By the Numbers: Coronavirus an infection odds, Medicaid waivers, correlating situations | Spectrum
Illustration by Laurène Boglio
Welcome to this month’s edition of the By the Numbers newsletter! At Spectrum, we do our best to summarize the latest in autism research – and sometimes the best summary comes in the form of a chart or map. In this newsletter we put interesting new research results in a nutshell, which are conveyed most concisely through data visualizations.
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Age Susceptible to SARS-CoV-2 Infection in Autistic People
According to a new study, people with autism ages 16 and younger and 40 to 60 are more likely than theirs to be infected with SARS-CoV-2, the virus that causes COVID-19 -autistic peers.
The researchers analyzed data from 16,406 autistic people enrolled with Israel’s largest health organization, which provides supplementary insurance to more than half of all Israelis. The team assigned a non-autistic person of the same age and gender to each participant.
Autistic people aged 16 and younger were 1.3 times more likely to be infected with SARS-CoV-2, and people aged 40 to 60 were twice as likely, the researchers found. The results appeared in the Journal of Autism and Developmental Disorders in July.
The results suggest that people with autism or other neurodevelopmental disorders should be a priority for the COVID-19 vaccine, according to study investigator Dana Tzur Bitan, a clinical psychologist at Ariel University in the West Bank.
Israeli officials issued guidelines a few weeks ago to start vaccinating children with neurodevelopmental disorders from the age of 5, says Tzur Bitan. “There is an awareness of the increased risk of morbidity in people with neurodevelopmental disorders, but I can’t really make the connection and say, ‘Okay, they took our findings and made a guideline out of it.'”
It is unclear why certain people with autism are at an increased chance of contracting COVID-19, and the dataset does not contain any information that could help answer this question, such as: B. the living situation of each participant – rural or urban, protected or unprotected.
“The differences we see between ages 40 and 60 could be related to family interactions, but we don’t know yet,” says Tzur Bitan. “We want to examine that more closely.”
Extending Medicaid Exemptions for Autism Care
According to a new study, the number of autism-specific Medicaid waivers more than quintupled from 2004 to 2015. States use these exemptions to provide services to people who might otherwise not be covered under Medicaid, a government program that provides health insurance to millions of people in the United States.
The researchers have compiled a list of 269 Medicaid programs that provide services to people with autism or intellectual disabilities. During the 11-year study period, 26 states changed their waivers to improve care options for people with autism; 9 of these states added a type of waiver called 1915 (c) specifically for people with autism that far surpassed the new 1915 (c) waivers for intellectual disability; and 21 states made no changes.
“There’s a big difference in the way states use Medicaid to meet the needs of autistic people throughout their lives,” said Lindsay Shea, associate professor and director of the Drexel’s Policy and Analytics Center at Drexel’s AJ Drexel Autism Institute University of Philadelphia.
Three states – Arizona, Rhode Island, and Vermont – do not offer 1915 (c) waivers, which were the most popular in the study, and were not included in the data. These states use another exemption called 1115 to provide long-term patient care. Shea says, “1115 programs work differently than traditional waivers. Ideally, we could put everything together and compare apples and oranges to better assess the effectiveness of political decisions. “
The researchers also used data from autism prevalence studies to estimate the percentage of autistic people in each state who could receive 1915 (c) Medicaid waivers. Wisconsin could care for more than 20 percent of people with autism or intellectual disabilities, they estimated, and Minnesota could care for about 14 percent. In most states, however, the number was much lower: the average state had only 4 percent of its autistic or intellectual disabled residents receiving Medicaid exemptions.
The results were published in Health Services Research in July.
The likelihood of an autistic person having another condition correlates strongly with the age at which they were diagnosed with autism, according to a new study. Also, autistic girls are more likely to have other conditions than non-autistic girls, to an extent that autistic boys do not.
The study looked at whether an autistic person’s age, age at diagnosis, or the gender of birth changed their chances of suffering from one of 11 common conditions, including epilepsy, anxiety, and attention deficit hyperactivity disorder (ADHD). It relied on data from around 16,000 people with autism and more than 650,000 people without autism up to the age of 16 in the Danish national patient registry, a large data set that records the date of birth, gender and diagnoses of people in the Danish hospital system.
Among people diagnosed late, ages 11 to 15, 26 percent of girls and 13 percent of boys were also diagnosed with a mood disorder, the study said. The trend in intellectual disability was reversed: 40 percent of people with an early diagnosis of autism had intellectual disability compared to just 10 percent of people with a late diagnosis of autism.
For the 11 coexisting conditions included in the study, the age at which autism was diagnosed was the single largest predictor of whether a participant had the condition. But sex was another important factor.
Among autistic individuals, girls were 2.2 times more likely than boys to be anxious, the study found. In contrast, anxiety in non-autistic girls is about 1.4 times higher than in non-autistic boys. And while non-autistic boys are 2.6 times more likely to have ADHD than non-autistic girls, that ratio has declined within the autism population. Autistic boys are only 1.6 times more likely to have ADHD than autistic girls. The results were published in Acta Psychiatrica Scandinavica in July.
86 percent: The proportion of people with autism who have “reasonable to very good levels of objective psychosocial functioning,” according to a study that looked at the jobs, happiness and close friendships of 917 adults – 425 men and 492 women Annual period recorded for a period of six years. The results appeared in Autism in June.
98.8 percent: The proportion of autism diagnoses independently verified using electronic medical records in a subset of participants in SPARK, an ongoing genetic study of autism. (SPARK is funded by the Simons Foundation, Spectrum’s parent organization.) Individuals who enroll with SPARK are required to have a professional diagnosis of autism, but that diagnosis has not usually been independently verified. The results appeared in the Journal of Autism and Developmental Disorders in July.
Tool Spotlight: Autism_genepheno, a text mining tool created using the Python programming language, can search thousands of autism papers and determine which genes (like FMR1) are associated with which phenotypes (like epilepsy or anxiety). The tool was described in Scientific Reports in July and is available free of charge on GitHub.