Date of Award

2017

Document Type

Dissertation

Degree Name

Doctor of Public Health (DrPH)

Department

Health Policy, Management & Behavior

First Advisor

Barry R Sherman

Second Advisor

Erin M. Bell

Committee Member(s)

Christopher A Kus, Kirsten M. Siegenthaler

Abstract

This study examined the prevalence of autism spectrum disorder (ASD), analyzed the trends, assessed children’s sociodemographic characteristics and examined timing of ASD diagnosis among children who enrolled in the New York State Early Intervention Program (NYSEIP).

Secondary data from the New York State Early Intervention data systems were used. The systems include NYEIS (New York State Early Intervention System), a centralized web-based system that electronically manages the NYSEIP administrative tasks and was designed to support the NYSEIP's services, and the legacy data system: KIDS (Kids Integrated Data System). The time-trend design employed in this study was a form of longitudinal ecological study, and was intended to provide a dynamic view of ASD status in the NYSEIP. Data were collected from the NYSEIP from 2005 to 2014 referral year, to look for trends and changes.

This study found that prevalence of ASD in at-risk children was higher than the estimated prevalence in the general population. ASD diagnoses have been increasing among at-risk children who enrolled in the NYSEIP. The increase was comparable to the national trends. In general, there were upward trends in the prevalence of ASD in all sub-groups over the study period, with a different pattern of prevalence between New York City and the Rest of the State.

In addition, the analysis also indicated that there were some discrepancies in age at ASD diagnosis and time to receive ASD diagnosis by race and geographical location. Children residing in Western and Central Region were diagnosed with ASD at an older age than children from other parts of New York State and had a longer time to receipt of the diagnosis after referral to the NYSEIP. Trend analyses demonstrated that the timing of services for ASD children in NYSEIP remained similar from 2005 to 2014.

The results from this analysis suggest that monitoring ASD trends is important for the effective and efficient planning of programs such as the NYSEIP. In addition, this study can inform local early intervention providers and healthcare professionals about the experience of evaluating children for ASD in the NYSEIP. By design, this study was intended to generate several important hypotheses for future research and contributes useful insights for the NYSEIP.

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Epidemiology Commons

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