Master of Science (M.S.) in Dentistry
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College of Dental Medicine
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Nova Southeastern University
Toni-Marie Small. 2020. Transitioning from Individualized Pediatric Dental Care of Children with Autism Spectrum Disorder at the Mailman Segal Dental Clinic to Traditional Dental Settings. Master's thesis. Nova Southeastern University. Retrieved from NSUWorks, College of Dental Medicine. (131)
Background: Children with special healthcare needs (SHCN) such as Autism Spectrum Disorder (ASD) usually develop strong bonds with their pediatric dental care provider. However, as they mature, transitioning to other services or providers is necessary. Low rates of successful transition of children with SHCN have gained national attention especially since their lifelong conditions require continuous care. It is important to facilitate a smooth transition among providers; dental care providers specifically. These transitions are imperative to prevent these children from losing access to dental care as they mature. This pilot study seeks to describe the proportion of children with ASD seen at the Mailman Segal Center for Human Development Dental Clinic (MSD) that were required to transition to other dental providers and determine characteristics that influenced the decision to remain at Nova Southeastern University (NSU) dental clinics. Objective: Although children with Autism Spectrum Disorder (ASD) develop strong bonds with their pediatric dental provider, as they age, a transition to other providers is necessary. Low rates of successful transition, coupled with the need for long-term care, highlight the importance of understanding the transition process. The objective of this study is to examine characteristics associated with the retention of patients at NSU dental clinics. Methods: A retrospective chart review of patients with an ASD diagnosis was conducted. Data such as demographics, insurance status, and household income were collected. A logistic regression analysis was conducted to examine patient factors associated with the transition to an NSU clinic. Results: Data were collected for 101 children (89.1% male & 10.9% female) required to transition between 2015-2019; Medicaid was the most frequently reported insurance type (68%). In terms of transitions, 42% of patients transitioned to an NSU clinic, 5.9% sought care privately, 19% are still active patients, and the remaining 33% were lost to follow up. Regression analysis indicated that insurance type was significantly associated with transition to NSU. Children with Medicaid were seven times more likely to transition to an NSU clinic than to seek private care (OR= 7.156; [CI: 2.931, 17.472]; p=0.000). Conclusion: Results demonstrate that insurance may play a major role in a family’s decision to seek care at a facility. Since many studies have shown that Medicaid acceptance is low among private dental care providers, these findings suggest that this may be a major barrier to finding facilities to transition children with ASD.
ASD, Autism, Autism Spectrum Disorder, Transition
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