Access to Dental Visits and Correlates of Preventive Dental Care in Children with Autism Spectrum Disorder
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ORIGINAL PAPER
Access to Dental Visits and Correlates of Preventive Dental Care in Children with Autism Spectrum Disorder Rachel M. Fenning1,2 · Robin Steinberg‑Epstein2 · Eric M. Butter3 · James Chan4 · Kelly McKinnon‑Bermingham2 · Kimberly J. Hammersmith5 · Jacquelyn Moffitt1,2 · Amy M. Shui4 · Robert A. Parker4,6 · Daniel L. Coury7 · Paul P. Wang8 · Karen A. Kuhlthau9
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Dental care received by children in the Autism Speaks Autism Treatment Network (ATN) was compared to National Survey of Children’s Health (NSCH) data for children without special healthcare needs and children with parent-reported ASD. Correlates of obtained preventive dental services were examined within the ATN sample. Participants included 375 families of children ages 4 to 17 enrolled in the ATN. ATN families reported levels of preventive dental care that were similar to, or exceeded, NSCH-reported care. However, disparities in obtained preventive dental services emerged within the ATN sample. Lower intellectual functioning was the most consistent correlate of reduced access to and completion of preventive dental care. Implications for developing system-wide supports and targeted interventions are discussed. Keywords Autism spectrum disorder (ASD) · Dental care · Preventive care · Intellectual functioning
Introduction
* Rachel M. Fenning [email protected] 1
Department of Child and Adolescent Studies and Center for Autism, California State University, Fullerton, 800 N. State College Blvd. EC‑560, Fullerton, CA 92831, USA
2
Department of Pediatrics, The Center for Autism and Neurodevelopmental Disorders, University of California, Irvine, School of Medicine, Irvine, CA, USA
3
Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA
4
Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
5
Department of Dentistry, Nationwide Children’s Hospital, Columbus, OH, USA
6
Department of Medicine, Harvard Medical School, Boston, MA, USA
7
Department of Developmental/Behavioral Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA
8
Simons Foundation, New York, NY, USA
9
Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Children with autism spectrum disorder (ASD) experience significant unmet healthcare needs, including difficulties engaging in routine preventive services, that are greater than those of children with other developmental disabilities, mental health needs, and chronic medical conditions (Chiri and Warfield 2012; Cummings et al. 2016; Kogan et al. 2008; Tregnago and Cheak-Zamora 2012). Dental care represents one of the most common unmet healthcare needs for children with ASD (McKinney et al. 2014), a population vulnerable to excessive plaque, caries, and oral infections (DeMattei et al. 2007; Jaber 2011; Kopycka-Kedzierawski and Auinger 2008). Demographic and systemic barriers to dental care have been identified for children with ASD, in
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