title: Caregiver Burdens and Preventive Dental Care for Children with Autism Spectrum Disorder, Developmental Disability and/or Mental Health Conditions: National Survey of CSHCN, 2009-2010.
abstract: Objective The purpose of this study is to examine the burdens of caregivers on perception of the need and receipt of preventive dental care for a subset of children with special health care needs-children with Autism Spectrum disorder, developmental disability and/or mental health conditions (CASD/DD/MHC). Methods The authors used the 2009-2010 National Survey of CSHCN. The survey included questions addressing preventive dental care and caregivers' financial, employment, and time-related burdens. The associations of these burdens on perceptions and receipt of preventive dental care use were analyzed with bivariate Chi square analyses and multinomial logistic regressions for CASD/DD/MHC (N = 16,323). Results Overall, 16.3 % of CASD/DD/MHC had an unmet preventive dental care need. There were 40.0 % of caregivers who reported financial burden, 20.3 % who reported employment burden, and 10.8 % who reported time burden. A higher percentage of caregivers with financial burden, employment burden, and time-related burden reported that their CASD/DD/MHC did not receive needed preventive dental care (14.1, 16.5, 17.7 % respectively) compared to caregivers without financial, employment, or time burdens (9.0, 9.6 %, 11.0 % respectively). Caregivers with financial burden (adjusted multinomial odds ratio, 1.38 [95 % CI 1.02, 1.86] and employment burden (adjusted multinomial odds ratio, 1.45 [95 % CI 1.02, 2.06] were more likely to report that their child did not receive preventive dental care despite perceived need compared to caregivers without financial or employment burdens. Conclusions for practice Unmet needs for preventive dental care were associated with employment and financial burdens of the caregivers of CASD/DD/MHC.
authors.affiliation: Dental Practice and Rural Health, School of Dentistry, West Virginia University, Robert C. Byrd Health Sciences Center Addition 104a, PO Box 9448, Morgantown, WV, 26506, USA. rwiener2@hsc.wvu.edu.
authors.forename: R Constance
authors.initials: RC
authors.lastname: Wiener
authors.affiliation: Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, 26505 9510, USA.
authors.forename: Rini
authors.initials: R
authors.lastname: Vohra
authors.affiliation: Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, 26505 9510, USA.
authors.forename: Usha
authors.initials: U
authors.lastname: Sambamoorthi
authors.affiliation: Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, 26505 9510, USA.
authors.forename: S Suresh
authors.initials: SS
authors.lastname: Madhavan
mesh_terms: D000293:Adolescent; D000067877:Autism Spectrum Disorder / Q000175:diagnosis / Q000453:epidemiology; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D003730:Dental Care for Persons with Disabilities / Q000706:statistics & numerical data*; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; 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 / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis; D009909:Oral Health; D011313:Preventive Dentistry; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
keywords: Autism; Dental preventive care; Dental utilization; Developmental disabilities; Mental health conditions