Can State Early Intervention Programs Meet the Increased Demand of Children Suspected of Having Autism Spectrum Disorders?

This article examines whether government-sponsored early intervention programs have the capacity to meet surging demand for autism services. In 2007, the American Academy of Pediatrics recommended that all children be screened for autism at 18 and 24 months of age. This recommendation is expected to result in increased demand for services for autism spectrum disorders. Early intervention programs provide autism services for children under three years of age in all 50 states, and provide almost all autism services for children living in poverty.

The authors interviewed 52 early intervention coordinators from 47 states, four territories, and the Bureau of Indian Education. They analyzed the results of the survey using unpaired t-tests and regression models.
Key Findings:

  • The majority of respondents reported an increase in demand for autistic spectrum disorder evaluations (65%) and services (58%) since the American Academy of Pediatrics 2007 recommendation.
  • Just under half of respondents (46%) reported that their capacity limited their ability to meet the 45-day time limit to create each child’s individualized family service plan.
  • Almost all respondents (94%) reported shortages of key providers for children with autism, particularly behavioral therapists, speech-language therapists, occupational therapists and psychologists. States with higher percentages of African American and Hispanic children were more likely to report provider shortages.
  • Among the 34 states that reported information on service hours, just under half (44%) indicated that they provided under five service hours to children, substantially less than the 25 weekly hours recommended by the National Research Council. Only four states reported providing 20 hours or more of services.

Diagnoses of autism spectrum disorders have increased significantly in the last decade and are expected to continue to increase as more children are screened early in life. Early Intervention programs are the first line of care for most poor children with autism and these programs may not have the capacity to address increasing demand for autism services.