Predictors of health service use among adolescents and adults with autism and aggression

Background: Clinical guidelines recommend that psychosocial interventions be used before medication to manage aggressive behavior in individuals with autism. However, the extent to which a multidisciplinary approach is implemented and the factors that influence service use in this complex population are not well understood. Methods: In this study, parents of 182 adolescents and adults with autism and a history of aggression were asked to report on their child's health service use every two months for a year. Individuals that used services in this time period (N = 158) were classified into three groups: users of psychotropic medication alone (n = 28, 17.7%); psychosocial services alone (n = 33, 20.9%); or users of both (n = 97, 61.4%). Results: Although the majority of the sample (82.3%) received guideline recommended treatment (i.e., psychosocial services or a combination of psychosocial services and psychotropic medication), 17.7% were using psychotropic medication alone. Several enabling variables, including visiting a family physician in the two-months prior to baseline, having higher parental education, and having parents who reported being able to effectively access services predicted using psychosocial services alone or in combination with medication. Predisposing and need variables (i.e., being younger and having no psychiatric disorders) also predicted using psychosocial services compared to medication alone. Conclusions: Understanding predictors of service use can help to identify and address barriers that may prevent adults with autism and aggression from accessing guideline recommended care.