Thursday, February 10, 2011

Many teens with autism lose access to services

From My Health News:

Many teenagers with autism stop receiving speech therapy and other needed mental and physical health care services once they leave high school, according to a new study. Graduating seniors lose access to the services they obtained through their school-based special education programs.

The loss is problematic because the need for those programs doesn't go away, said study researcher Paul Shattuck, of Washington University in St. Louis.

"Difficulty with language and communicating is one of the core, hallmark characteristics of autism," Shattuck said. "Being able to communicate with other people effectively is a fundamental ability that you need if you want to succeed in college or in a job or be independent as a young adult."

And access to care as students leave high school is critical because this transition period "sets the stage for what happens in the rest of adulthood," Shattuck said.

Federal, state and local policies that were established decades ago to help adults who have developmental disabilities need to be revisited, Shattuck said. The number of children diagnosed with autism has rapidly increased in recent years, and this diverse group of patients is now entering adulthood.

"We have to recognize that the population of people who have developmental disabilities has changed," Shattuck said.

"The good news is, if we provide support and assistance, a lot of people with autism can function very well" and contribute to society, Shattuck said.

Between 1998 and 2007, the number of children ages 12-17 with autism who were enrolled in special education increased by about 15,500, to nearly 100,000, the researchers said. Children and young adults with autism often have a high need for mental and physical health services because the disorder is associated with other conditions such as attention deficient hyperactivity disorder (ADHD) and epilepsy.

Shattuck and his colleagues analyzed data from questionnaires given to parents and guardians of young adults (ages 19 to 23) with autism. More than 400 parents and guardians answered questions about their children's use of four types of services after high school — mental health services, medical services, speech therapy and case management — or about the coordination of the patients' care.

The researchers found the rates of use of these services all had fallen since the students were surveyed six years earlier. Most notably, the number of students receiving speech therapy dropped from close to 75 percent to 9.1 percent. While these two estimates are not directly comparable because some of the participants discontinued the study during those six years, the results still showed a steep decline in use of services, the researchers said.

About 39 percent of the young adults did not receive any special services after high school. Teens in this group were more likely to be black and from families with low incomes.

The drop in speech therapy use may be due to cost — after students graduate, health insurance disability programs usually don't cover it, Shattuck said.

"One of the services they need the most is the one service that is essentially excluded by way of eligibility and reimbursement policies," Shattuck said.

The results are published in February issue of the journal Archives of Pediatrics & Adolescent Medicine.