Health Services Utilization Among Children With and Without Autism Spectrum Disorders
Using data from multiple health systems (2009–2010) and the largest sample to date, this study compares health services use among youth with and without an autism spectrum disorder (ASD)—including preventive services not previously studied. To examine these differences, we estimated logistic and cou...
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| Published in: | Journal of autism and developmental disorders Vol. 46; no. 3; pp. 910 - 920 |
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| Main Authors: | , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
New York
Springer US
01.03.2016
Springer Springer Nature B.V |
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| ISSN: | 0162-3257, 1573-3432, 1573-3432 |
| Online Access: | Get full text |
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| Abstract | Using data from multiple health systems (2009–2010) and the largest sample to date, this study compares health services use among youth with and without an autism spectrum disorder (ASD)—including preventive services not previously studied. To examine these differences, we estimated logistic and count data models, controlling for demographic characteristics, comorbid physical health, and mental health conditions. Results indicated that youth with an ASD had greater health care use in many categories, but were less likely to receive important preventive services including flu shots and other vaccinations. An improved understanding of the overall patterns of health care use among this population could enable health systems to facilitate the receipt of appropriate and effective health care. |
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| AbstractList | Using data from multiple health systems (2009–2010) and the largest sample to date, this study compares health services use among youth with and without an autism spectrum disorder (ASD)—including preventive services not previously studied. To examine these differences, we estimated logistic and count data models, controlling for demographic characteristics, comorbid physical health, and mental health conditions. Results indicated that youth with an ASD had greater health care use in many categories, but were less likely to receive important preventive services including flu shots and other vaccinations. An improved understanding of the overall patterns of health care use among this population could enable health systems to facilitate the receipt of appropriate and effective health care. Using data from multiple health systems (2009-2010) and the largest sample to date, this study compares health services use among youth with and without an autism spectrum disorder (ASD)-including preventive services not previously studied. To examine these differences, we estimated logistic and count data models, controlling for demographic characteristics, comorbid physical health, and mental health conditions. Results indicated that youth with an ASD had greater health care use in many categories, but were less likely to receive important preventive services including flu shots and other vaccinations. An improved understanding of the overall patterns of health care use among this population could enable health systems to facilitate the receipt of appropriate and effective health care.Using data from multiple health systems (2009-2010) and the largest sample to date, this study compares health services use among youth with and without an autism spectrum disorder (ASD)-including preventive services not previously studied. To examine these differences, we estimated logistic and count data models, controlling for demographic characteristics, comorbid physical health, and mental health conditions. Results indicated that youth with an ASD had greater health care use in many categories, but were less likely to receive important preventive services including flu shots and other vaccinations. An improved understanding of the overall patterns of health care use among this population could enable health systems to facilitate the receipt of appropriate and effective health care. |
| Audience | Academic |
| Author | Cummings, Janet R. Croen, Lisa A. Lynch, Frances L. Massolo, Maria L. Yau, Vincent M. Quinn, Virginia P. Crawford, Phillip M. Qian, Yinge Madden, Jeanne M. Rust, Kristal C. Coleman, Karen J. Owen-Smith, Ashli A. Pearson, Kathryn A. |
| AuthorAffiliation | 3 Department of Research & Evaluation, Kaiser Permanente Southern California (KPSC), Pasadena, CA 4 School of Pharmacy, Northeastern University, Boston, MA 7 Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA 1 Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA 8 McKesson Corporation, San Francisco, CA 9 Center for Clinical Outcomes Research, Kaiser Permanente Georgia (KPGA), Atlanta, GA 6 Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, GA 5 Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute (HPHCI), Boston, MA 2 The Center for Health Research/Northwest, Kaiser Permanente Northwest (KPNW), Portland OR |
| AuthorAffiliation_xml | – name: 2 The Center for Health Research/Northwest, Kaiser Permanente Northwest (KPNW), Portland OR – name: 5 Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute (HPHCI), Boston, MA – name: 8 McKesson Corporation, San Francisco, CA – name: 3 Department of Research & Evaluation, Kaiser Permanente Southern California (KPSC), Pasadena, CA – name: 9 Center for Clinical Outcomes Research, Kaiser Permanente Georgia (KPGA), Atlanta, GA – name: 6 Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, GA – name: 4 School of Pharmacy, Northeastern University, Boston, MA – name: 7 Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA – name: 1 Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA |
| Author_xml | – sequence: 1 givenname: Janet R. surname: Cummings fullname: Cummings, Janet R. email: jrcummi@emory.edu organization: Department of Health Policy and Management, Rollins School of Public Health, Emory University – sequence: 2 givenname: Frances L. surname: Lynch fullname: Lynch, Frances L. organization: The Center for Health Research/Northwest, Kaiser Permanente Northwest (KPNW) – sequence: 3 givenname: Kristal C. surname: Rust fullname: Rust, Kristal C. organization: The Center for Health Research/Northwest, Kaiser Permanente Northwest (KPNW) – sequence: 4 givenname: Karen J. surname: Coleman fullname: Coleman, Karen J. organization: Department of Research & Evaluation, Kaiser Permanente Southern California (KPSC) – sequence: 5 givenname: Jeanne M. surname: Madden fullname: Madden, Jeanne M. organization: School of Pharmacy, Northeastern University, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute (HPHCI) – sequence: 6 givenname: Ashli A. surname: Owen-Smith fullname: Owen-Smith, Ashli A. organization: Division of Health Management and Policy, School of Public Health, Georgia State University, Center for Clinical and Outcomes Research, Kaiser Permanente Georgia (KPGA) – sequence: 7 givenname: Vincent M. surname: Yau fullname: Yau, Vincent M. organization: Division of Research, Kaiser Permanente Northern California (KPNC), McKesson Corporation – sequence: 8 givenname: Yinge surname: Qian fullname: Qian, Yinge organization: Division of Research, Kaiser Permanente Northern California (KPNC) – sequence: 9 givenname: Kathryn A. surname: Pearson fullname: Pearson, Kathryn A. organization: The Center for Health Research/Northwest, Kaiser Permanente Northwest (KPNW) – sequence: 10 givenname: Phillip M. surname: Crawford fullname: Crawford, Phillip M. organization: The Center for Health Research/Northwest, Kaiser Permanente Northwest (KPNW) – sequence: 11 givenname: Maria L. surname: Massolo fullname: Massolo, Maria L. organization: Division of Research, Kaiser Permanente Northern California (KPNC) – sequence: 12 givenname: Virginia P. surname: Quinn fullname: Quinn, Virginia P. organization: Department of Research & Evaluation, Kaiser Permanente Southern California (KPSC) – sequence: 13 givenname: Lisa A. surname: Croen fullname: Croen, Lisa A. organization: Division of Research, Kaiser Permanente Northern California (KPNC) |
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| Copyright | Springer Science+Business Media New York 2015 COPYRIGHT 2016 Springer Springer Science+Business Media New York 2016 |
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| Keywords | Autism spectrum disorders Preventive services Children Health care utilization Adolescents |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Ashli A. Owen-Smith is currently in the Department of Health Management and Policy at the Georgia State University School of Public Health, Atlanta, Georgia. Vincent M. Yau is currently with McKesson Corporation, San Francisco, California. Janet R. Cummings is in the Department of Health Policy and Management at the Emory University Rollins School of Public Health, Atlanta, Georgia. Frances L. Lynch, Kristal C. Rust, Kathryn A. Pearson, and Phillip M. Crawford are at the Center for Health Research/Northwest, Kaiser Permanente Northwest (KPNW), Portland, Oregon. Karen J. Coleman and Virginia P. Quinn are in the Department of Research & Evaluation, Kaiser Permanente Southern California (KPSC), Pasadena, CA. Jeanne M. Madden is in the School of Pharmacy at Northeastern University, Boston, Massachusetts and in the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute (HPHCI), Boston, Massachusetts. Yinge Qian, Maria L. Massolo, and Lisa A. Croen are in the Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, California. At the time of the study, Ashli A. Owen-Smith was with the Center for Health Research/Southeast, Kaiser Permanente Georgia (KPGA), Atlanta, Georgia, and Vincent M. Yau was in the Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, California. |
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| PublicationTitle | Journal of autism and developmental disorders |
| PublicationTitleAbbrev | J Autism Dev Disord |
| PublicationTitleAlternate | J Autism Dev Disord |
| PublicationYear | 2016 |
| Publisher | Springer US Springer Springer Nature B.V |
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S. (1997). Count outcomes: Regression models for counts. In Regression models for categorical and limited dependent variables. Advanced quantitative techniques in the social sciences (pp. 217–250). Thousand Oaks, CA: Sage Publications. RogersSJOzonoffSAnnotation: What do we know about sensory dysfunction in autism? A critical review of the empirical evidenceJournal of Child Psychology and Psychiatry and Allied Disciplines2005461255126810.1111/j.1469-7610.2005.01431.x SimonoffEPicklesACharmanTChandlerSLoucasTBairdGPsychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sampleJournal of the American Academy of Child and Adolescent Psychiatry20084792192910.1097/CHI.0b013e318179964f18645422 MyersSMJohnsonCPThe Council on Children with DisabilitiesManagement of children with autism spectrum disordersPediatrics20071201162118210.1542/peds.2007-236217967921 Centers for Disease Control and Prevention. (2014). People at high risk of developing flu-related complications. http://www.cdc.gov/flu/about/disease/high_risk.htm. Accessed March 2015. LordCRisiSDiLavorePSShulmanCThurmAPicklesAAutism from 2 to 9 years of ageArchives of General Psychiatry20066369470110.1001/archpsyc.63.6.69416754843 ThomasKCEllisARMcLaurinCDanielsJMorrisseyJPAccess to care for autism-related servicesJournal of Autism and Developmental Disorders2007371902191210.1007/s10803-006-0323-717372817 GolnikAIrelandMBorowskyIWMedical homes for children with autism: A physician surveyPediatrics200912396697110.1542/peds.2008-132119255027 Medicode (Firm). (1996). ICD-9-CM: International classification of diseases, 9th revision, clinical modification. Salt Lake City, UT: Medicode. KC Thomas (2634_CR36) 2007; 37 LA Croen (2634_CR8) 2006; 118 A Golnik (2634_CR15) 2009; 123 J Van Cleave (2634_CR38) 2008; 8 KW Eisenberg (2634_CR9) 2008; 122 JG Gurney (2634_CR16) 2006; 160 P Howlin (2634_CR17) 2009; 114 B Taylor (2634_CR35) 1999; 353 CY Pan (2634_CR30) 2006; 36 E Fombonne (2634_CR11) 2003; 33 2634_CR2 2634_CR1 SE Levy (2634_CR21) 2010; 31 Z Cidav (2634_CR6) 2013; 43 JM Ferdinands (2634_CR10) 2014; 210 2634_CR5 2634_CR24 C Lord (2634_CR25) 2006; 63 2634_CR26 SM Myers (2634_CR28) 2007; 120 TM Selden (2634_CR32) 2006; 118 GS Liptak (2634_CR23) 2006; 36 2634_CR27 SA Fontana (2634_CR12) 1997; 87 SB Omer (2634_CR29) 2009; 360 E Simonoff (2634_CR33) 2008; 47 J Van Cleave (2634_CR39) 2007; 161 G Joshi (2634_CR19) 2010; 40 L Copeland (2634_CR7) 2013; 3 R Keren (2634_CR20) 2005; 294 KS Yarnall (2634_CR40) 2003; 93 SE Bowen (2634_CR4) 2014 SJ Rogers (2634_CR31) 2005; 46 F Andre (2634_CR3) 2008; 86 A Gadomski (2634_CR13) 1998; 101 GS Liptak (2634_CR22) 2011; 32 F Godlee (2634_CR14) 2011; 342 2634_CR34 2634_CR37 S Hyman (2634_CR18) 2012; 42 19255027 - Pediatrics. 2009 Mar;123(3):966-71 22411200 - J Autism Dev Disord. 2012 Jun;42(6):1156-64 19420367 - N Engl J Med. 2009 May 7;360(19):1981-8 9240111 - Am J Public Health. 1997 Jul;87(7):1190-6 17015508 - Pediatrics. 2006 Oct;118(4):e1203-11 18977968 - Pediatrics. 2008 Nov;122(5):911-9 22941343 - J Autism Dev Disord. 2013 Apr;43(4):924-31 19143460 - Am J Intellect Dev Disabil. 2009 Jan;114(1):23-41 12959416 - J Autism Dev Disord. 2003 Aug;33(4):365-82 21209060 - BMJ. 2011;342:c7452 12660210 - Am J Public Health. 2003 Apr;93(4):635-41 16855879 - J Autism Dev Disord. 2006 Oct;36(7):871-9 18297169 - Bull World Health Organ. 2008 Feb;86(2):140-6 20309621 - J Autism Dev Disord. 2010 Nov;40(11):1361-70 16894082 - Arch Pediatr Adolesc Med. 2006 Aug;160(8):825-30 17142499 - Pediatrics. 2006 Dec;118(6):e1766-78 18645422 - J Am Acad Child Adolesc Psychiatry. 2008 Aug;47(8):921-9 16264160 - JAMA. 2005 Nov 2;294(17):2188-94 9481020 - Pediatrics. 1998 Mar;101(3):E1 17967921 - Pediatrics. 2007 Nov;120(5):1162-82 10376617 - Lancet. 1999 Jun 12;353(9169):2026-9 16652237 - J Autism Dev Disord. 2006 Jul;36(5):597-606 17372817 - J Autism Dev Disord. 2007 Nov;37(10):1902-12 21285894 - J Dev Behav Pediatr. 2011 May;32(4):277-83 16754843 - Arch Gen Psychiatry. 2006 Jun;63(6):694-701 18922504 - Ambul Pediatr. 2008 Sep-Oct;8(5):305-11 24676207 - J Infect Dis. 2014 Sep 1;210(5):674-83 18056562 - Arch Pediatr Adolesc Med. 2007 Dec;161(12):1170-5 16313426 - J Child Psychol Psychiatry. 2005 Dec;46(12):1255-68 20431403 - J Dev Behav Pediatr. 2010 May;31(4):267-75 |
| References_xml | – reference: GodleeFSmithJMarcovitchHWakefield’s article linking MMR vaccine and autism was fraudulentBMJ2011342c745210.1136/bmj.c745221209060 – reference: JoshiGThe heavy burden of psychiatric comorbidity in youth with autism spectrum disorders: A large comparative study of a psychiatrically referred populationJournal of Autism and Developmental Disorders2010401361137010.1007/s10803-010-0996-920309621 – reference: CidavZLawerLMarcusSCMandellDSAge-related variation in health service use and associated expenditures among children with autismJournal of Autism and Developmental Disorders20134392493110.1007/s10803-012-1637-222941343 – reference: OmerSBSalmonDAOrensteinWAdeHartMPHalseyNVaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseasesThe New England Journal of Medicine20093601981198810.1056/NEJMsa080647719420367 – reference: MyersSMJohnsonCPThe Council on Children with DisabilitiesManagement of children with autism spectrum disordersPediatrics20071201162118210.1542/peds.2007-236217967921 – reference: Van CleaveJDavisMMPreventive care utilization among children with and without special health care needs: Associations with unmet needAmbulatory Pediatrics2008830531110.1016/j.ambp.2008.04.00318922504 – reference: TaylorBAutism and measles, mumps, and rubella vaccine: No epidemiological evidence for a causal associationLancet19993532026202910.1016/S0140-6736(99)01239-810376617 – reference: GurneyJGMcPheetersMLDavisMMParental report of health conditions and health care use among children with and without autism: National Survey of Children’s HealthArchives of Pediatrics and Adolescent Medicine200616082583010.1001/archpedi.160.8.82516894082 – reference: Mental Health Research Network. (2015). Mental Health Research Network participating members: 13 sites across the U.S. https://sites.google.com/a/mhresearchnetwork.org/mhrn/home/Members. Accessed April 21, 2015. – reference: RogersSJOzonoffSAnnotation: What do we know about sensory dysfunction in autism? A critical review of the empirical evidenceJournal of Child Psychology and Psychiatry and Allied Disciplines2005461255126810.1111/j.1469-7610.2005.01431.x – reference: HowlinPMagiatiICharmanTSystematic review of early intensive behavioral interventions for children with autismAmerican Journal on Intellectual and Developmental Disabilities2009114234110.1352/2009.114:23-4119143460 – reference: Centers for Disease Control and Prevention. (2014). People at high risk of developing flu-related complications. http://www.cdc.gov/flu/about/disease/high_risk.htm. Accessed March 2015. – reference: CroenLANajjarDVRayGTLotspeichLBernalPA comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health planPediatrics2006118e1203e121110.1542/peds.2006-012717015508 – reference: LordCRisiSDiLavorePSShulmanCThurmAPicklesAAutism from 2 to 9 years of ageArchives of General Psychiatry20066369470110.1001/archpsyc.63.6.69416754843 – reference: ThomasKCEllisARMcLaurinCDanielsJMorrisseyJPAccess to care for autism-related servicesJournal of Autism and Developmental Disorders2007371902191210.1007/s10803-006-0323-717372817 – reference: AndreFVaccination greatly reduces disease, disability, death and inequity worldwideBulletin of the World Health Organization200886140146264738710.2471/BLT.07.04008918297169 – reference: FontanaSABaumannLCHelbergCLoveRRThe delivery of preventive services in primary care practices according to chronic disease statusAmerican Journal of Public Health19978711901196138089510.2105/AJPH.87.7.11909240111 – reference: Medicode (Firm). (1996). ICD-9-CM: International classification of diseases, 9th revision, clinical modification. Salt Lake City, UT: Medicode. – reference: Van CleaveJHeislerMDevriesJMJoinerTADavisMMDiscussion of illness during well-child care visits with parents of children with and without special health care needsArchives of Pediatrics and Adolescent Medicine20071611170117510.1001/archpedi.161.12.117018056562 – reference: YarnallKSPollakKIOstbyeTKrauseKMMichenerJLPrimary care: Is there enough time for prevention?American Journal of Public Health200393635641144780310.2105/AJPH.93.4.63512660210 – reference: GadomskiAJenkinsPNicholsMImpact of a Medicaid primary care provider and preventive care on pediatric hospitalizationPediatrics1998101e110.1542/peds.101.3.e19481020 – reference: LiptakGSKennedyJADosaNPSocial participation in a nationally representative sample of older youth and young adults with autismJournal of Developmental and Behavioral Pediatrics: JDBP20113227728310.1097/DBP.0b013e31820b49fc21285894 – reference: CopelandLBuchGEarly intervention issues in autism spectrum disordersAutism: The international Journal of Research and Practice20133109 – reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. In American Psychiatric Association (5th ed.). dsm.psychiatryonline.org. Accessed February 1, 2015. – reference: HymanSJohnsonJAutism and pediatric practice: Toward a medical homeJournal of Autism and Developmental Disorders2012421156116410.1007/s10803-012-1474-322411200 – reference: SimonoffEPicklesACharmanTChandlerSLoucasTBairdGPsychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sampleJournal of the American Academy of Child and Adolescent Psychiatry20084792192910.1097/CHI.0b013e318179964f18645422 – reference: SeldenTMCompliance with well-child visit recommendations: Evidence from the Medical Expenditure Panel Survey, 2000–2002Pediatrics2006118e1766e177810.1542/peds.2006-028617142499 – reference: GolnikAIrelandMBorowskyIWMedical homes for children with autism: A physician surveyPediatrics200912396697110.1542/peds.2008-132119255027 – reference: StataCorp LP. (2013). Stata Statistical Software (13.1 ed). College Station, TX. – reference: Long, J. S. (1997). Count outcomes: Regression models for counts. In Regression models for categorical and limited dependent variables. Advanced quantitative techniques in the social sciences (pp. 217–250). Thousand Oaks, CA: Sage Publications. – reference: BowenSEAutism Spectrum Disorders (ASD): State of the states of services and supports for people with ASD2014Washington, DCL & M Policy Research LLC – reference: FombonneEEpidemiological surveys of autism and other pervasive developmental disorders: An updateJournal of Autism and Developmental Disorders20033336538210.1023/A:102505461055712959416 – reference: LiptakGSStuartTAuingerPHealth care utilization and expenditures for children with autism: Data from U.S. national samplesJournal of Autism and Developmental Disorders20063687187910.1007/s10803-006-0119-916855879 – reference: American Academy of Pediatrics. (2014). Well-child care: A check-up for success. http://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx. Accessed March 2015. – reference: KerenRZaoutisTEBridgesCBNeurological and neuromuscular disease as a risk factor for respiratory failure in children hospitalized with influenza infectionJAMA20052942188219410.1001/jama.294.17.218816264160 – reference: PanCYFreyGCPhysical activity patterns in youth with autism spectrum disordersJournal of Autism and Developmental Disorders20063659760610.1007/s10803-006-0101-616652237 – reference: LevySEAutism spectrum disorder and co-occurring developmental, psychiatric, and medical conditions among children in multiple populations of the United StatesJournal of Developmental and Behavioral Pediatrics: JDBP20103126727510.1097/DBP.0b013e3181d5d03b20431403 – reference: U.S. Census Bureau. (2000, 2006–2010). United States Census, American Community Survey. http://www.census.gov/acs/www/. – reference: EisenbergKWVaccine effectiveness against laboratory-confirmed influenza in children 6 to 59 months of age during the 2003–2004 and 2004–2005 influenza seasonsPediatrics2008122911919369573410.1542/peds.2007-330418977968 – reference: FerdinandsJMEffectiveness of influenza vaccine against life-threatening RT-PCR-confirmed influenza illness in US children, 2010–2012The Journal of Infectious Diseases201421067468310.1093/infdis/jiu18524676207 – volume: 87 start-page: 1190 year: 1997 ident: 2634_CR12 publication-title: American Journal of Public Health doi: 10.2105/AJPH.87.7.1190 – volume: 118 start-page: e1766 year: 2006 ident: 2634_CR32 publication-title: Pediatrics doi: 10.1542/peds.2006-0286 – volume: 93 start-page: 635 year: 2003 ident: 2634_CR40 publication-title: American Journal of Public Health doi: 10.2105/AJPH.93.4.635 – volume: 63 start-page: 694 year: 2006 ident: 2634_CR25 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| Snippet | Using data from multiple health systems (2009–2010) and the largest sample to date, this study compares health services use among youth with and without an... Using data from multiple health systems (2009-2010) and the largest sample to date, this study compares health services use among youth with and without an... |
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| SubjectTerms | Access to Health Care Adolescent Adolescents Age Factors Autism Autism Spectrum Disorder - psychology Autistic children Behavioral Science and Psychology Care and treatment Case-Control Studies Child Child and School Psychology Child, Preschool Children Childrens health Comorbidity Demography Development and progression Disorders Emergency Medical Services - utilization Female Health Needs Health Services Health services utilization Health status Humans Immunization Immunization Programs Influenza Male Mental disorders Mental health Mental health services Mental Health Services - utilization Neurosciences Original Paper Patient Acceptance of Health Care - psychology Patient Acceptance of Health Care - statistics & numerical data Pediatrics Pervasive Developmental Disorders Preventive Health Services - utilization Preventive medicine Primary Health Care - utilization Psychology Public Health Risk factors Service provision United States Use Studies Vaccines Youth |
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| Title | Health Services Utilization Among Children With and Without Autism Spectrum Disorders |
| URI | https://link.springer.com/article/10.1007/s10803-015-2634-z http://eric.ed.gov/ERICWebPortal/detail?accno=EJ1090395 https://www.ncbi.nlm.nih.gov/pubmed/26547921 https://www.proquest.com/docview/1762952610 https://www.proquest.com/docview/1764339140 https://www.proquest.com/docview/1768568697 https://pubmed.ncbi.nlm.nih.gov/PMC4747787 |
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