Health Status and Health Care Use Among Adolescents Identified With and Without Autism in Early Childhood — Four U.S. Sites, 2018–2020
Patrick Powell, Karen Pazol, Lisa D. Wiggins, Julie L. Daniels, Gabriel S. Dichter, Chyrise Bradley, Rebecca Edmondson Pretzel, Joy M. Kloetzer, Charmaine McKenzie, Alexys Scott, Britney Robinson, Amy Sims, Eric P. Kasten, M. Daniele Fallin, Susan E. Levy, Patricia M. Dietz, Mary E. Cogswell
Abstract
Persons identified in early childhood as having autism spectrum disorder (autism) often have co-occurring health problems that extend into adolescence (1-3). Although only limited data exist on their health and use of health care services as they transition to adolescence, emerging data suggest that a minority of these persons receive recommended guidance* from their primary care providers (PCPs) starting at age 12 years to ensure a planned transition from pediatric to adult health care (4,5). To address this gap in data, researchers analyzed preliminary data from a follow-up survey of parents and guardians of adolescents aged 12-16 years who previously participated in the Study to Explore Early Development (https:// www.cdc.gov/ncbddd/autism/seed.html). The adolescents were originally studied at ages 2-5 years and identified at that age as having autism (autism group) or as general population controls (control group). Adjusted prevalence ratios (aPRs) that accounted for differences in demographic characteristics were used to compare outcomes between groups. Adolescents in the autism group were more likely than were those in the control group to have physical difficulties (21.2% versus 1.6%; aPR = 11.6; 95% confidence interval [CI] = 4.2-31.9), and to have additional mental health or other conditions * Recommended guidance on health care transition is defined in the context of three transition elements included in the National Performance Measure of the Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau (MCHB) (https://mchb.tvisdata.hrsa.gov/PrioritiesAndMeasures/ NationalPerformanceMeasures). The three elements are 1) time alone, without a parent present, with PCP at last preventive visit; 2) PCP actively worked with child; and 3) parent knows how child will be insured as he or she becomes an adult. Adolescents met the health care transition measure if all three elements were endorsed by the adolescent's parent. https://doi.org/10.