Comparison of unmet health care needs in children with intellectual disability, autism spectrum disorder and both disorders combined.
Kids with intellectual disability alone miss far more medical care than kids with autism alone.
01Research in Context
What this study did
Lee et al. (2022) asked parents about missed care. They compared three groups: kids with intellectual disability alone, kids with autism alone, and kids with both. Families filled out a survey on medical, dental, hearing, and mental-health needs that went unmet. They also reported how steady their insurance felt.
What they found
Children with ID alone were nearly four times more likely to miss needed medical care. They also had shakier insurance and more unmet hearing and mental-health visits. Surprisingly, kids with autism alone fared better than kids with ID alone. Having both conditions landed in the middle.
How this fits with other research
McConkey et al. (2010) extends the story. Their Canadian data show adults with ID are hospitalized for preventable problems six times more often than peers. The same access gap seen in K’s children shows up later as costly ER stays.
Faso et al. (2016) matches the survey style. In Australia, people with ID had fewer routine check-ups and vaccines. The two studies line up: missed everyday care today means bigger problems tomorrow.
Lancioni et al. (2011) looks similar but flips the lens. Kids with cerebral palsy had only modestly higher unmet needs, and only when GI or mood issues were present. The gap for ID-alone children in K’s study is much wider, showing ID carries its own heavy burden.
Why it matters
If you serve a child with ID, treat medical care like any other goal. Ask about missed appointments, hearing tests, and therapy referrals at every team meeting. Help families lock down stable insurance and find primary doctors comfortable with ID. Catching small issues early keeps kids out of the hospital and in your therapy room.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add one question to your caregiver check-in: ‘Any appointments you couldn’t get this month?’ If yes, script the next step together.
02At a glance
03Original abstract
BACKGROUND: The purpose of this study was to assess the unmet health care needs of children with intellectual disability (ID) compared with children with autism spectrum disorder (ASD) and whether access to health insurance coverage is a contributing factor. Children with ID may be masked in the health care system due to increased diagnosis and awareness of ASD. The needs, unmet needs and insurance coverage of children with ID alone, ASD alone, and co-occurring ID and ASD were assessed in this study. METHODS: The 2016 to 2019 United States' Census Bureau National Survey of Children's Health was used to determine differences in unmet needs, care not received and health insurance coverage during the past year for children with ID and/or ASD. Adjusted odds ratios and 95% confidence intervals for care not received were determined controlling for sex, insurance, race, age and parents' highest education level. RESULTS: Children with ID were nearly four times more likely not to receive needed medical care as children with ASD. Results were similar for unmet hearing and mental health care. Children with both ID and ASD were more likely to have unmet health care but less likely to have unmet medical care compared with children with ASD alone. There were no significant differences for unmet dental or vision care. Children with ID were 3.58 (95% confidence interval: 1.6-8.0) times more likely to have inconsistent health insurance compared with children with ASD. CONCLUSIONS: Children with ID alone are more likely to have unmet medical, hearing and mental health care needs than children with ASD alone. Children with co-occurring ID and ASD have a large amount of general unmet health care needs but less unmet medical needs. Children with ID are less likely to have consistent health insurance than children with ASD. This hinders the ability of children with ID to receive quality care. Further research is needed to determine if the diagnosis of ASD in children in the United States is negatively affecting children with ID alone.
Journal of intellectual disability research : JIDR, 2022 · doi:10.1111/jir.12932