234 - Social Needs in Children with Autism: Insights from a Pediatric Health System’s Screening Initiative

Publication Number: 4230.234

Rachel Kraan, Florida International University Herbert Wertheim College of Medicine, Doral, FL, United States; Gabriel Cardenas, Nicklaus Children’s Hospital, miami, FL, United States; Julie Katz, Nicklaus Children's Health System, Miami, FL, United States; Alexandra Byrne, Nicklaus Children’s Hospital, Miami, FL, United States; Joanna Perdomo, Nicklaus Children’s Hospital, Miami, FL, United States

Background: Families of children with autism spectrum disorder (ASD) face significant financial burdens. Identifying the unique social needs of families of children with ASD can help target interventions to address inequities and improve outcomes.

Objective: Our aims were to 1) examine the prevalence of social needs in domains of food, nutrition, housing, transportation, utilities, and overall resource needs for patients with ASD screened in our health system, 2) compare the social needs of patients with vs without ASD.

Design/Methods: This is a cross-sectional study of patients who completed an 8-item electronic SDOH screener during an ambulatory visit at our health system between October 2023 through September 2024. Patients with ASD were defined as those having an ICD-10 code in the visit diagnosis or problem list of ASD, Asperger's syndrome, and/or pervasive developmental disorder. The most recent screening results were used in the analysis for patients who had completed the screener multiple times in the study period. Descriptive statistics were used for the percentage and domain of social needs identified. Odds ratios and 95% CIs were calculated and adjusted for age, gender, race, ethnicity, insurance, and language using multivariable regression analysis to determine if the association between identified social needs and a diagnosis of ASD was statistically significant.

Results: Between October 2023 and September 2024, 69,042 unique patients were screened for social needs, of which 3,548 (5.1%) had ASD (Table 1). Among patients with ASD, 37.6% identified at least one social need, 20.8% identified only one social need, and 16.9% identified more than one social need, as compared to 27.6% (aOR 1.32 [95% CI 1.22,1.43]), 17.0% (aOR, 1.15 [95% CI 1.05,1.25]) and 10.6% (aOR, 1.37 [95% CI 1.25,1.51]) of patients without ASD, respectively. As compared to patients without ASD, patients with ASD had significantly higher odds of food, (aOR, 1.41 [95% CI 1.30,1.53]), nutrition (aOR, 1.32 [95% CI 1.20,1.45]), transportation (aOR, 1.35 [95% CI 1.15,1.58]), and utilities (aOR, 1.45 [95% CI 1.23,1.71]) insecurity; however, not housing insecurity (aOR 1.08 , [95% CI 0.97,1.21]).

Conclusion(s): This study highlights that patients with ASD have significantly higher adjusted odds of experiencing social needs across multiple domains compared to those without ASD, except in the domain of housing. These results speak to the importance of comprehensive SDOH screening and referral systems for the ASD population and the development of tailored interventions to improve access to support resources.

Table 1: Demographic Characteristics of Patients Screened with Autism Spectrum Disorder (ASD)


Table 1 Continued


Table 2: Percentage of Patients and Unadjusted and Adjusted Odds of Identifying Social Needs by Autism Spectrum Disorder (ASD) Diagnosis