Evidence map›Paper›PMID 39894052›Full record

ArticlePediatrics2025

Autism and Medical Complexity Among Children in the United States.

Philip H Smith, Lindsay L Shea, Jessica E Rast, Lauren Hino, Corey Briskey, Diana E Schendel

Abstract read
In one paragraph

Article in Pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Philip H SmithA.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania.
Lindsay L SheaA.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania.
Jessica E RastA.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania.
Lauren HinoA.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania.
Corey BriskeyCommunity partner and advocate, Raleigh, North Carolina.
Diana E SchendelA.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania.

Funding

Strategies to Facilitate Early Detection of Autism in Primary CareP50HD111142 · NICHD · DREXEL UNIVERSITY · PI Diana L Robins, Diana Schendel · 2022 to 2026
$12.4M
NICHD NIH HHS P50 HD111142
6 · The paper itself

Abstract

BACKGROUND AND

objectivesOngoing systems-level changes aim to better identify and remedy the unmet health care needs of children with medical complexity (CMC). In tandem, home- and community-based services are expanding to support autistic children and their families. Despite the potential for overlap, CMC and autistic children are treated independently in services, research, and policy. We estimated the overlapping prevalence of CMC and autism among US children and health care expenditures for autistic CMC in comparison with other children.

methodsWe analyzed 2 national cross-sectional surveys: the National Survey of Children's Health (NSCH; 2017-2018, 2019-2022, and 2021-2022) and the Medical Expenditures Panel Survey (MEPS; combined 2010-2021), selecting for children aged 0 to 17 years. CMC were defined using 2 different algorithms varying in stringency.

resultsIn the most recent 2021 to 2022 NSCH (n = 103 748), the prevalence of CMC among autistic children was 59.28% (95% CI, 55.61%-62.84%) using one algorithm and 17.56% (95% CI, 14.41%-21.24%) using the more stringent algorithm. Forty-one percent of CMC were autistic using either algorithm. In the MEPS data (n = 55 637), autistic CMC had significantly greater median health care expenditures compared with other CMC and other autistic children.

conclusionsThere is extensive overlap of CMC and autism among children in the United States. When medical complexity and autism are both evident, expenditures are significantly higher than for either category alone. Despite this overlap and the associated high need, CMC and autism are generally treated as separate groups in services, research, and policy. These findings underscore the importance of cohesively understanding service needs across CMC, autistic children, and their caretakers.

Identifiers

PMID39894052
PMCPMC12318121

What Socratic holds

Textmetadata
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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.