Missed check-ups, delayed autism diagnoses amongst low-income kids | Spectrum
Missed Opportunity: Most of the autistic children in the new study attended fewer than half of the recommended visits to healthy children.
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According to a new study, children from low-income families are diagnosed with autism about eight months later than their wealthier peers, regardless of how many “good children” visits they attend.
The analysis examined insurance claims for 253 autistic children born in Virginia in 2011. Those who received Medicaid, a government-funded health insurance policy for low-income families in the United States, were diagnosed with autism at an average of 48.5 months, compared with 40.7 months for those with private insurance.
The American Academy of Pediatrics recommends that children be screened at 12, 15, 18, 24, 30, and 36 months of age and once a year thereafter. Early signs of autism typically appear in the second year of life, so these tests are important for early detection. “The sooner you are diagnosed, the better your results will be,” says study director Pamela DeGuzman, associate professor of nursing at the University of Virginia at Charlottesville.
But almost one in five of the children in the study did not attend a single visit between the ages of 1 and 5, and most children attended fewer than half of the recommended visits. Children who receive Medicaid are less likely to have these checkups than those with private health insurance. The results were published in the Journal of Pediatrics in September.
For children who were still undiagnosed at their 3-year visit, those with Medicaid insurance are 85 percent less likely to be diagnosed than privately insured children, DeGuzman says.
A previous study by DeGuzman also found that young children in rural Virginia attend less well-attended children than children who live in urban areas. One reason for this difference could be that in some parts of western Virginia the nearest developmental pediatrician is more than three hours away by car.
The new work has a few holes; Since it is based on insurance claims, it does not contain any information about race or income. And race, DeGuzman says, “is something that needs to be assessed to see if that is another source of disparities that we need to address.”
Unequal time to diagnosis in children receiving Medicaid could be related to their family’s financial circumstances. People who take Medicaid “paid for vacations much less often. They have less flexible schedules. Sometimes people have more than one job, ”says DeGuzman. All of these factors make it more difficult to get a child to the doctor. And “if you miss a visit, that visit is likely not being rescheduled for the correct time,” she says.
To fill the void, medical facilities could help families miss appointments to visit healthy children to reschedule, just as they do with vaccinations, DeGuzman suggests. Still, these controls shouldn’t be a burden on parents “who are likely already pretty taxed because we’re talking about Medicaid children who are most at risk,” she says.
“A lot happens in people’s lives.”
Quote this article: https://doi.org/10.53053/NCXV8090
