Burden of Developmental Disabilities and Ethnic Differences in Utilization of Non-Pharmacotherapies Among Children in the US

OBJECTIVES: To examine the burden of developmental disabilities and ethnic differences in the utilization of therapies among children aged 3 to 17 years

METHODS: We used Optum’s de-identified Clinformatics® Data Mart Database to identify patients with developmental disabilities and those utilizing therapy services between 1 January 2017 to 31 December 2021. International Classification of Diseases, Tenth Revision (ICD-10) and Current Procedure Terminology (CPT) codes were used to identify the study population. The date of the first claim was considered as the index and patients with continuous enrollment 12 months post-index were included in the study. We included patients with bipolar disorder, cerebral palsy, down’s syndrome, attention deficit hyperactivity disorder (ADHD), any developmental delays (autism, learning disability, stuttering, and stammering of speech), intellectual disability, hearing loss, seizure, blindness, and other developmental delays. Further, the utilization of non-pharmacotherapy therapies was analyzed. Descriptive analysis was done, and results were stratified by age, gender, and race. A tree-based classifier model was used to test the significance of race, gender, and age on developmental disability.

RESULTS: Of 315,659 patients identified as having a developmental disability, 55.0% had ADHD and 31.7% had any developmental disability with a greater number of patients being at age 9 and 3 years, respectively. Disabilities were common among the white race (35%) as compared with other race. Overall, prevalence of disabilities was more in boys (62%) as compared with girls. The commonly used therapies were 1) medication and medical support and consultation services and 2) speech therapy, utilized by age group 9 and 8 years, respectively. We conclude that race, gender, and age are significant with an accuracy score of 0.65.

CONCLUSIONS: This study shows a higher prevalence of selected developmental disabilities and racial disparity in access to therapies. Early screening and targeted sessions will help to curb the racial disparity.