The Role of Adverse Childhood Experience in the Relationship Between Autism Severity and Early Intervention and Special Education Plan

The purpose of this study is to examine the association between autism spectrum disorder (ASD) severity and having a special education or early intervention plan and the impact of adverse childhood experiences (ACEs) on this association. This study used the 2020–2021 National Survey of Children’s Health (NSCH) and included 2,537 children aged 3–17 years old who currently have ASD. Multivariable logistic regression, controlling for demographic and family characteristics and health status, was used to explore the association between autism severity and having an early intervention plan. The analysis was stratified by the number of ACEs to explore their role in the association. Children with moderate or severe ASD were more likely to have a special education or early intervention plan than those with mild ASD in the crude and adjusted models. This association continued to be true for children who experienced 1 ACE (aOR: 2.28, 95%CI: 1.09–4.77) but not true for those who experienced no ACEs (aOR: 1.16, 95%CI: 0.70–1.94) and 2 or more ACEs (aOR: 1.84, 95%CI: 0.92–3.69). Results demonstrate that children with moderate or severe autism were more likely to receive early intervention or special education. This association changed depending on the number of ACEs experiences.