Service Delivery Experiences and Intervention Needs of Military Families with Children with ASD

Impact of Respite Care Services Availability on Stress, Anxiety and Depression in Military Parents who have a Child on the Autism Spectrum

OBJECTIVE

Parenting an autistic child can affect a family's well-being. Finding resources is critical. This pilot study looked at respite's impact on parental stress, anxiety, and depression in military families and demographic factors associated with presence of respite care.

METHOD

Participants completed three surveys on anonymous basis, including two standardized surveys measuring parental stress and anxiety/depression. Data analysis used Chi-square test and regression analysis.

RESULTS

Parents receiving respite reported less stress and anxiety/depression. Respite utilization was associated with absence of comorbid conditions in child and other variables. Predictor variables for parental stress and anxiety/depression included presence of comorbid conditions in child.

CONCLUSION

Respite care may be linked to lower parental stress, anxiety, and depression, but more study is needed.

Effects of a 9-Month Military-Base Internship on the Competitive Integrated Employment of Military Dependent and Connected Youth with ASD

This waitlist-controlled cluster randomized clinical trial presents the results of PS + ASD for military dependent and connected youth with ASD. Following earlier findings regarding PS + ASD, this study expands upon that previous work by including a new population, military dependent and connected transition aged youth with ASD. Findings indicate that military dependent and connected youth who participated in PS + ASD gained competitive integrated employment at 60% despite the impact of the COVID-19 pandemic and economic downturn. In addition, these youth worked a mean of 24.42 h weekly and earned an average hourly wage of $9.38 at one year post baseline while the waitlist control group participants did not gain CIE. In addition, by 18 months, 58.3% of participants gained positions in federal employment. Implications of the study are discussed.

TRICARE Extended Care Health Option Program: Prevalence of pediatric ECHO enrollees and healthcare service utilization in the Military Health System

BACKGROUND

The Extended Care Health Option (ECHO) Program is a TRICARE program aimed at reducing the disabling effects of chronic medical conditions for beneficiaries of the Department of Defense (DoD) healthcare program. However, little is known about military-connected children enrolled in the program.

OBJECTIVE/HYPOTHESIS

The aim of this study was to examine the demographic makeup of pediatric ECHO beneficiaries and their healthcare claims data. This is the first study to evaluate healthcare utilization of this subset of military dependents.

METHODS

A cross-sectional study was performed evaluating ECHO enrolled pediatric beneficiaries and their health service utilization during 2017-2019. TRICARE claims and military treatment facility (MTF) encounter data were utilized to evaluate health service utilization and identify the most frequently reported ICD-10-CM and CPT codes associated with care for this population.

RESULTS

Of the 2,001,619 dependents aged 0-26 years who received medical care in the Military Health System (MHS) during 2017-2019, 21,588 individuals (1.1%) were enrolled in ECHO. The majority of encounters (65.4%) were provided in the MTFs. Inpatient visits, therapeutic services, and in-home nursing care were the top utilized private sector care services. Outpatient visits encompassed 94.8% of healthcare encounters, and neurodevelopmental disorders were the top principal diagnoses among ECHO beneficiaries.

CONCLUSIONS

With the increasing prevalence of children with medical complexity and developmental delay, the pediatric TRICARE beneficiaries eligible for ECHO will likely continue to rise. Improving services and supports for military children with special healthcare needs is needed to maximize their developmental trajectory.

Brief Report: Identifying Concerns of Military Caregivers with Children Diagnosed with ASD Following a Military Directed Relocation

Military families relocate three times more often than non-military families. Those whom have children diagnosed with Autism Spectrum Disorder face challenges related to inconsistencies in services, delay of services, and lack of continuity of care. The current study expands the limited research examining the experiences of military families with children with Autism by focusing on impact of relocation, specifically identifying potential causes of delays in services. An online survey of 25 military caregivers of children with autism suggests potential delays in service related to provider waitlists, obtaining new referrals, and lengthy intake processes. The impact of these inconsistencies is discussed in relation to child progress and the need for future research in this area.

Peer Experiences of Military Spouses with Children with Autism in a Distance Peer Mentoring Program: A Pilot Study

Previous research has indicated military families with children with autism reported significant difficulties when relocating with their child with autism. One possible relocation support for these families is an online peer mentorship program with another military spouse with a child with autism who has more relocation experience. The purpose of this pilot investigation was to determine the feasibility, acceptability, and collect initial outcome data for an online peer mentorship program for military spouses with children with autism. Results from this study indicated an online peer mentorship program is feasible, and may be a helpful program to support military spouses with children with autism before relocations.

The Effectiveness of a Distance Peer Mentor Training Program with Military Spouses with Children with Autism

Several researchers have described a training for mentorship programs; however, few studies have examined the effects of mentor training on mentor knowledge of communication strategies taught in the training. This investigation developed and tested a distance peer mentor training for military spouses with children with autism. Results indicated prospective military spouse mentors scored significantly higher on training assessments than those in the comparison group, demonstrating they acquired knowledge and skills from the online training. Further, military spouse mentors in the training group felt the training was useful and helped prepare them to mentor other military spouses. This pilot investigation demonstrated a brief, online peer mentor training may be used to train peer mentors.

Health and Mental Health Needs of Children in US Military Families

Children in US military families share common experiences and unique challenges, including parental deployment and frequent relocation. Although some of the stressors of military life have been associated with higher rates of mental health disorders and increased health care use among family members, there are various factors and interventions that have been found to promote resilience. Military children often live on or near military installations, where they may attend Department of Defense-sponsored child care programs and schools and receive medical care through military treatment facilities. However, many families live in remote communities without access to these services. Because of this wide geographic distribution, military children are cared for in both military and civilian medical practices. This clinical report provides a background to military culture and offers practical guidance to assist civilian and military pediatricians caring for military children.

Caring for military families: Understanding their unique stressors

Military families are often faced with unique stressors that civilian families do not have to deal with, such as deployment, geographic separation, and frequent relocation. When an NP is providing care for a military family, it is important that these unique stressors are discussed and understood. NPs can employ the Causal Uncertainty Model to encourage effortful cognition and support family attributes to ameliorate the negative effects of the stressors these families may face.