR Morb Mortal Wkly Rep. 2016;65(3):1–23. - PMC - PubMed
    1. Lyall K, Croen L, Daniels J, et al. The changing epidemiology of autism spectrum disorders. Annu Rev Public Health. 2017;38:81–102. - PMC - PubMed
    1. Zablotsky B, Black LI, Maenner MJ, et al. Estimated prevalence of autism and other developmental disabilities following questionnaire changes in the 2014 National Health Interview Survey. National Health Statistics Reports. 2015;87:1–20. - PubMed

MeSH terms