Age-Related Variation in Health Service Use and Associated Expenditures Among Children with Autism / Zuleyha CIDAV in Journal of Autism and Developmental Disorders, 43-4 (April 2013)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 43-4 (April 2013) . - p.924-931 Titre : Age-Related Variation in Health Service Use and Associated Expenditures Among Children with Autism Type de document : Texte imprimé et/ou numérique Auteurs : Zuleyha CIDAV, Auteur ; Lindsay LAWER, Auteur ; Steven C. MARCUS, Auteur ; David S. MANDELL, Auteur Article en page(s) : p.924-931 Langues : Anglais (eng) Mots-clés : Autism  Economics  Cost  Expenditures  Utilization  Medicaid  Age variation Index. décimale : PER Périodiques Résumé : This study examined differences by age in service use and associated expenditures during 2005 for Medicaid-enrolled children with autism spectrum disorders. Aging was associated with significantly higher use and costs for restrictive, institution-based care and lower use and costs for community-based therapeutic services. Total expenditures increased by 5 % with each year of age; by 23 % between 3–5 and 6–11 year olds, 23 % between 6–11 and 12–16, and 14 % between 12–16 and 17–20 year olds. Use of and expenditures for long-term care, psychiatric medications, case management, medication management, day treatment/partial hospitalization, and respite services increased with age; use of and expenditures for occupational/physical therapy, speech therapy, mental health services, diagnostic/assessment services, and family therapy declined. En ligne : http://dx.doi.org/10.1007/s10803-012-1637-2 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=194 [article] Age-Related Variation in Health Service Use and Associated Expenditures Among Children with Autism [Texte imprimé et/ou numérique] / Zuleyha CIDAV, Auteur ; Lindsay LAWER, Auteur ; Steven C. MARCUS, Auteur ; David S. MANDELL, Auteur . - p.924-931. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 43-4 (April 2013) . - p.924-931 Mots-clés : Autism  Economics  Cost  Expenditures  Utilization  Medicaid  Age variation Index. décimale : PER Périodiques Résumé : This study examined differences by age in service use and associated expenditures during 2005 for Medicaid-enrolled children with autism spectrum disorders. Aging was associated with significantly higher use and costs for restrictive, institution-based care and lower use and costs for community-based therapeutic services. Total expenditures increased by 5 % with each year of age; by 23 % between 3–5 and 6–11 year olds, 23 % between 6–11 and 12–16, and 14 % between 12–16 and 17–20 year olds. Use of and expenditures for long-term care, psychiatric medications, case management, medication management, day treatment/partial hospitalization, and respite services increased with age; use of and expenditures for occupational/physical therapy, speech therapy, mental health services, diagnostic/assessment services, and family therapy declined. En ligne : http://dx.doi.org/10.1007/s10803-012-1637-2 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=194

County-Level Variation in the Prevalence of Medicaid-Enrolled Children with Autism Spectrum Disorders / David S. MANDELL in Journal of Autism and Developmental Disorders, 40-10 (October 2010)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 40-10 (October 2010) . - p.1241-1246 Titre : County-Level Variation in the Prevalence of Medicaid-Enrolled Children with Autism Spectrum Disorders Type de document : Texte imprimé et/ou numérique Auteurs : David S. MANDELL, Auteur ; Aubyn C. STAHMER, Auteur ; Knashawn H. MORALES, Auteur ; Ming XIE, Auteur ; Daniel POLSKY, Auteur ; Steven C. MARCUS, Auteur Année de publication : 2010 Article en page(s) : p.1241-1246 Langues : Anglais (eng) Mots-clés : Autism-spectrum-disorders Medicaid Geographic-variation Prevalence Index. décimale : PER Périodiques Résumé : This study examined how county-level resources are associated with the identification of children with autism spectrum disorders (ASD) in Medicaid. Medicaid claims from 2004 were combined with county-level data. There were 61,891 children diagnosed with ASD in the Medicaid system in 2004. Counties with lower per-student education expenditures, more students, a greater proportion of students in special education, higher per capita number of pediatricians and pediatric specialists, and a greater proportion of Medicaid enrollees and white residents had higher Medicaid prevalence. Within states, counties differ in how they implement Medicaid policies. The results suggest the substitution of education and Medicaid-reimbursed services. Our findings highlight the need for geographically targeted outreach to minority groups and clinicians to improve recognition of ASD. En ligne : http://dx.doi.org/10.1007/s10803-010-0982-2 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=110 [article] County-Level Variation in the Prevalence of Medicaid-Enrolled Children with Autism Spectrum Disorders [Texte imprimé et/ou numérique] / David S. MANDELL, Auteur ; Aubyn C. STAHMER, Auteur ; Knashawn H. MORALES, Auteur ; Ming XIE, Auteur ; Daniel POLSKY, Auteur ; Steven C. MARCUS, Auteur . - 2010 . - p.1241-1246. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 40-10 (October 2010) . - p.1241-1246 Mots-clés : Autism-spectrum-disorders Medicaid Geographic-variation Prevalence Index. décimale : PER Périodiques Résumé : This study examined how county-level resources are associated with the identification of children with autism spectrum disorders (ASD) in Medicaid. Medicaid claims from 2004 were combined with county-level data. There were 61,891 children diagnosed with ASD in the Medicaid system in 2004. Counties with lower per-student education expenditures, more students, a greater proportion of students in special education, higher per capita number of pediatricians and pediatric specialists, and a greater proportion of Medicaid enrollees and white residents had higher Medicaid prevalence. Within states, counties differ in how they implement Medicaid policies. The results suggest the substitution of education and Medicaid-reimbursed services. Our findings highlight the need for geographically targeted outreach to minority groups and clinicians to improve recognition of ASD. En ligne : http://dx.doi.org/10.1007/s10803-010-0982-2 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=110

Dismantling the Active Ingredients of an Intervention for Children with Autism / Melanie PELLECCHIA in Journal of Autism and Developmental Disorders, 45-9 (September 2015)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 45-9 (September 2015) . - p.2917-2927 Titre : Dismantling the Active Ingredients of an Intervention for Children with Autism Type de document : Texte imprimé et/ou numérique Auteurs : Melanie PELLECCHIA, Auteur ; James E. CONNELL, Auteur ; Rinad S. BEIDAS, Auteur ; Ming XIE, Auteur ; Steven C. MARCUS, Auteur ; David S. MANDELL, Auteur Article en page(s) : p.2917-2927 Langues : Anglais (eng) Mots-clés : Treatment packages  Autism  Treatment fidelity  Implementation science Index. décimale : PER Périodiques Résumé : This study evaluated the association of fidelity to each of the components of the Strategies for Teaching based on Autism Research (STAR) program, a comprehensive treatment package for children with autism that includes discrete trial training, pivotal response training, and teaching in functional routines, on outcomes for 191 students ages 5–8 years in a large public school district. Fidelity to all components was relatively low, despite considerable training and support, suggesting the need to develop new implementation strategies. Fidelity to pivotal response training, but not discrete trial training or functional routines, was positively associated with gains in cognitive ability despite low levels of fidelity, and may be an effective intervention choice in under-resourced settings. En ligne : http://dx.doi.org/10.1007/s10803-015-2455-0 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 [article] Dismantling the Active Ingredients of an Intervention for Children with Autism [Texte imprimé et/ou numérique] / Melanie PELLECCHIA, Auteur ; James E. CONNELL, Auteur ; Rinad S. BEIDAS, Auteur ; Ming XIE, Auteur ; Steven C. MARCUS, Auteur ; David S. MANDELL, Auteur . - p.2917-2927. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 45-9 (September 2015) . - p.2917-2927 Mots-clés : Treatment packages  Autism  Treatment fidelity  Implementation science Index. décimale : PER Périodiques Résumé : This study evaluated the association of fidelity to each of the components of the Strategies for Teaching based on Autism Research (STAR) program, a comprehensive treatment package for children with autism that includes discrete trial training, pivotal response training, and teaching in functional routines, on outcomes for 191 students ages 5–8 years in a large public school district. Fidelity to all components was relatively low, despite considerable training and support, suggesting the need to develop new implementation strategies. Fidelity to pivotal response training, but not discrete trial training or functional routines, was positively associated with gains in cognitive ability despite low levels of fidelity, and may be an effective intervention choice in under-resourced settings. En ligne : http://dx.doi.org/10.1007/s10803-015-2455-0 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267

Short report on navigating access to care for Medicaid-enrolled autistic youth and young adults: Examining accrual of intellectual disability diagnoses in adolescence / Meghan E. Carey in Autism, 28-3 (March 2024)  

Public ISBD [article]  inAutism > 28-3 (March 2024) . - p.780-785 Titre : Short report on navigating access to care for Medicaid-enrolled autistic youth and young adults: Examining accrual of intellectual disability diagnoses in adolescence Type de document : Texte imprimé et/ou numérique Auteurs : Meghan E. Carey, Auteur ; Katherine ARDELEANU, Auteur ; Steven C. MARCUS, Auteur ; Sha TAO, Auteur ; David MANDELL, Auteur ; Andrew J. EPSTEIN, Auteur ; Lindsay L. SHEA, Auteur Article en page(s) : p.780-785 Langues : Anglais (eng) Mots-clés : adolescents  autism spectrum disorders  health services  policy Index. décimale : PER Périodiques Résumé : Medicaid is a major insurer of autistic people. However, during the transition to adulthood, autistic individuals are more likely than people with intellectual disability to lose their Medicaid benefits. Individuals with intellectual disability may have greater success maintaining Medicaid coverage during this time because most states provide coverage to individuals with intellectual disability throughout adulthood, which is not the case for autism. Using national Medicaid data from 2008 to 2016, we estimated the probability of intellectual disability diagnosis accrual among autistic Medicaid beneficiaries. Medicaid beneficiaries ages 8 to 25 with 1+?inpatient or 2+?outpatient autism spectrum disorder claims, but no intellectual disability claim, in a 12-month eligibility period were included. We used a person-month discrete-time proportional hazards model. Disruptions in Medicaid coverage were operationalized as 2+?consecutive months of no coverage before coverage resumed (yes/no). One in five autistic individuals ages 8-25 accrued an intellectual disability diagnosis. The probability of accruing an intellectual disability diagnosis was higher among autistic individuals who had disruptions in Medicaid coverage compared to those without disruptions, and peaked at age 21 (during the transition to adulthood). Expanding Medicaid to cover autistic people of all ages could decrease the need for intellectual disability diagnosis accrual and improve health outcomes for autistic adults. Lay abstract What is known? In most states, Medicaid waivers provide individuals with an intellectual disability diagnosis generous healthcare coverage throughout adulthood. By comparison, fewer Medicaid programs are available for autistic individuals, and they are more likely to experience disruptions, or gaps, in Medicaid coverage and subsequently not re-enroll. What this paper adds? One in five autistic individuals with Medicaid coverage between ages 8 and 25 accrued a new intellectual disability diagnosis. The probability of a new intellectual disability diagnosis was higher among those who had previous disruptions in Medicaid coverage. Implications for research and policy. Expanding Medicaid to cover autistic people of all ages could decrease the need for intellectual disability diagnosis accrual. Input from autistic individuals and their families regarding their health insurance access and healthcare experiences is critically important to understanding next steps for research. En ligne : https://dx.doi.org/10.1177/13623613231177559 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=523 [article] Short report on navigating access to care for Medicaid-enrolled autistic youth and young adults: Examining accrual of intellectual disability diagnoses in adolescence [Texte imprimé et/ou numérique] / Meghan E. Carey, Auteur ; Katherine ARDELEANU, Auteur ; Steven C. MARCUS, Auteur ; Sha TAO, Auteur ; David MANDELL, Auteur ; Andrew J. EPSTEIN, Auteur ; Lindsay L. SHEA, Auteur . - p.780-785. Langues : Anglais (eng) in Autism > 28-3 (March 2024) . - p.780-785 Mots-clés : adolescents  autism spectrum disorders  health services  policy Index. décimale : PER Périodiques Résumé : Medicaid is a major insurer of autistic people. However, during the transition to adulthood, autistic individuals are more likely than people with intellectual disability to lose their Medicaid benefits. Individuals with intellectual disability may have greater success maintaining Medicaid coverage during this time because most states provide coverage to individuals with intellectual disability throughout adulthood, which is not the case for autism. Using national Medicaid data from 2008 to 2016, we estimated the probability of intellectual disability diagnosis accrual among autistic Medicaid beneficiaries. Medicaid beneficiaries ages 8 to 25 with 1+?inpatient or 2+?outpatient autism spectrum disorder claims, but no intellectual disability claim, in a 12-month eligibility period were included. We used a person-month discrete-time proportional hazards model. Disruptions in Medicaid coverage were operationalized as 2+?consecutive months of no coverage before coverage resumed (yes/no). One in five autistic individuals ages 8-25 accrued an intellectual disability diagnosis. The probability of accruing an intellectual disability diagnosis was higher among autistic individuals who had disruptions in Medicaid coverage compared to those without disruptions, and peaked at age 21 (during the transition to adulthood). Expanding Medicaid to cover autistic people of all ages could decrease the need for intellectual disability diagnosis accrual and improve health outcomes for autistic adults. Lay abstract What is known? In most states, Medicaid waivers provide individuals with an intellectual disability diagnosis generous healthcare coverage throughout adulthood. By comparison, fewer Medicaid programs are available for autistic individuals, and they are more likely to experience disruptions, or gaps, in Medicaid coverage and subsequently not re-enroll. What this paper adds? One in five autistic individuals with Medicaid coverage between ages 8 and 25 accrued a new intellectual disability diagnosis. The probability of a new intellectual disability diagnosis was higher among those who had previous disruptions in Medicaid coverage. Implications for research and policy. Expanding Medicaid to cover autistic people of all ages could decrease the need for intellectual disability diagnosis accrual. Input from autistic individuals and their families regarding their health insurance access and healthcare experiences is critically important to understanding next steps for research. En ligne : https://dx.doi.org/10.1177/13623613231177559 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=523

The Effects of Community Preschool Characteristics on Developmental Outcomes for Students With Autism Spectrum Disorder / Samantha CRABBE ; Steven C. MARCUS ; David S. MANDELL in Focus on Autism and Other Developmental Disabilities, 38-4 (December 2023)  

Public ISBD [article]  inFocus on Autism and Other Developmental Disabilities > 38-4 (December 2023) . - p.268-282 Titre : The Effects of Community Preschool Characteristics on Developmental Outcomes for Students With Autism Spectrum Disorder Type de document : Texte imprimé et/ou numérique Auteurs : Samantha CRABBE, Auteur ; Steven C. MARCUS, Auteur ; David S. MANDELL, Auteur Article en page(s) : p.268-282 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  preschool  early intervention  inclusion Index. décimale : PER Périodiques Résumé : This study examined factors associated with 9-month outcomes of 78 preschoolers with autism spectrum disorder ([ASD]; 66 males, mean age = 44.8 [7.0] months) receiving preschool special education services. Use of recommended intervention practices was observed in each student?s primary educational setting: autism-only (n = 28), mixed-disability (n = 25), and general early education (n = 25). Recommended practice use across setting types and developmental changes were compared using generalized estimating equations. Autism-only settings had the highest implementation of classroom structure, classroom environment, and curriculum and instruction. General early education had greater implementation of practices to support social and peer relationships. Supporting social and peer relationships was the largest predictor of gains, controlling for setting type; the association was greater for children with lower initial receptive language or developmental skills. These findings highlight the importance of supporting and promoting peer engagement in students with ASD across preschool placement types. En ligne : https://dx.doi.org/10.1177/10883576221133495 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=515 [article] The Effects of Community Preschool Characteristics on Developmental Outcomes for Students With Autism Spectrum Disorder [Texte imprimé et/ou numérique] / Samantha CRABBE, Auteur ; Steven C. MARCUS, Auteur ; David S. MANDELL, Auteur . - p.268-282. Langues : Anglais (eng) in Focus on Autism and Other Developmental Disabilities > 38-4 (December 2023) . - p.268-282 Mots-clés : autism spectrum disorders  preschool  early intervention  inclusion Index. décimale : PER Périodiques Résumé : This study examined factors associated with 9-month outcomes of 78 preschoolers with autism spectrum disorder ([ASD]; 66 males, mean age = 44.8 [7.0] months) receiving preschool special education services. Use of recommended intervention practices was observed in each student?s primary educational setting: autism-only (n = 28), mixed-disability (n = 25), and general early education (n = 25). Recommended practice use across setting types and developmental changes were compared using generalized estimating equations. Autism-only settings had the highest implementation of classroom structure, classroom environment, and curriculum and instruction. General early education had greater implementation of practices to support social and peer relationships. Supporting social and peer relationships was the largest predictor of gains, controlling for setting type; the association was greater for children with lower initial receptive language or developmental skills. These findings highlight the importance of supporting and promoting peer engagement in students with ASD across preschool placement types. En ligne : https://dx.doi.org/10.1177/10883576221133495 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=515

The role of treatment fidelity on outcomes during a randomized field trial of an autism intervention / David S. MANDELL in Autism, 17-3 (May 2013)  

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