Time-Lag Between Diagnosis of Autism Spectrum Disorder and Onset of Publicly-Funded Early Intensive Behavioral Intervention: Do Race-Ethnicity and Neighborhood Matter?

J Autism Dev Disord. 2018 Feb;48(2):561-571. doi: 10.1007/s10803-017-3354-3.

Abstract

Health coverage of early intensive behavioral intervention (EIBI) for children with autism spectrum disorder (ASD) is rapidly expanding across the United States. Yet we know little about the time-lag between diagnosis and treatment onset. We integrated administrative, Medicaid claims, and Census data for children in an EIBI Medicaid waiver (n = 473) to examine the relationship between time-lag and (a) child race-ethnicity and (b) neighborhood racial composition, poverty, affluence, and urbanicity. We explored whether the relationship between child race-ethnicity and time-lag varies by neighborhood characteristics. Average time-lag between diagnosis and treatment onset was nearly 3 years. Child race-ethnicity and neighborhood characteristics did not predict time-lag. Reducing time-lag is critical to ensuring that children with ASD receive treatment as early as possible.

Keywords: Autism spectrum disorder; Disparities; Early intensive behavioral intervention; Medicaid; Time-lag.

MeSH terms

  • Autism Spectrum Disorder / diagnosis*
  • Autism Spectrum Disorder / ethnology
  • Autism Spectrum Disorder / therapy*
  • Behavior Therapy*
  • Child
  • Child, Preschool
  • Ethnicity
  • Female
  • Healthcare Disparities*
  • Humans
  • Male
  • Medicaid
  • Racial Groups
  • Socioeconomic Factors
  • Time-to-Treatment
  • United States