Many and varied treatment options are available for children with autism spectrum disorders (ASD), yet little is understood about the characteristics of parents and children that may influence the type and number of therapies received. The interventions available vary widely, ranging from self-contained preschool classrooms to therapeutic horseback riding, to chelation therapy. This immense array of available services can lead to confusion for families and professionals considering which services to choose for children with ASD.
Earlier research has highlighted a few trends in the utilization of services. The more commonly reported interventions are educational and therapeutic. A national survey of 552 participants revealed applied behavioral analysis (ABA) as the most frequently used educational intervention, although that was not the case in North Carolina where TEACCH led the way. Other researchers found that, of the traditional therapeutic interventions, speech-language therapy (SLT) is the most common intervention followed by occupational therapy (OT) and physical therapy (PT). Given that communication deficits are one of the core features of ASD, this high utilization of SLT is not surprising. OT services target a variety of functional problems in daily living and school performance, and often include sensory-based therapies that address sensory processing issues.
Other findings from previous research identified the use of additional common therapeutic interventions including pharmacological (medications) and alternative (vitamins, gluten/casein-free diets) interventions. They noted that culture also seems to play a role in therapy decisions, with Latino children being six times more likely than children of other ethnicities to use non-traditional therapeutic strategies. Furthermore, children of minority race and ethnicity have been found to receive therapies at a later age than white children.
For this research study, interviews that were done with 70 parents of children with ASD between the ages of 2 and 7 years were analyzed to determine which factors might be influencing things such as when services were first started and which services were sought.
With regard to specific services parents sought, the results of this study are partially consistent with the finding of other researchers. This study’s data did, however, reflect a lower utilization of behavioral interventions (i.e., ABA) compared with national averages. It is important to remember when looking at the results of this study that the researchers were hoping to understand the variables that influence the choice of services utilized. They were NOT assessing the worth / effectiveness of those therapies.
Only three factors predicted which therapies were sought:
- severity of sensory processing problems, as reported by the parents, was associated with services being sought when the child was younger
- higher parental educational level was associated with the use of dietary and/or vitamin therapy
- higher parental educational level was also associated with the use of a greater number of services
None of the other variables studied had predictive value.
In summary, the researchers found that specific child characteristics (i.e., sensory processing symptom severity) may be associated with earlier initiation of services and that specific family characteristics (i.e. parental educational level)) may be associated with greater utilization of specific alternative therapies. However, given the limited significant findings, it seems likely that service utilization is a complex issue for families with children with ASD, and that it is most probably influenced by many factors that were not investigated.
This Research Brief is based on the article: Patten, E., Baranek, G.T., Watson, L.R., & Schultz, B.S. (2012). Child and family characteristics influencing intervention choices in autism spectrum disorders. Focus on Autism and Other Developmental Disabilities. Advance online publication. doi: 10.1177/1088357612468028
This research was supported by a grant from NICHD (R01 HD42168). We thank the families whose participation made this study possible. For more information about The Sensory Experiences Project please visit our website: http://www.med.unc.edu/sep
The University of
North Carolina at Chapel Hill