ORIGINAL PAPER Urbanicity-related Variation in Help-seeking and Services Utilization among Preschool-age Children with Autism in Taiwan Chuan-Yu Chen Æ Chieh-Yu Liu Æ Wen-Chuan Su Æ Su-Ling Huang Æ Keh-Ming Lin Ó Springer Science+Business Media, LLC 2007 Abstract The present study examines urbanicity-related differences in help-seeking process among preschool chil- dren with autism and investigates the factors associated with utilization of autism-related services within the year of diagnosis. Using the 1997–2004 National Health Insur- ance Research Database (NHIRD) in Taiwan, we identified a total of 3495 autistic children born in 1997–1999 and 13964 matched controls. Results indicate that suburban and rural autism tended to receive the diagnosis at an older age and to have a longer diagnosis process as compared with urban counterparts. Male gender, a younger age of diag- nosis, and being diagnosed by psychiatric specialty strongly predict subsequent greater utilization of autism- specific services (all p < 0.05). Health policy makers and other service providers should address the needs of children with early-onset neurodevelopmental disorders in rural areas, particularly those from disadvantaged families. Keywords Autism Á Health services Á Urbanicity Á Children There is considerable evidence that the number of children diagnosed with autism has been remarkably increasing in the past decade (Costello et al. 2006; Rutter 2005). In conjunction with this rising prevalence rate, a growing concern has been raised regarding unmet needs for services among autism-affected children and their families. Given that autism is an early-onset disease which affects many spheres of child development and functioning (e.g., lan- guage and social communication), the ideal care program serving autistic children usually involves comprehensive services which are offered and managed on a developmental stage approach (Aman 2005; Howlin 1998). Various ap- proaches have demonstrated some effectiveness in ame- liorating core symptoms of autism and in reducing behavioral or emotional problems, including pharmaco- therapy, speech and language therapy, and behavioral intervention (Aman 2005; Howlin 1998; McConnell 2002; King and Bostic 2006; Volkmar et al. 2006). Since the gains in the improvement of adaptive behaviors, social skills, cognition, or other comorbid problems are believed crucial before autistic children start school, treatment and inter- vention programs are usually encouraged initiated shortly after diagnosis and sustained, at least, throughout the school years (Hollander et al. 2003; Volkmar et al. 2006). Although effective medical management and interven- tions are available, a higher proportion of autistic children and their families do not receive such health services (Committee on Educational Interventions for Children with Autism 2001; Howlin 2005; Williams White et al. 2006). Prior research has linked the characteristics of children and families, care providers, and health resources and system with differential help seeking and services utilization (Lavigne et al. 1998; Leslie et al. 2005; Mandell and No- vak 2005; Owens et al. 2002; Rubble et al. 2005; Simpson et al. 2005; Zwaanswijk et al. 2003). While the relative C.-Y. Chen (&) Á W.-C. Su Á S.-L. Huang Á K.-M. Lin Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Fl. 5, Campus 2, No. 309, Sung-Te Rd, Taipei 110, Taiwan e-mail: cychen@nhri.org.tw C.-Y. Chen Institute of Public Health and Department of Social Medicine, National Yang-Ming University, Taipei, Taiwan C.-Y. Liu Department of Nursing, National Taipei College of Nursing, Taipei, Taiwan 123 J Autism Dev Disord DOI 10.1007/s10803-007-0416-y