Kathleen Thomas, Ph.D., Co-Investigator
Susan Parish, Ph.D., Co-Investigator
Our proposal addresses MCHB/HRSA’s priority interest in autism service systems and infrastructure. The issue of concern is that families with children with autism have a more difficult time finding and paying for services than other families with children with special health care needs. To what extent is state insurance policy on autism associated with better access for children with autism? The proposed study seeks to answer this question through three specific aims: 1. Assess whether access to care for children with autism varies across states, 2. Assess the extent that state characteristics, such as insurance policy on autism, enhance access to care for children with autism, and 3. Identify the states that have achieved the best access to care for children with autism for future study. Data from the 2005-2006 National Survey of Children with Special Health Care Needs (NSCSHCN) will be augmented with data on state autism insurance policy features to allow an analysis of the association between state autism policy and access to care for families with children with autism compared to families with children with other special health care needs. The NSCSHCN is a complex, multistage sample of children with special health care needs, including autism, representative of the nation as well as each state and the District of Columbia. Multilevel regression will be used to correct for the nonindependence of family-level observations nested within states and to assess the effects of family and state variables on access to care.
This will be the first national study of autism policy tied to outcomes for families. The proposed study can move the field forward in a short timeframe by filling in the big picture of autism state policy impacts. The findings will identify state policies associated with better access to care for children with autism, and those states where the constellation of policies is associated with better access. The findings will also generate hypotheses for future studies to determine why these policies work. The need to develop our understanding of what insurance policies work for autism is pressing. The Autism Treatment Acceleration Act (ATAA), recently introduced in the US Congress, calls for private insurance coverage of the diagnosis and treatment of autism. The proposed study will provide important insights for policy design and future study of access to care for children with autism.