Is inclusivity an indicator of quality of care for children with autism in special education?

OBJECTIVE To determine whether the proportion of time spent in an inclusive educational setting, a process indicator of the quality of schooling for children with autism, improves key outcomes. METHODS Patients were 484 children and youth educated in special education with a primary diagnosis of autism in the National Longitudinal Transition Study-2. These individuals were ages 20 to 23 in 2007. We used propensity-score inverse probability of treatment weights to eliminate the effect of multiple confounders. A causal interpretation of the effect of inclusivity on key educational and functional outcomes still depends on a critical assumption, that inclusivity is not confounded by remaining, omitted confounders. RESULTS Compared with children with autism who were not educated in an inclusive setting (n = 215), children with autism who spent 75% to 100% of their time in a general education classroom (n = 82) were no more likely to attend college (P = .40), not drop out of high school (P = .24), or have an improved functional cognitive score (P = .99) after controlling for key confounders. CONCLUSIONS We find no systematic indication that the level of inclusivity improves key future outcomes. Research on educational and functional outcomes for children with autism can benefit from data on large samples of children educated in real-world settings, such as the National Longitudinal Transition Study-2, but more nuanced indicators should be developed to measure the quality of special education for children with autism.