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Saturday, March 5, 2016

Early Intervention in Europe

In The Politics of Autism, I discuss the need for more study of the issue in other countries.

At Autism, Erica Salomone and many colleagues have an article titled: Use of Early Intervention for Young Children with Autism Spectrum Disorder across Europe."  The abstract:
Little is known about use of early interventions for autism spectrum disorder in Europe. Parents of children with autism spectrum disorder aged 7 years or younger (N = 1680) were recruited through parent organisations in 18 European countries and completed an online survey about the interventions their child received. There was considerable variation in use of interventions, and in some countries more than 20% of children received no intervention at all. The most frequently reported interventions were speech and language therapy (64%) and behavioural, developmental and relationship-based interventions (55%). In some parts of Europe, use of behavioural, developmental and relationship-based interventions was associated with higher parental educational level and time passed since diagnosis, rather than with child characteristics. These findings highlight the need to monitor use of intervention for children with autism spectrum disorder in Europe in order to contrast inequalities.
From the article:
A number of relevant findings emerged. First, almost 1 in 10 parents who took part in the survey reported that their child was not currently receiving any type of intervention. At a country level, there was large variation in the overall use of intervention. The proportion of children not receiving any intervention was more than 20% in Denmark, Ireland and the United Kingdom, between 10% and 20% in The Netherlands, Czech Republic and the former Yugoslav Republic of Macedonia, and less than 10% in the rest of the  countries. This figure is much lower than the rate reported by Bowker et al. (2011), the only study reporting on use of any type of intervention (23% in North America and 43% in a smaller sample, n = 63, from Europe and other background). This and other differences in our results might be due to sampling bias and the different recruitment methods employed in our and other studies, as well as availability of different interventions. However, it should also be noted that we enquired about a greater range of interventions (for example, parent training was not included in the Bowker et al. survey) in a much larger sample
In the absence of systematic information on differences and similarities in national health and educational policies across Europe, it is not possible to speculate on which might be the most influential factors driving the differences in service use we found. However, our finding that in Southern and Eastern Europe children of individuals with a lower educational level had considerably fewer chances of using interventions suggests per se that there are health inequalities in Europe in respect to intervention for ASD. This is something that policy makers in Europe, both at a national and a union level, need to be made aware of. Furthermore, finding such an effect in this highly educated sample raises the possibility that the gap in terms of use of intervention between richer and poorer sectors of