Access to specialists more likely to elude children with autism.

SAN FRANCISCO -- Children with autism are significantly less likely to have a medical home, compared with children without autism and also compared with children who have other special health care needs, according to data from a large national survey presented in a poster at the annual meeting of the Pediatric Academic Societies.

Dr. Dana Hargunani and her colleagues from the Oregon Health and Science University, Portland, analyzed data from the National Survey of Children's Health, which was administered to more than 100,000 U.S. households in 2003 and 2004 by the National Center for Health Statistics.

For the purposes of this study, the investigators considered a child aged 0-17 years to have a medical home if he or she has a personal doctor or nurse who spends enough time and communicates well with the parent and child, and if the child had at least one preventive medical care visit during the previous 12 months. Additional criteria for determining whether a child has a medical home included whether the child usually or always gets needed care and advice from the personal doctor or nurse and is consistently able to access needed specialist care.

One-half of 1% of the children whose parents were surveyed were reported to have autism. Of those, 25.6% were reported to have a medical home, a significantly smaller percentage than the 46.3% of children without autism and the 44.7% of children who have other special health care needs.

Parents of autistic children also reported significantly less access to specialist care--67.2% compared with 84.8% of children without autism and 79.4% of children with other special health care needs.

Autistic children were significantly less likely to have the benefit of care coordination, compared with children without autism (45.4% vs. 58%). A similar comparison between autistic children and children with other special health care needs showed no statistically significant difference.

"Children with autism face significant barriers to the receipt of health care they need and deserve," wrote the investigators. Physicians "must address this disparity by further investigating the underlying challenges for families with autistic children."

The meeting was sponsored by the American Pediatric Society, Society for Pediatric Research, Ambulatory Pediatric Association, and American Academy of Pediatrics.

Autistic Children Have Less Access to Specialist Care

Children with autism     67.2%
Children without autism  84.8%

Note: Data from 2003-04 National Survey of Children's Health.
Source: Dr. Hargunani
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Note: Table made from bar graph.