594 - Social Determinants of Health (SDOH) Screening in Children with Neurodevelopmental Disabilities (NDD)

Poster Number: 594
Publication Number: 594.1871

Background: Families of children with neurodevelopmental disabilities (NDD) are likely to be especially vulnerable to the effects of social determinants of health (SDOH). The SDOH screening questionnaire is a commonly utilized tool for assessing patients’ unmet social needs. To date, there has been limited study of SDOH in children with NDD.

Objective: To assess prevalence of SDOHs among children with NDD and their families, and determine whether SDOHs vary with family characteristics and/or type and number of NDD.

Design/Methods: This is a cross-sectional retrospective study of 1040 children seen by a developmental-behavioral pediatrician (DBP) for new consultation at a southeastern medical center between April 2022 and August 2023. Demographic information and SDOH data were extracted from the electronic health record and CHADIS, a HIPPA-compliant online questionnaire system. SDOH data was classified as either ‘no DOH documented’, ‘negative screen’ or ‘positive screen’. SDOHs were further categorized as financial strain (FS), food insecurity (FI), housing/utility insecurity (HU), interpersonal violence (IPV), and transportation insecurity (TI). Chi square and Fischer exact test analyses assessed variation in SDOH by type and number of co-existing NDD conditions, insurance, and race/ethnicity.

Results: 84% (871) of patients were screened for SDOH. 17.5% of patients (182) screened positive for any SDOH. Percentage of patients screened for specific SDOH types varied significantly: 83% (867) were screened for FI, 32% (328) for FS, 31% (319) for TI, 36% (373) for HU and 9% (97) for IPV. Although FI was most commonly screened for, the % of patients screening positive for FS (22%, 73) and IPV (28%, 27) were higher than % of patients screening positive for FI (13%, 114), TI (9%, 29), and HU (11%, 40). Numerous patients reported >1 unmet social need: 63% (115) of patients had 1 SDOH, 38% (44) had 2 SDOH, 13% (15) endorsed 3 unmet social needs, and 7% (8) had > 3 unmet social needs. Statistically significant differences were found for insurance, race, and ethnicity. No statistical difference was found between type or number of NDD.

Conclusion(s): A significant portion of families of children with NDD experience unmet social needs, with financial strain and interpersonal violence being the most commonly reported concerns. Clinicians should recognize potential impact of these stressors on developmental outcome. Findings emphasize the importance of addressing SDOH in children with NDD to improve healthcare access and overall well-being, and highlights the need for further research in this area.