The Prevalence of Parent-Reported Autism Spectrum Disorder Among US Children.

: media-1vid110.1542/5839990273001PEDS-VA_2017-4161Video Abstract OBJECTIVES: To estimate the national prevalence of parent-reported autism spectrum disorder (ASD) diagnosis among US children aged 3 to 17 years as well as their treatment and health care experiences using the 2016 National Survey of Children's Health (NSCH). METHODS: The 2016 NSCH is a nationally representative survey of 50 212 children focused on the health and well-being of children aged 0 to 17 years. The NSCH collected parent-reported information on whether children ever received an ASD diagnosis by a care provider, current ASD status, health care use, access and challenges, and methods of treatment. We calculated weighted prevalence estimates of ASD, compared health care experiences of children with ASD to other children, and examined factors associated with increased likelihood of medication and behavioral treatment. RESULTS: Parents of an estimated 1.5 million US children aged 3 to 17 years (2.50%) reported that their child had ever received an ASD diagnosis and currently had the condition. Children with parent-reported ASD diagnosis were more likely to have greater health care needs and difficulties accessing health care than children with other emotional or behavioral disorders (attention-deficit/hyperactivity disorder, anxiety, behavioral or conduct problems, depression, developmental delay, Down syndrome, intellectual disability, learning disability, Tourette syndrome) and children without these conditions. Of children with current ASD, 27% were taking medication for ASD-related symptoms, whereas 64% received behavioral treatments in the last 12 months, with variations by sociodemographic characteristics and co-occurring conditions. CONCLUSIONS: The estimated prevalence of US children with a parent-reported ASD diagnosis is now 1 in 40, with rates of ASD-specific treatment usage varying by children's sociodemographic and co-occurring conditions.

Family socioeconomic status and maternal depressive symptoms: Mediation through household food insecurity across five years.

RATIONALE: Food insecurity is a significant social problem that has been found to co-occur with both poverty and depression. However, few studies have utilized longitudinal data to investigate the associations among poverty, depression, and food insecurity. OBJECTIVE: This study tested two competing hypotheses, the food inadequacy hypothesis and the mental health hypothesis, in examining the associations among family socioeconomic status (SES), maternal depression, and household food insecurity across children's first five years of life. METHODS: Data were drawn from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), a dataset nationally representative of all children born in the United States in 2001. Mothers reported family SES and household food insecurity when their children were nine months, 24 months, four years, and at kindergarten entry; maternal self-rated depressive symptoms were included at nine months, four years, and kindergarten entry. RESULTS: An autoregressive cross-lagged model showed that family SES was predictive of later household food insecurity, which in turn was associated with later maternal depressive symptoms. Significant mediation pathways were found with household food insecurity mediating the link between family SES and maternal depressive symptoms. CONCLUSIONS: This study highlights the need to consider household food insecurity as an underlying mechanism of maternal depressive symptoms in under-resourced families. Findings of this study can inform public health policy by highlighting the importance of considering factors such as food insecurity in the delivery of services to depressed mothers and their children in under-resourced contexts, and emphasizing the need for coordinated, integrated care in responding to the needs of these high-risk, vulnerable families.

The creation of the federal MCH Extramural Research Program, 1950-1969: lessons for today.

On April 9, 1912, the law establishing the Children's Bureau was signed by President William Howard Taft. The original mission of the Children's Bureau was to "investigate and report … upon all matters pertaining to the welfare of children and child life among all classes of our people." This paper focuses on the transitional years from roughly 1950 to 1969, when the Children's Bureau's investigative mandate was transformed from a set of intramural activities that viewed maternal and child health research as part of a larger effort cutting across investigative, programmatic, and policy goals, and across different domains of the child's life, to an extramural research program focused specifically on maternal and child health. Discussion focuses on the mission of the Maternal and Child Health (MCH) Research Program, housed now within the Maternal and Child Health Bureau (MCHB), Health Resources and Services Administration (HRSA), of the U.S. Department of Health and Human Services.

Autism spectrum disorders and developmental disabilities in children from immigrant families in the United States.

OBJECTIVES: Recent census data show that nearly one-quarter of US children have at least 1 immigrant parent; moreover, there has been a dramatic increase in children diagnosed with autism spectrum disorders (ASDs) and select developmental disabilities (DDs). However, little is known about access to medical home and adequacy of insurance coverage for children with ASDs and select DDs from immigrant families. METHODS: By using the 2007 National Survey of Children's Health, we compared children with ASDs and select DDs from immigrant (n = 413, foreign born or reside with at least 1 immigrant parent) and nonimmigrant (n = 5411) families on various measures of medical home and insurance coverage. We used weighted logistic regression to examine the association between immigrant family and selected outcome measures while controlling for confounding factors. RESULTS: Compared with nonimmigrant families, children with ASD and select DD from immigrant families were more than twice as likely to lack usual source of care and report physicians not spending enough time with family. Furthermore, multivariable analyses indicate that insurance coverage is an important factor in mitigating health care barriers for immigrant families. CONCLUSIONS: The study demonstrates important areas of deficits in the health care experiences of children with ASD and select DD from immigrant households. Public policy implications include increasing access to existing insurance programs, augmenting public awareness resources for ASD and select DD, and offering assistance to immigrant families that are struggling with the medical needs of their children.