Rutgers research shows that children from minority backgrounds and those who are socially disadvantaged are less likely to obtain services before the age of 36 months.
Fewer than half of autistic children in four New Jersey counties got treatment before the age of 36 months, despite a federal mandate necessitating access to early intervention programs (EIP) for children with disabilities, according to a Rutgers University study.
Children’s brains are more plastic during this timeframe, increasing the chance of treatment effectiveness. Therefore, early interventions are important in order to give children the best chance of developing to their full potential. However, access to EIP assistance was significantly hindered by income and racial disparities, researchers found.
“For infants and toddlers on the autism spectrum, early intervention is important for improved later-life outcomes,” said Josephine Shenouda, an adjunct professor at the Rutgers School of Public Health and lead author of the study which was recently published in the journal JAMA Pediatrics. “We wanted to understand the level of early intervention participation among children with autism.”
Young children in the United States must have access to EIP as mandated by the Individuals with Disabilities Education Act. The degree to which children with autism partake in early intervention programs, on the other hand, has not previously been evaluated.
Shenouda and her coworkers examined data from the New Jersey Autism Study, a monitoring system for autism spectrum disorder (ASD) created and maintained by researchers at Rutgers New Jersey Medical School. The data was collected between 2006 and 2016.
The researchers identified 4,050 8-year-olds with autism spectrum disorder after analyzing medical and special education data of 23,441 children in Essex, Hudson, Ocean, and Union counties. Less than half (1,887; 47%) had received EIP services.
The researchers discovered that ASD children living in wealthy locations were 80% more likely to obtain EIP treatment than children living in poor areas by connecting cases to data representing various wealth indicators, such as median family income. Children of color and Hispanic children were also less likely to take part in EIP.
While the study was conducted in New Jersey metropolitan areas, Shenouda said the findings have important implications nationwide.
“New Jersey is known as an epicenter of autism, but it also has many resources for autism detection and treatment,” she said. “If only half of the children with autism in our study area are getting early interventions, chances are the disparities are even more pronounced in other communities and regions with fewer services.”
Shenouda said there may be multiple reasons why children from disadvantaged and minority areas aren’t enrolled in EIP, such as lower rates of ASD screening or less likely follow-through with recommendations. In either case, focused outreach can help increase EIP referrals and participation.
Shenouda added: “With autism prevalence estimates approaching 7 percent in some areas, we need universal autism screening between 18 and 36 months and enhanced support for the early intervention system. These actions will reduce economic and race-based disparities in autism identification and care.”
Reference: “Disparities in Early Intervention Program Participation by Children With Autism Spectrum Disorder in a US Metropolitan Area, 2006 to 2016” by Josephine Shenouda, DrPH, MS, Emily Barrett, Ph.D., Amy L. Davidow, Ph.D., Kate Sidwell, BA, William Halperin, MD, DrPH, MPH, Vincent M. B. Silenzio, MD, MPH and Walter Zahorodny, Ph.D., 18 July 2022, JAMA Pediatrics.
The study was funded by the Centers for Disease Control and Prevention and the National Institutes of Health.