National report calls for autism health care policy improvements for future public health emergencies

The COVID-19 pandemic and mitigation measures have changed the way people access health services and participate in communities. Access to appropriate services and accommodation can help people with autism stay employed, educated, take care of their health and establish independence.

According to the latest National Autism Index report, people with autism often have higher health care needs than people without autism, so pandemic-related changes in health care access could impact their health and ultimately their health. In terms of quality of life, it may be an additional burden. , published by the AJ Drexel Autism Institute at Drexel University.

Researchers at the Autism Institute’s Center for Policy Analysis investigated changes and disruptions in access to health services for children and adults with autism as the COVID-19 pandemic began. These findings will inform better evidence-based practices to improve policies and programs for people with autism in preparation for future public health emergencies.

“The COVID-19 pandemic is an unprecedented public health emergency with far-reaching impacts,” said Jessica M. Dr. Last said. “Our hope is that we can learn from our response to this pandemic to improve care systems for people with autism and for all. While such improvements will help us in future times of crisis. , we hope it can also be introduced in times of less disruption” to improve overall care. ”

Last and co-authors noted that changes in access to services could have long-term consequences and disastrous consequences for people with autism.

“It’s a question of equity. If people who need more care don’t get it, the whole nation suffers,” Last said. “And unfortunately, care has been further disrupted during the COVID-19 pandemic for otherwise disadvantaged populations, such as black people with autism.”

The research team examined various data sources before and after the start of the COVID-19 pandemic, including medical insurance claims and administrative records. Availability of services for children with autism based on caregiver reports from the National Child Health Survey. National emergency admission records from the National Emergency Service sample. Hospitalization data from a national inpatient sample. Records from Kaiser Permanente in Northern California document service use among adults with autism.

Data sources cover a wide variety of populations, from nationally representative photographs of children and adults with autism to other sources covering specific but diverse populations.

The researchers found that adults with autism over the age of 45 were more likely to visit emergency departments for COVID-19 than non-autistic adults, children with autism, and young people (under 44). found high rates of hospitalization. The significant increase in hospital visits among older adults with autism compared to other older adults suggests that public health policies should be encouraged to maintain normal medical services for individuals in public health emergencies. needs to be improved.

During the COVID-19 pandemic, access to care such as well-child visits, dental care, emergency department visits, and hospitalization decreased for young people with autism. Black and Hispanic children with autism experienced greater reductions compared with white children. Virtual healthcare has become an important means of care during the COVID-19 pandemic.

Nearly half of children with autism will receive virtual or telemedicine visits in 2021, as will non-autistic children with special medical needs. Due to the COVID-19 pandemic, just over a third of children with autism have missed or been delayed in visiting wells.

Early in the COVID-19 pandemic, there were also policy changes to increase access to healthcare. But enrollment in public health insurance, such as Medicaid, for children with autism remained roughly the same as before the pandemic. However, there are differences in the coverage of insurance among children with autism depending on race and ethnicity. increased compared to before the pandemic.

“Changes in health care policies during the COVID-19 pandemic, such as increased Medicaid and Child Health Insurance Program (CHIP) enrolment and ongoing coverage requirements, have impacted health insurance and care for people with autism. It played an important role in securing access,” he said. Caitlin Coffer-Miller, Ph.D., Autism Institute Policy Impact Project Director and co-author of the report.

“These policies have helped mitigate negative impacts, ensure uninterrupted health care services, and reduce uninsured rates across the United States. , the overall improvement highlights the importance of comprehensive health policies for the well-being of the nation.”People with autism. ”

Rast and Koffer Miller highlighted the report’s recommendations, including ensuring healthcare providers have fair and high-quality access on virtual platforms.

“This includes giving individuals the opportunity to request accommodation and creating sensory-friendly physical and virtual environments,” Coffer-Miller said.

“In addition, providers can use communication strategies that cater to diverse communication preferences, including the use of visual aids, written instructions, or plain language to facilitate comprehension; ensuring that it is user-friendly and accessible to individuals with similar sensory and cognitive profiles.” Organizations like the ASERT Collaborative can serve as models for It is an information originator providing accessible resources focused on COVID-19. ”

They also noted that health policy should continue to support telemedicine and virtual care options for mental health services, including easing restrictions on portability and expanding coverage. The report shows that while mental health care did not change significantly in the early days of the COVID-19 pandemic, just under half of children with autism received mental health care before and during the pandemic. rice field. In 2019 and 2021, about 10% had an unmet need for mental health care, researchers said.

By supporting telemedicine and virtual care, people on the autism spectrum and other neurodiverse people can benefit from increased accessibility and convenience, the report suggests.

Last and Koffer-Miller also focus on the impact, effectiveness, and disparities of telemedicine access for mental illness, and the long-term mental health implications of autism in the years after the official end of the COVID-19 pandemic. They called for further investigation of changes in physical health. health care.

As a continuation of the National Autism Indicator Reports series, this report provides important information for a better understanding of the medical experience of people with autism and the impact the COVID-19 pandemic has had on people with autism. Focus on impact. With a better understanding of the challenges they face, steps can be taken to develop interventions that improve their health care and quality of life.