The Impact of Medical Home on the Early Identification and Intervention Receipt of Children with Autism and Developmental Disabilities
Grantee: Georgia State University Research Foundation, Inc.
Principal Investigator: Brian Barger
Project Number: R41MC42489
Project Date: 9/1/2021
Age group(s)
- Perinatal/Infancy (0-12 months)
- Toddlerhood (13-35 months)
- Toddlerhood (13-35 months)
Targeted/Underserved Population
- African American
- Hispanic/Latino
Abstract
Despite substantial advances in the early identification of children with autism spectrum disorder and developmental disabilities (ASD/DD), the majority of cases are not identified early enough to benefit from interventions during early developmental stages marked by high neuroplasticity. Most early ASD/DD identification research focuses on psychometric studies of screening tools, though a multi-disciplinary systems perspective is emerging with a few studies investigating screening within and across community systems. At the same time, medical home studies in the ASD/DD literature tend to be descriptive or focus on medical home as an outcome. Despite the understanding that a medical home should engage in developmental screening and monitoring, there is little research explicitly showing that having access to a medical home decreases the age at which ASD/DD is identified. Nor are there reports showing that having a medical home results in young children with identified ASD/DD having greater access to EI or community based treatments. The primary purpose of this project is to determine whether having a medical home is associated with earlier identified ASD/DD, and whether children with ASD/DD under the age of 5 with a medical home have increased odds of receiving EI or community based treatment compared to children with ASD/DD without a medical home. Furthermore, we will seek to determine if having a medical home mediates racial/ethnic disparities in the age of early ASD/DD identification, or EI and community based treatment receipt. These analyses align with priority research and surveillance activities in the Autism Cares Act (2019) in that medical home and screening/monitoring are directly relevant to value-based care delivery initiatives, and targets a noted health workforce need to improve access to EI and other mental health services for children with ASD/DD. Analyses will use measures available from the National Surveys of Children's Health (NSCH, 2016-2020), which are publicly available public health datasets that include variables related to developmental screening and monitoring, age of ASD/DD identification, medical home, early intervention receipt, community based treatment receipt, and relevant co-variates. To determine the impact of medical home, we will conduct a series of regression analyses investigating the relationship between having a medical home and age of identified ASD/DD, EI receipt, and community based treatment receipt. We will also conduct follow up analyses to determine which medical home subscales are the primary source of variance in age of ASD/DD identification, EI receipt, and community based treatment receipt. Finally, we will conduct mediation analyses to determine if medical home measures mediate racial/ethnic disparities in age of identified ASD/DD, EI receipt, and community based treatment receipt. These data will help broaden the early identification literature by linking medical home to early identified ASD/DD and crosssystem EI/treatment service receipt. They will also help policy makers determine which aspects of medical home mediate ASD/DD disparities.Publications
Listed is descending order by year published.
Barger, Brian et al. “Correlations Between State-Level Monitoring and Screening Rates and Early Identified ASD/DD Across Racial and Ethnic Groups.” Infants & Young Children 37 (2024): 64 - 81.
Barger, B., Salmon, A. & Moore, Q. Medical Home, Developmental Monitoring/Screening, and Early Autism Identification. J Autism Dev Disord (2023). Https://doi.org/10.1007/s10803-023-06044-0
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