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Use and Nondisclosure of Complementary Health Approaches Among US Children with Developmental Disabilities

Lindly, Olivia, PhD, MPH*,†,‡; Thorburn, Sheryl, PhD, MPH; Zuckerman, Katharine, MD, MPH

Journal of Developmental & Behavioral Pediatrics: April 2018 - Volume 39 - Issue 3 - p 217–227
doi: 10.1097/DBP.0000000000000536
Original Articles

Objectives: Many US children use complementary health approaches (CHAs), including some modalities that may be ineffective, unsafe, and/or costly. Yet, little is known about the prevalence and correlates of CHA use among children with developmental disabilities (DDs), as well as parent nondisclosure of CHAs used for children with DDs to health care providers. We, therefore, aimed to profile the use and nondisclosure of CHAs among US children with DDs.

Methods: We analyzed data from the 2012 National Health Interview Survey, which included the most recent Child Complementary and Alternative Medicine Supplement. The study sample was comprised of 2141 children with DDs aged 4 to 17 years.

Results: Nearly one-quarter (23%) of US children with DDs used CHAs. Among those with a personal health provider, 42% of parents did not disclose some or all CHAs used to the child's provider. The adjusted odds ratios of using CHAs were greater among those with female sex, higher household income, residences not in the South, difficulty accessing care, or comorbid conditions. CHA was most commonly used because “it is natural.” Nondisclosure was associated with female sex, older age, having no functional limitations, less conventional services use, and use of fewer CHAs. The most common reason for nondisclosure was that the child's provider did not ask.

Conclusion: Complementary health approach use is prevalent among US children with DDs, and nondisclosure is likely among those who use CHAs. Future intervention targeting education and communication about CHAs for parents of children with DDs and their health care providers may promote disclosure.

*Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA;

Division of General Pediatrics, Oregon Health & Science University, Portland, OR;

School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR.

Address for reprints: Olivia Lindly, PhD, MPH, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA 02114; e-mail:

O. Lindly's effort was supported in part by the Oregon State University Ruth E. Warnke Graduate Fellowship and grant number T32HS000063 from the Agency for Healthcare Research and Quality.

Disclosure: The authors declare no conflict of interest.

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Received July , 2017

Accepted November , 2017

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.