Abstract
Greater understanding can increase our knowledge and intervention effectiveness for activity participation problems of children with disabilities. We examined participation difficulties of children with autism spectrum disorders (ASD) and intellectual disabilities (ID) in the 2011 Survey of Pathway to Diagnosis and Services. We utilized propensity score matching with inverse probability of treatment weight with questions from parents of 1783 children aged 6–17 years. Friendship was the most difficult area for all children. Children with both ASD and ID experienced the most difficulty in all areas, followed by ASD alone. Reported levels of home life, friendships, classroom and leisure difficulties were moderately correlated for all children. Children who were previously diagnosed, but have no current diagnosis experienced substantial difficulties.
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References
American Association on Intellectual and Developmental Disabilities. (2008). Frequently asked questions on intellectual disability and the AAIDD Definition. https://aaidd.org/docs/default-source/sis-docs/aaiddfaqonid_template.pdf?sfvrsn=2
Anaby, D., Hand, C., Bradley, L., DiRezze, B., Forhan, M., DiGiacomo, A., et al. (2013). The effect of the environment on participation of children and youth with disabilities: A scoping review. Disability and Rehabilitation, 35, 1589–1598.
Ashburner, J., Ziviani, J., & Rodger, S. (2010). Surviving in the mainstream: Capacity of children with autism spectrum disorders to perform academically and regulate their emotions and behavior at school. Research in Autism Spectrum Disorders, 4(1), 18–27.
Ayvazoglu, N. R., Kozub, F. M., Butera, G., & Murray, M. J. (2015). Determinants and challenges in physical activity participation in families with children with high functioning autism spectrum disorders from a family systems perspective. Research in Developmental Disabilities, 47, 93–105. https://doi.org/10.1016/j.ridd.2015.08.015.
Baker, B. L., & Blacher, J. (2019). Brief report: Behavior disorders and social skills in adolescents with autism spectrum disorder: Does IQ matter? Journal of Autism Developmental Disorders. https://doi.org/10.1007/s10803-019-03954-w.
Bal, V. H., Kim, S.-H., Fok, M., & Lord, C. (2019). Autism Spectrum Disorder symptoms from 2 to 19: Implications for diagnosing adolescents and young adults. Autism Research, 12(1), 89–99. https://doi.org/10.1002/aur.2004.
Baldwin, S., Costley, D., & Warren, A. (2014). Employment activities and experiences of adults with high-functioning autism and Asperger's Disorder. Journal of Autism Developmental Disorders, 44(10), 2440–2449. https://doi.org/10.1007/s10803-014-2112-z.
Billstedt, E., Gillberg, I. C., & Gillberg, C. (2005). Autism after adolescence: Population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood. Journal of Autism and Developmental Disorders, 35(3), 351–360. https://doi.org/10.1007/s10803-005-3302-5.
Billstedt, E., Gillberg, I. C., & Gillberg, C. (2011). Aspects of quality of life in adults diagnosed with autism in childhood: A population-based study. Autism, 15(1), 7–20. https://doi.org/10.1177/1362361309346066.
Blacher, J., Howell, E., Lauderdale-Littin, S., Reed, F. D. D., & Laugeson, E. A. (2014). Autism spectrum disorder and the student teacher relationship: A comparison study with peers with intellectual disability and typical development. Research in Autism Spectrum Disorders, 8(3), 324–333.
Bohnert, A., Lieb, R., & Arola, N. (2019). More than leisure: Organized activity participation and socio-emotional adjustment among adolescents with autism spectrum disorder. Journal of Autism Developmental Disorders, 49(7), 2637–2652. https://doi.org/10.1007/s10803-016-2783-8.
Boslaugh, S. (2007). Secondary data sources for public health: A practical guide. Cambridge: Cambridge University Press.
Brereton, A. V., Tonge, B. J., & Einfeld, S. L. (2006). Psychopathology in children and adolescents with autism compared to young people with intellectual disability. Journal of Autism and Developmental Disorders, 36, 863–870. https://doi.org/10.1007/s10803-006-0125-y.
Chang, Y. C., Chen, C. H., Huang, P. C., & Lin, L. Y. (2019). Understanding the characteristics of friendship quality, activity participation, and emotional well-being in Taiwanese adolescents with autism spectrum disorder. Scandinavian Journal of Occupational Therapy, 26(6), 452–462. https://doi.org/10.1080/11038128.2018.1449887.
Chang, Y.-C., Shih, W., & Kassari, C. (2016). Friendships in preschool children with autism spectrum disorder: What holds them back, child characteristics or teacher behavior? Autism, 20(1), 65–74. https://doi.org/10.1177/1362361314567761.
Chiang, H. L., Kao, W. C., Chou, M. C., Chou, W. J., Chiu, Y. N., Wu, Y. Y., et al. (2018). School dysfunction in youth with autistic spectrum disorder in Taiwan: The effect of subtype and ADHD. Autism Research, 11(6), 857–869. https://doi.org/10.1002/aur.1923.
Child and Adolescent Health Measurement Initiative. (2015). 2011 Pathways outcome measures SPSS Codebook, Version 1. www.childhealthdata.org
Conroy, M. A., Asmus, J. M., Boyd, B. A., Ladwig, C. N., & Sellers, J. A. (2007). Antecedent classroom factors and disruptive behaviors of children with autism spectrum disorders. Journal of Early Intervention, 30(1), 19–35.
Corbett, B. A., Swain, D. M., Coke, C., Simson, D., Newsom, C., & Song, Y. (2014). Improvement in social deficits in autism spectrum disorders using a theatre based, peer-mediated intervention. Autism Research, 7, 4–16. https://doi.org/10.1002/aur.1341.
Danielsson, H., Henry, L., Ronnberg, J., & Nilsson, L. G. (2010). Executive functions in individuals with intellectual disability. Research in Developmental Disabilities, 31(6), 1299–1304. https://doi.org/10.1016/j.ridd.2010.07.012.
Daughrity, B. L. (2019). Parent perceptions of barriers to friendship development for children with autism spectrum disorders. Communication Disorders Quarterly, 40(3), 142–151. https://doi.org/10.1177/1525740118788039.
Daunhauer, L. A., Fidler, D. J., & Will, E. (2014). School function in students with Down syndrome. American Journal of Occupational Therapy, 68, 167–176. https://doi.org/10.5014/ajot.2014.009274.
Dean, M., Kasari, C., Shih, W., Frankel, F., Whitney, R., Landa, R., et al. (2014). The peer relationships of girls with ASD at school: Comparison to boys and girls with and without ASD. Journal of Child Psychology and Psychiatry, 55(11), 1218–1225. https://doi.org/10.1111/jcpp.12242.
Denning, C. B. & Moody, A. K. (2013). Supporting students with autism spectrum disorders in inclusive settings: Rethinking instruction and design. Electronic Journal for Inclusive Education, 3(1): 6. https://corescholar.libraries.wright.edu/cgi/viewcontent.cgi?article=1153&context=ejie
Dovgan, K. N., & Mazurek, M. O. (2019). Relations among activity participation, friendship, and internalizing problems in children with autism spectrum disorder. Autism, 23(3), 750–758. https://doi.org/10.1177/1362361318775541.
Dudley, K. M., Klinger, M. R., Meyer, A., Powell, P., & Klinger, L. G. (2019). Understanding service usage and needs for adults with ASD: The importance of living situation. Journal of Autism and Developmental Disorders, 49, 556–568. https://doi.org/10.1007/s10803-018-3729-0.
Eaves, L. C., & Ho, H. H. (2008). Young adult outcome of autism spectrum disorders. Journal of Autism and Developmental Disorders, 38(4), 739–747. https://doi.org/10.1007/s10803-007-0441-x.
Egilson, S. T., Jakobsdottir, G., & Olafsdottir, L. B. (2018). Parent perspectives on home participation of high-functioning children with autism spectrum disorder compared with a matched group of children without autism spectrum disorder. Autism, 22(5), 560–570. https://doi.org/10.1177/1362361316685555.
Engström, I., Ekström, L., & Emilsson, B. (2003). Psychosocial functioning in a group of Swedish adults with Asperger syndrome or high-functioning autism. Autism, 7(1), 99–110.
Eversole, M., Collins, D. M., Karmarkar, A., Colton, L., Quinn, J. P., Karsbaek, R., et al. (2016). Leisure activity enjoyment of children with autism spectrum disorders. Journal of Autism Developmental Disorders, 46(1), 10–20. https://doi.org/10.1007/s10803-015-2529-z.
Freeman, L. M., Locke, J., Rotheram-Fuller, E., & Mandell, D. (2017). Brief report: Examining executive and social functioning in elementary-aged children with autism. Journal of Autism and Developmental Disorders, 47, 1890–1895. https://doi.org/10.1007/s10803-017-3079-3.
Garrote, A. (2017). The relationship between social participation and social skills of pupils with an intellectual disability: A study in inclusive classrooms. Frontline Learning Research, 5(1), 1–15. https://doi.org/10.14786/flr.v5i1.266.
Goodman, R. (1997). The strengths and difficulties questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581–586.
Granader, Y., Wallace, G. L., Hardy, K. K., Yerys, B. E., Lawson, R. A., Rosenthal, M., et al. (2014). Characterizing the factor structure of parent reported executive function in autism spectrum disorders: The impact of cognitive inflexibility. Journal of Autism and Developmental Disorders, 44(12), 3056–3062.
Gray, K. M., Keating, C. M., Taffe, J. R., Brereton, A. V., Einfeld, S. L., Reardon, T. C., et al. (2014). Adult outcomes in autism: community inclusion and living skills. Journal of Autism and Developmental Disorders, 44(12), 3006–3015. https://doi.org/10.1007/s10803-014-2159-x.
Guli, L. A., Semrud-Clikeman, M., Lerner, M. D., & Britton, N. (2013). Social Competence Intervention Program (SCIP): A pilot study of a creative drama program for youth with social disabilities. Arts in Psychotherapy, 40(1), 37–44. https://doi.org/10.1016/j.aip.2012.09.002.
Hart, D., Grigal, M., & Weir, C. (2010). Expanding the paradigm: Postsecondary education options for individuals with autism spectrum. Focus on Autism and Other Developmental Disabilities, 25, 134–150. https://doi.org/10.1177/1088357610373759.
Head, A. M., McGillivray, J. A., & Stokes, M. A. (2014). Gender differences in emotionality and sociability in children with autism spectrum disorders. Molecular Autism, 5(1), 19. https://doi.org/10.1186/2040-2392-5-19.
Hilton, C. L., Crouch, M. C., & Israel, H. (2008). Out-of-school participation patterns in children with high-functioning autism spectrum disorders. American Journal of Occupational Therapy, 62(5), 554–563. https://doi.org/10.5014/ajot.62.5.554.
Hilton, C. L., Ratcliff, K., Collins, D. M., Flanagan, J., & Hong, I. (2019). Flourishing in children with autism spectrum disorders. Autism Research, 12(6), 952–966. https://doi.org/10.1002/aur.2097.
Hirata, S., Okuzumi, H., Kitajima, Y., Hosobuchi, T., Nakai, A., & Kokubun, M. (2014). Relationship between motor skill and social impairment in children with autism spectrum disorders. International Journal of Developmental Disabilities, 60(4), 251–256.
Howells, K., Sivaratnam, C., May, T., Lindor, E., McGillivray, J., & Rinehart, N. (2019). Efficacy of group-based organised physical activity participation for social outcomes in children with autism spectrum disorder: A systematic review and meta-analysis. Journal of Autism and Developmental Disorders, 49(8), 3290–3308. https://doi.org/10.1007/s10803-019-04050-9.
Howlin, P., Goode, S., Hutton, J., & Rutter, M. (2004). Adult outcome for children with autism. Journal of Child Psychology and Psychiatry and Allied Disciplines, 45(2), 212–229.
Hwang, A. W., Yen, C. F., Liou, T. H., Simeonsson, R. J., Chi, W. C., Lollar, D. J., et al. (2015). Participation of children with disabilities in Taiwan: The gap between independence and frequency. PLoS ONE, 10(5), e0126693. https://doi.org/10.1371/journal.pone.0126693.
Janssen, I., & Leblanc, A. G. (2010). Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. International Journal of Behavioral Nutrition and Physical Activity, 7, 40.
Kim, S. Y., Yoo, E. Y., Jung, M. Y., Park, S. H., Lee, J. S., & Ji-Yeon, L. (2016). Reliability and Validity of the Activity Participation Assessment for School-age Children in Korea. Hong Kong Journal of Occupational Therapy, 28(1), 33–42. https://doi.org/10.1016/j.hkjot.2016.08.001.
King, G., Law, M., King, S., Hurley, P., Rosenbaum, P., Hanna, S., et al. (2004). Children's Assessment of Participation and Enjoyment (CAPE) and Preferences for Activities of Children (PAC). San Antonio: Harcourt Assessments.
Koenig, K., & Kinnealey, M. (2010). Adults with autism spectrum disorders. In H. Kuhaneck & R. Watling (Eds.), Autism: A comprehensive occupational therapy approach (3rd ed.). Bethesda, MD: AOTA Press.
Kraft, E. (2019). Examining the perceived impacts of recreational swimming lessons for children with autism spectrum disorder. International Journal of Aquatic Research and Education, 10(4), 6. https://doi.org/10.25035/ijare.10.04.06.
Larson, R. W. (2000). Toward a psychology of positive youth development. American Psychologist, 55(1), 170–183.
Law, M., Anaby, D., Teplicky, R., Khetani, M. A., Coster, W., & Bedell, G. (2013). Participation in the home environment among children and youth with and without disabilities. British Journal of Occupational Therapy, 76(2), 58–66. https://doi.org/10.4276/030802213X13603244419112.
Lawlor, M. C. (2003). The significance of being occupied: the social construction of childhood occupations. American Journal of Occupational Therapy, 57, 424–434.
Liao, Y.-T., Hwang, A.-W., Liao, H.-F., Granlund, M., & Kang, L.-J. (2019). Understanding the participation in home, school, and community activities reported by children with disabilities and their parents: A pilot study. International Journal of Environmental Research and Public Health, 16(12), 2217. https://doi.org/10.3390/ijerph16122217.
Lieb, R. W., & Bohnert, A. M. (2017). Relations between executive functions, social impairment, and friendship quality on adjustment among high functioning youth with autism spectrum disorder. Journal of Autism and Developmental Disorders, 47, 2861–2872. https://doi.org/10.1007/s10803-017-3205-2.
Majoko, T. (2016). Inclusion of children with autism spectrum disorders: Listening and hearing to voices from the grassroots. Journal of Autism and Developmental Disorders, 46, 1429–1440. https://doi.org/10.1007/s10803-015-2685-1.
Matson, J. L., Dempsey, T., & Fodstad, J. C. (2009). The effect of autism spectrum disorders on adaptive independent living skills in adults with severe intellectual disability. Research in Developmental Disabilities, 30, 1203–1211.
Mazurek, M. O., & Kanne, S. M. (2010). Friendship and internalizing symptoms among children and adolescents with ASD. Journal of Autism and Developmental Disorders, 40(12), 1512–1520. https://doi.org/10.1007/s10803-010-1014-y.
McClelland, M. M., Acock, A. C., & Morrison, F. J. (2006). The impact of kindergarten learning-related skills on academic trajectories at the end of elementary school. Early Childhood Research Quarterly, 21, 471–490. https://doi.org/10.1016/j.ecresq.2006.09.003.
McCollum, M., LaVesser, P., & Berg, C. (2016). Participation in daily activities of young adults with high functioning autism spectrum disorder. Journal of Autism Developmental Disorders, 46(3), 987–997. https://doi.org/10.1007/s10803-015-2642-z.
Meindl, J. N., Delgado, D., & Casey, L. B. (2020). Increasing engagement in students with autism in inclusion classrooms. Children and Youth Services Review. https://doi.org/10.1016/j.childyouth.2020.104854.
Memari, A. H., Panahi, N., Ranjbar, E., Moshayedi, P., Shafiei, M., Kordi, R., et al. (2015). Children with autism spectrum disorder and patterns of participation in daily physical and play activities. Neurology Research International, 2015, 531906. https://doi.org/10.1155/2015/531906.
Mostofsky, S. H., Powell, S. K., Simmonds, D. J., Goldberg, M. C., Caffo, B., & Pekar, J. J. (2009). Decreased connectivity and cerebellar activity in autism during motor task performance. Brain, 132(Pt 9), 2413–2425. https://doi.org/10.1093/brain/awp088.
Newman, L., Wagner, M., Knokey, A.-M., Marder, C., Nagle, K., Shaver, D., et al. (2011). The Post-High School outcomes of young adults with disabilities up to 8 years after High School. A report from the National Longitudinal Transition Study-2 (NLTS2) (NCSER 2011-3005). Menlo Park, CA: SRI International.
Oates, A., Bebbington, A., Bourke, J., Girdler, S., & Leonard, H. (2011). Leisure participation for school-aged children with Down syndrome. Disability and Rehabilitation, 33(19–20), 1880–1889. https://doi.org/10.3109/09638288.2011.553701.
Orsmond, G. I., Krauss, M. W., & Seltzer, M. M. (2004). Peer relationships and social and recreational activities among adolescents and adults with autism. Journal of Autism Developmental Disorders, 34(3), 245–256. https://doi.org/10.1023/b:jadd.0000029547.96610.df.
Orsmond, G. I., Shattuck, P. T., Cooper, B. P., Sterzing, P. R., & Anderson, K. A. (2013). Social participation among young adults with an autism spectrum disorder. Journal of Autism Developmentla Disorder, 43(11), 2710–2719. https://doi.org/10.1007/s10803-013-1833-8.
Pfeiffer, B., Coster, W., Snethen, G., Derstine, M., Piller, A., & Tucker, C. (2017). Caregivers' perspectives on the sensory environment and participation in daily activities of children with autism spectrum disorder. American Journal of Occupational Therapy, 71(4), 7104220020. https://doi.org/10.5014/ajot.2017.021360.
Ponitz, C. C., McClelland, M. M., Matthews, J. S., & Morrison, F. J. (2009). A structured observation of behavioral self-regulation and its contribution to kindergarten outcomes. Developmental Psychology, 45, 605–619. https://doi.org/10.1037/a0015365.
Potvin, M. C., Snider, L., Prelock, P., Kehayia, E., & Wood-Dauphinee, S. (2013). Recreational participation of children with high functioning autism. Journal of Autism Developmental Disorders, 43(2), 445–457. https://doi.org/10.1007/s10803-012-1589-6.
Ratcliff, K., Hong, I., & Hilton, C. (2018). Leisure participation patterns for school age youth with autism spectrum disorders: Findings from the 2016 National Survey of Children’s Health. Journal of Autism and Developmental Disorders, 48(11), 3783–3793. https://doi.org/10.1007/s10803-018-3643-5.
Reynolds, S., Bendixen, R. M., Lawrence, T., & Lane, S. J. (2011). A pilot study examining activity participation, sensory responsiveness, and competence in children with high functioning autism spectrum disorder. Journal of Autism Developmental Disorders, 41(11), 1496–1506. https://doi.org/10.1007/s10803-010-1173-x.
Roelofs, R. L., Visser, E. M., Berger, H. J., Prins, J. B., Van Schrojenstein Lantman-De Valk, H. M., & Teunisse, J. P. (2015). Executive functioning in individuals with intellectual disabilities and autism spectrum disorders. Journal of Intellectual Disability Research, 59(2), 125–137. https://doi.org/10.1111/jir.12085.
Rosenbaum, P. R., & Rubin, D. B. (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70(1), 41–55.
Rotheram-Fuller, E., Kasari, C., Chamberlain, B., & Locke, J. (2010). Social involvement of children with autism spectrum disorders in elementary school classrooms. Journal of Child Psychology and Psychiatry, 51(11), 1227–1234. https://doi.org/10.1111/j.1469-7610.2010.02289.x.
Salley, B., Gabrielli, J., Smith, C. M., & Braun, M. (2015). Do communication and social interaction skills differ across youth diagnosed with autism spectrum disorder, attention-deficit/hyperactivity disorder, or dual diagnosis? Research in Autism Spectrum Disorders, 20, 58–66. https://doi.org/10.1016/j.rasd.2015.08.006.
Shattuck, P. T., Orsmond, G. I., Wagner, M., & Cooper, B. P. (2011). Participation in social activities among adolescents with an autism spectrum disorder. PLoS ONE, 6(11), e27176. https://doi.org/10.1371/journal.pone.0027176.
Shattuck, P., Narendorf, S. C., Cooper, B., Sterzing, P. R., Wagner, M., & Taylor, J. L. (2012). Postsecondary education and employment among youth with an autism spectrum disorder. Pediatrics, 129(6), 1042–1049. https://doi.org/10.1542/peds.2011-2864.
Sigstad, H. M. H. (2016). Significance of friendship for quality of life in adolescents with mild intellectual disability: A parental perspective. Journal of Intellectual and Developmental Disability, 41(4), 289–298. https://doi.org/10.3109/13668250.2016.1200018.
Smith, L. E., Maenner, M. J., & Seltzer, M. M. (2012). Developmental trajectories in adolescents and adults with autism: The case of daily living skills. Journal of the American Academy of Child and Adolescent Psychiatry, 51(6), 622–631.
Solish, A., Perry, A., & Minnes, P. J. J. (2010). Participation of children with and without disabilities in social, recreational and leisure activities. Journal of Applied Research in Intellectual Disabilities, 23(3), 226–236.
Sood, D., LaVesser, P., & Schranz, C. (2014). Influence of home environment on participation in home activities of children with autism spectrum disorder. The Open Journal of Occupational Therapy. https://doi.org/10.15453/2168-6408.1082.
Sparapani, N., Morgan, L., Reinhardt, V. P., Schatschneider, C., & Wetherby, A. M. (2016). Evaluation of classroom active engagement in elementary students with autism spectrum disorder. Journal of Autism Developmental Disorders, 46(3), 782–796. https://doi.org/10.1007/s10803-015-2615-2.
Sperry, L. A., & Mesibov, G. B. (2005). Perceptions of social challenges of adults with autism spectrum disorder. Autism, 9(4), 362–376. https://doi.org/10.1177/1362361305056077.
Taheri, A., Perry, A., & Minnes, P. (2016). Examining the social participation of children and adolescents with intellectual disabilities and autism spectrum disorder in relation to peers. Journal of Intellectual Disability Research, 60(5), 435–443. https://doi.org/10.1111/jir.12289.
Taylor, J. L., & Seltzer, M. M. (2011). Employment and post-secondary educational activities for young adults with autism spectrum disorders during the transition to adulthood. Journal of Autism Developmental Disorders, 41(5), 566–574. https://doi.org/10.1007/s10803-010-1070-3.
Tint, A., Maughan, A. L., & Weiss, J. A. (2017). Community participation of youth with intellectual disability and autism spectrum disorder. Journal of Intellectual Disability Research, 61(2), 168–180. https://doi.org/10.1111/jir.12311.
Townsend, J. A., & Van Puymbroeck, M. (2017). Parental perceptions of changes in family well-being following participation in a camp- Experiences of families with a child with ASD. Therapeutic Recreation Journal, LI(2), 143–169. https://doi.org/10.18666/TRJ-2017-V51-I2-8359.
Turner, K. C., Frost, L., Linsenbardt, D., McIlroy, J. R., & Muller, R. A. (2006). A typically diffuse functional connectivity between caudate nuclei and cerebral cortex in autism. Behavioral and Brain Functions, 2, 34. https://doi.org/10.1186/1744-9081-2-34.
van Asselt-Goverts, A. E., Embregts, P. J., Hendriks, A. H., Wegman, K. M., & Teunisse, J. P. (2015). Do social networks differ? Comparison of the social networks of people with intellectual disabilities, people with autism spectrum disorders and other people living in the community. Journal of Autism Developmental Disorders, 45(5), 1191–1203. https://doi.org/10.1007/s10803-014-2279-3.
Wang, H. Y., & Berg, C. (2014). Participation of young adults with high-functioning autism in Taiwan: a pilot study. OTJR, 34(1), 41–51. https://doi.org/10.3928/15394492-20131209-01.
Zingerevich, C., & LaVesser, P. D. (2009). The contribution of executive functions to participation in school activities of children with high functioning autism spectrum disorder. Research in Autism Spectrum Disorders, 3(2), 429–437. https://doi.org/10.1016/j.rasd.2008.09.002.
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This research was supported in part the American Occupational Therapy Foundation (AOTF) Health Services Research program [Grant number AOTFHSR2019HILTON]. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the AOTF. This study used a publicly available de-identified data set which was supported by the U.S. Data Resource Center for Child and Adolescent Health (DRC) and U.S. National Center for Health Statistics (NCHS). The study data set and survey questionnaire are available on the DRC website at www.childhealthdata.org
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The original idea and literature review was done by CH, KR. The data analysis, manuscript preparation and manuscript editing was done by CH, KR, IH.
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Hilton, C.L., Ratcliff, K. & Hong, I. Participation Difficulties in Autism Spectrum Disorders and Intellectual Disabilities: Findings from the 2011 Survey of Pathway to Diagnosis and Services. J Autism Dev Disord 51, 1210–1223 (2021). https://doi.org/10.1007/s10803-020-04591-4
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DOI: https://doi.org/10.1007/s10803-020-04591-4