Date Approved

7-1-2025

Embargo Period

7-1-2025

Document Type

Thesis

Degree Name

M.A. Clinical Psychology

Department

Clinical Psychology

College

College of Science & Mathematics

Advisor

Katherine Gotham, Ph.D.

Committee Member 1

Jeffrey Greeson, Ph.D.

Committee Member 2

Christina Simmons, Ph.D.

Disciplines

Clinical Psychology | Psychology | Social and Behavioral Sciences

Abstract

Autistic people—particularly adults—experience high rates of co-occurring mental health problems and often report unmet service needs. Although several barriers to accessing quality care are well-documented, the broader landscape of autism-specific services across the lifespan remains under-researched. This two-part thesis aimed to address this gap by examining the availability of autism-specific services, as well as patterns in service utilization and associated costs, among autistic children and adults. The first study employed a systematic web-scraping protocol and data extraction procedure to identify and characterize autism specialty services offered by U.S. academic medical centers. This work revealed a general lack of autism specialty services for autistic adults, especially with respect to post-diagnostic supports, and uneven geographic distribution of services across the U.S. The second study analyzed population-level Medicaid claims data to compare service use and expenditures between autistic children and adults. The odds of utilizing psychiatric inpatient/ER services increased by 35-125% for autistic adolescents and adults compared to children, despite similar rates of outpatient service use. Sex, race/ethnicity, and co-occurring mental health conditions further predicted psychiatric service utilization. Findings highlight disparities in autism-specific services, underscoring the need for more equitable, comprehensive support across the lifespan.

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