title: Unmet Need for Therapy Among Children with Autism Spectrum Disorder: Results from the 2005-2006 and 2009-2010 National Survey of Children with Special Health Care Needs.
abstract: OBJECTIVE
  We examined population-based trends in unmet need for therapy service in children with autism spectrum disorder (ASD) compared to other children with special health care needs (CSHCN), and identified factors associated with unmet need for therapy.
  
  
  METHODS
  A pooled cross-sectional comparison of the 2005-2006 and 2009-2010 waves of the National Survey for Children with Special Health Care Needs (NS-CSHCN) was used. Weighted bivariate analyses were used to compare children ages 3-17 years with ASD (n = 5113) to other CSHCN (n = 71,294) on unmet need for therapy services. Survey weighted multivariate models were used to examine child, family, and contextual characteristics associated with unmet need.
  
  
  RESULTS
  A greater percentage of children with ASD across both surveys were reported to need therapy than other children with CSHCN. Among children with a reported need, children with ASD were 1.4 times more likely to report an unmet need for therapy compared to other CSHCN (OR 1.42, 95 % CI 1.18-1.71). Variables significantly associated with unmet need for therapy services included not receiving a well-child visit in the past year (OR 5.81, CI 3.83-8.81), surveyed in 2009 (OR 1.42, CI 1.18-1.71), child being female (OR 1.27, CI 1.05-1.53), uninsured (OR 1.72, CI 1.15-2.56), and having greater functional limitation (OR 2.44, CI 1.80-3.34).
  
  
  CONCLUSIONS
  Children with ASD require supportive services such as occupational, physical, and speech therapy but are less likely to receive such services than other CSHCN. Receiving a well-child visit in the past year was strongly associated with receipt of needed therapy services.
authors.affiliation: Department of Occupational Therapy, College of Health Professions, Thomas Jefferson University, 901 Walnut Street, Suite 600, Philadelphia, PA, 19107, USA. teal.benevides@jefferson.edu.
authors.forename: Teal W
authors.initials: TW
authors.lastname: Benevides
authors.affiliation: Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, P.O. Box 3064300, Tallahassee, FL, 32306-4300, USA.
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Carretta
authors.affiliation: Department of Occupational Therapy, School of Allied Health Professions, Virginia Commonwealth University, P.O. Box 980008, Richmond, VA, 23298-0008, USA.|School of Health Sciences, Department of Occupational Therapy, University of Newcastle, University Drive, Callaghan, 2300 NSW, Newcastle, Australia.
authors.forename: Shelly J
authors.initials: SJ
authors.lastname: Lane
mesh_terms: D000067877:Autism Spectrum Disorder / Q000523:psychology / Q000628:therapy*; D002648:Child; D002662:Child Health Services / Q000458:organization & administration; D003430:Cross-Sectional Studies; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D017057:Medically Uninsured; D020380:Needs Assessment; D011787:Quality of Health Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Access; Autism spectrum disorder; Health disparities; Special health care needs; Therapy services