Unmet health care needs and health care quality in youth with autism spectrum disorder with and without intellectual disability.
Autistic kids with ID face almost double the unmet mental-health needs—screen early and route them to care faster.
01Research in Context
What this study did
Menezes et al. (2021) asked 1,165 U.S. caregivers about health care for their autistic kids. Half the kids also had intellectual disability (ID).
The team used a big national survey. They counted unmet needs and asked parents to rate care quality.
What they found
Kids with ASD plus ID were nearly twice as likely to have unmet mental-health needs. Parents also gave their care lower marks.
The gap stayed even after the authors adjusted for income, race, and insurance.
How this fits with other research
Emerson et al. (2023) looked at the same ASD-plus-ID group and found they get more daily medicines. Together the two studies show more needs and more pills, but not better care.
Shawler et al. (2021) found low-income families lost services during COVID-19. Michelle’s work says ID creates a second, separate barrier that hits even when money is not the problem.
Laugeson et al. (2014) tracked preschoolers and saw social skills fall further behind in the ASD-plus-ID group. The new data suggest those widening skill gaps turn into harder-to-meet health-care needs later.
Why it matters
If you screen for ID at intake you can flag the kids whose mental-health needs will likely slip through the cracks. Build faster referral paths to psychiatry or counseling for this subgroup and check in sooner after the first visit.
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02At a glance
03Original abstract
The increase in the prevalence of autism spectrum disorder has placed greater demands on the health care system. Children and adolescents with autism spectrum disorder often experience challenges accessing high-quality physical and mental health care due to characteristic social-communication deficits and behavioral difficulties, as well as high rates of complex medical and psychiatric comorbidities. Intellectual disability commonly co-occurs with autism spectrum disorder and individuals affected by this co-occurrence may have additional impairments that compound challenges accessing health care. This study investigated the relations among co-occurring intellectual disability, unmet physical and mental health care needs, and health care quality in a large, nationally distributed sample of youth with autism spectrum disorder using structural equation modeling techniques. Co-occurring intellectual disability was significantly associated with unmet mental health care needs in children with autism. In addition, unmet mental health care needs mediated the relationship between co-occurring intellectual disability and health care quality; youth with autism spectrum disorder and co-occurring intellectual disability who had a past-year unmet mental health need had significantly poorer caregiver-reported health care quality. These findings suggest that youth with autism spectrum disorder and co-occurring intellectual disability may be more likely to experience unmet mental health care needs and receive poorer quality of care than the broader autism spectrum disorder population.
Autism : the international journal of research and practice, 2021 · doi:10.1177/13623613211014721