P2.046: Social Needs in Children with Autism: Insights from a Pediatric Health System’s Screening Initiative

Background: Families of children with autism spectrum disorder (ASD) face significant financial burdens. However, literature assessing whether these families experience a higher burden of challenges related to social drivers of health (SDOH) is limited. By identifying the unique social needs of this patient population, interventions can be targeted to address inequities and improve outcomes.

In October 2023, we implemented an 8-item self-administered electronic health record-based screening and referral process for SDOH across our pediatric health system’s ambulatory primary care and subspecialty clinics. Screening was provided to the caregiver/patient once every 90 days during visit registration. Resources were provided for identified needs.

Our aims were to 1) examine the prevalence of identified 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 identified social needs of patients with vs without ASD.

Methods: This is a cross-sectional study of patients who completed SDOH screening 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 their visit diagnosis or problem list of autism spectrum disorder, 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 used 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% (OR 1.579 [95% CI 1.473,1.694]), 17.0% (OR, 1.203 [95% CI 1.177,1.392]) and 10.6% (OR, 1.703 [95% CI 1.554,1.866]) of patients without ASD, respectively. As compared to patients without ASD, patients with ASD had higher odds of food (OR, 1.804 [95% CI 1.669, 1.950]), nutrition (OR, 1.455 [95% CI [1.326,1.597]), housing (OR, 1.223 [95% CI 1.096,1.364]), transportation (OR, 1.68 [95% CI 1.442,1.956]), and utility (OR, 1.737 [95% CI 1.480,2.039]) insecurity as well as identified need for resources (OR 1.932 [95% CI 1.784,2.093]) (Table 2).

Conclusion: This study highlights that patients with ASD have significantly higher odds of experiencing social needs across multiple domains compared to those without ASD. 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.