{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:43:03Z","timestamp":1792183383864,"version":"4.4.0"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,1,10]],"date-time":"2019-01-10T00:00:00Z","timestamp":1547078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007013","name":"F. Hoffmann-La Roche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["PPRN\u20101501\u201026462"],"award-info":[{"award-number":["PPRN\u20101501\u201026462"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000893","name":"Simons Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000893","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Autism Research"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:label\/><jats:p>Children with autism receive different types of non\u2010drug treatments. We aimed to describe caregiver\u2010reported pattern of care and its variability by geography and healthcare coverage in a US\u2010wide sample of children aged 3\u201317 years. We recruited caregivers from the Simons Foundation Powering Autism Research for Knowledge (SPARK) cohort. Two online questionnaires (non\u2010drug treatment, Autism Impact Measure) were completed in September\/October 2017. Primary outcome measures were caregiver\u2010reported types and intensities of treatments (behavioral, developmental\/relationship, speech and language (SLT), occupational, psychological, \u201cother\u201d; parent\/caregiver training) in the previous 12 months. Main explanatory variables were geography and type of healthcare coverage. We investigated associations between the type\/intensity of treatments and geography (metropolitan\/nonmetropolitan) or coverage (Medicaid vs privately insured by employer) using regression analysis. Caregivers (<jats:italic>n<\/jats:italic> = 5,122) were mainly mothers (92.1%) with mean (<jats:italic>SD<\/jats:italic>) age of 39.0 (7.3) years. Mean child age was 9.1 (3.9) years; mostly males (80.0%). Almost all children received at least one intervention (96.0%). Eighty percent received SLT or occupational therapy, while 52.0% received both. Behavioral therapy and SLT were significantly more frequent and more intense in metropolitan than in nonmetropolitan areas. No consistently significant associations were seen between healthcare coverage and frequency or intensity of interventions. At least one barrier such as \u201cwaiting list\u201d and \u201cno coverage\u201d was reported by 44.8%. In conclusion, in children sampled from SPARK, we observed differences between metropolitan and nonmetropolitan areas, while we did not find significant differences between those privately insured versus Medicaid. <jats:bold><jats:italic>Autism Res<\/jats:italic><\/jats:bold> 2019, 12: 517\u2013526 \u00a9 2019 The Authors. <jats:italic>Autism Research published by International Society for Autism Research<\/jats:italic> published by Wiley Periodicals, Inc.<\/jats:p><\/jats:sec><jats:sec><jats:title>Lay Summary<\/jats:title><jats:p>The American Academy of Child and Adolescent Psychiatry recommends the use of multiple treatment modalities in autism spectrum disorder (ASD). We wanted to understand what types of treatment children (aged 3\u201317 years) with ASD receive in the United States, how and where the treatments take place and for how long. We invited caregivers from Simons Foundation Powering Autism Research for Knowledge (\u201cSPARK ,\u201d <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/sparkforautism.org\/\">https:\/\/sparkforautism.org\/<\/jats:ext-link>) to complete the study questions online. Participants reported on utilization of conventional, non\u2010drug treatments for ASD, including behavioral interventions, developmental\/relationship interventions, speech and language therapy (SLT), occupational therapy, psychological therapy, and parent\/caregiver training. People that completed the study (<jats:italic>n<\/jats:italic> = 5,122) were primarily mothers of the child with ASD (92%); most of the children were boys (80%). The ASD care for the child was mostly coordinating by the mother. Almost all children received at least some type of non\u2010drug therapies (96%), most often SLT and\/or occupational therapy, mainly provided in school. Behavioral therapy was most often received in public school in rural areas, while at home in urban areas. We saw less use of behavioral therapy and SLT in rural areas, but overall comparable use between children covered by Medicaid and those covered by private insurance. Almost half the caregivers reported at least one barrier to treatment, such as \u201cwaiting list\u201d and \u201cno coverage.\u201d More than half said that their child benefited \u201cmuch\u201d or \u201cvery much\u201d from the therapies received. While overall non\u2010drug treatment rates for children with ASD were high in the United States in our study, differences existed depending on where the family lives; not only regarding the type of therapy, but also where it takes place.<\/jats:p><\/jats:sec>","DOI":"10.1002\/aur.2070","type":"journal-article","created":{"date-parts":[[2019,1,10]],"date-time":"2019-01-10T15:19:00Z","timestamp":1547133540000},"page":"517-526","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":86,"title":["Treatment patterns in children with autism in the United States"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6645-1734","authenticated-orcid":false,"given":"Brigitta U.","family":"Monz","sequence":"first","affiliation":[{"name":"Personalized Health Care Data Science, Real World Data F. Hoffmann\u2010La Roche Ltd.  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3708-0393","authenticated-orcid":false,"given":"Richard","family":"Houghton","sequence":"additional","affiliation":[{"name":"Personalized Health Care Data Science, Real World Data F. Hoffmann\u2010La Roche Ltd.  Basel Switzerland"},{"name":"Department of Clinical Pharmacy and Toxicology, School CAPHRI Maastricht UMC+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiely","family":"Law","sequence":"additional","affiliation":[{"name":"Kennedy Krieger Institute Interactive Autism Network  Baltimore Maryland"},{"name":"Department of Pediatrics Johns Hopkins University School of Medicine  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Loss","sequence":"additional","affiliation":[{"name":"Personalized Health Care Data Science, Real World Data F. Hoffmann\u2010La Roche Ltd.  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2017.00590"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.7812\/TPP\/16-009","article-title":"A survey of parents with children on the autism spectrum: Experience with services and treatments","volume":"21","author":"Becerra T. A.","year":"2017","journal-title":"The Permanente Journal"},{"issue":"3","key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1097\/MLR.0000000000000863","article-title":"The differential effects of insurance mandates on health care spending for children's autism spectrum disorder","volume":"56","author":"Candon M. 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