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Prahl A. The Effects of Functional Reading Activities to Motivate and Empower for Autistic Young Adults: A Single-Case Design Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-18. [PMID: 39302878 DOI: 10.1044/2024_ajslp-23-00425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2024]
Abstract
PURPOSE The purpose of this study was to examine the effects of Functional Reading Activities to Motivate and Empower (FRAME) on use of reading comprehension strategies in intellectually and/or developmentally disabled young adults. METHOD A single-case, multiple-probe design across functional literacy stimuli (e.g., text messages, e-mails) was replicated across three intellectually or developmentally disabled 23- to 26-year-old young adults, all of whom had a primary diagnosis of autism. Within FRAME, reading comprehension strategies were taught and practiced within the context of functional texts or activities of daily living that involve written language (e.g., text messages, e-mails). Each session followed the teach-model-coach-review approach and was conducted via telepractice. Participants' use of reading comprehension strategies was measured in baseline, intervention, maintenance, and with generalization probes. RESULTS Visual analysis of the data indicated a functional relation between FRAME and the use of reading comprehension strategies for two of the three autistic young adults. All participants maintained increased use of reading comprehension strategies post-intervention. CONCLUSIONS This study provides preliminary evidence that FRAME is associated with improved use of reading comprehension strategies that maintains over time. Thus, FRAME has the potential to support continued improvement of functional reading skills throughout the lifespan, which is critical as autistic individuals make the transition from adolescence to adult life. Further research is needed to evaluate the effects of the intervention on more distal outcomes of written language and to examine how to best tailor the intervention to individual differences to optimize outcomes. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.26882422.
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Affiliation(s)
- Alison Prahl
- Department of Communication Sciences and Disorders, Baylor University, Waco, TX
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2
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Ferman S, Segal O. The Face of Autism in Israel. Neuropsychiatr Dis Treat 2024; 20:1677-1692. [PMID: 39262631 PMCID: PMC11389695 DOI: 10.2147/ndt.s466420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 08/15/2024] [Indexed: 09/13/2024] Open
Abstract
This article seeks to offer a comprehensive perspective on autism in Israel, aligning with global reports. It aims to serve as a foundational resource for policymakers in developing relevant support and point to unmet needs. The data was drawn from publications by Israeli government authorities and academic publications. In 2022, the prevalence of child and adolescent autism in Israel was approximately 1.13%, with a male-to-female ratio of 4:1, and an annual increase of 23%, particularly among young children. In Israel, the diagnosis of autism follows the DSM-5 guidelines and is conducted by a physician and a psychologist specializing in autism. Typically, diagnosis is at age 2. The autism intervention approaches prevalent in Israel are consistent with those that are globally accepted. Children with autism are entitled to special education services adapted to their needs and developmental levels. The legally established package of services for children with autism includes sessions with occupational therapists, speech-language pathologists (SLPs), physical therapists, psychologists, and social workers. Children and adults with autism are eligible for disability allowance along with support regarding residence, educational programs, and employment opportunities. Nonetheless, underdiagnosis and low accessibility to services are common in minority populations and rural areas. Furthermore, in recent years, services for autistic individuals have declined. This decline, particularly considering the ongoing rise in the prevalence of autism, pose significant challenges for Israeli government authorities in ensuring that autistic persons receive appropriate support.
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Affiliation(s)
- Sara Ferman
- Department of Communication Disorders, Faculty of Medicine, Tel-Aviv University, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Ono Academic College, 1, Academic Avenue, Kiriat-Ono, Israel
| | - Osnat Segal
- Department of Communication Disorders, Faculty of Medicine, Tel-Aviv University, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
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Schiltz HK, Clarke E, Rosen N, De La Rosa SG, Masjedi N, Christopher K, Lord C. A Longitudinal Mixed-Methods Characterization of Family Support from Adolescence to Young Adulthood in Autism and Other Developmental Disabilities. J Autism Dev Disord 2024; 54:3225-3241. [PMID: 37668851 PMCID: PMC11362242 DOI: 10.1007/s10803-023-06070-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 09/06/2023]
Abstract
Although caregiving responsibilities and need for support persist and evolve across the life course in families with autistic youth or youth with other developmental disabilities (DDs), little is known about support during their child's adulthood years. Therefore, the present study used a mixed-methods approach to examine change and stability in formal and informal family support across the transition to adulthood. Caregivers of 126 individuals with autism or DDs completed a modified version of the Family Support Scale, including open-ended questions, at five time points from adolescence (age 16) into young adulthood (age 22). Caregivers reported that informal support from family members was the most frequently used, helpful, and valued source of support with relative stability across time. In contrast, the reported helpfulness, use, and value of formal support (e.g., professionals, schools) for caregivers declined over time. Qualitative content analyses revealed characteristics of highly valued support included support type (e.g., instrumental or emotional) and features of the support source (e.g., their understanding). There was a shift to valuing emotional support more than instrumental support over time, especially for caregivers of less able adults. Partnership and dependability emerged as highly valued features of the support source. These findings fit within a social convoy perspective and likely reflect the "service cliff" experienced by autistic individuals or people with DDs and their families. As social networks shrink over time and formal services are less readily available in adulthood, remaining sources of support, particularly from family members, become increasingly important.
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Affiliation(s)
- Hillary K Schiltz
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA.
| | - Elaine Clarke
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Nicole Rosen
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Sofi Gomez De La Rosa
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Nina Masjedi
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Kourtney Christopher
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Catherine Lord
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
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Ferguson EF, Barnett ML, Goodwin JW, Vernon TW. "There is No Help:" Caregiver Perspectives on Service Needs for Adolescents and Adults with Profound Autism. J Autism Dev Disord 2024:10.1007/s10803-024-06451-x. [PMID: 38963473 DOI: 10.1007/s10803-024-06451-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2024] [Indexed: 07/05/2024]
Abstract
The underrepresentation of individuals with profound autism (who require 24/7 access to care) in autism research has resulted in limited knowledge about their service needs and a lack of evidence-based practices tailored to those needs. This study explored caregiver perspectives on service needs, barriers to accessing care, and treatment priorities to guide treatment development and improvement of service delivery. A sequential mixed-methods design integrated quantitative survey data (n = 423; Mage = 18.89 years; 26.7% female) with qualitative interviews (n = 20) with caregivers of adolescents and adults with profound autism. Quantitative findings indicated regular socialization opportunities were the most frequently endorsed unmet service need (60.3% of caregivers), followed by primary health care with autism-trained staff (59.3%), social skills instruction (55.8%), life skills instruction (51.3%), and behavioral support (47.3%). Higher likelihood of needing social activity groups was associated with elevated emotional reactivity, higher language level, minoritized ethnicity, and lower household income. Greater need for specialized primary health care was associated with lower income, while the need for social and life skills instruction was associated with increased age and elevated dysphoria. Qualitative analysis identified 10 themes that converged and expanded quantitative findings by highlighting a pervasive shortage of individualized, goal-oriented services, common barriers to care, and the priority of developing centralized treatment settings that coordinate care throughout adulthood. This study identified pressing service needs for adolescents and adults with profound autism in the United States. These insights are crucial for improving the accessibility and quality of clinical care.
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Affiliation(s)
- Emily F Ferguson
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, 401 Quarry Rd, Stanford, CA, 94305-5719, USA.
| | | | | | - Ty W Vernon
- University of California, Santa Barbara, CA, USA
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5
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Girolamo T, Escobedo A, Butler L, Larson CA, Campos I, Greene-Pendelton K. Social drivers of health in communicative outcomes of racially and ethnically minoritized autistic adolescents and adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.17.24309053. [PMID: 38947098 PMCID: PMC11213112 DOI: 10.1101/2024.06.17.24309053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Despite their importance, little is known about how social drivers of health shape communicative outcomes in autism. Even less is known when considering the intersection of race and language impairment. An understanding of factors in communicative outcomes is key for characterizing developmental trajectories and informing supports. This cross-sectional observational study examined the role of social drivers of health in communicative outcomes of racially and ethnically minoritized autistic adolescents and adults. Participants ages 13 to 30 (N = 73) completed a behavioral assessment protocol, including language and nonverbal cognitive skills, as well as social drivers of health (sense of community, unmet services, barriers to services). Correlational analyses revealed associations between social drivers of health on social communication impairment and real-world communication. Generalized linear mixed-effects modeling revealed that language predicted real-world communication, but sense of community predicted social communication impairment. Findings point to the importance of assessing both individual differences and social drivers of health in outcomes in autism research. Future work should focus on social drivers of health in larger-scale analyses of outcomes in minoritized autistic individuals during the transition to adulthood, considering supports that align with service eligibility and person-centered outcomes.
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Marsack-Topolewski CN, Samuel PS. Experiences of Parental Caregivers of Adults with Autism in Navigating the World of Employment. J Autism Dev Disord 2024:10.1007/s10803-024-06381-8. [PMID: 38764071 DOI: 10.1007/s10803-024-06381-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/21/2024]
Abstract
PURPOSE Caregiving often presents challenges for parents, particularly for parents of loved ones with disabilities or health challenges, who need and/or want to be employed. This study describes the employment experiences of aging parents as they continue to balance engagement in the paid workforce with the ongoing provision of care for their adult children with autism spectrum disorder (ASD). The purpose of this study was to examine the lived experiences of parents of adult children with ASD in the context of balancing career and caregiving responsibilities. METHODS The current study uses a qualitative phenomenological research approach to describe the lived experiences of 51 parents who were caring for an adult child with ASD. The parents participated in telephone interviews to obtain information about their career experiences while providing care and support to their adult children with ASD. RESULTS Three caregiving themes emerged including: (a) difficulty balancing caregiving with work responsibilities, (b) reasons for working, not working, or working intermittently, and (c) work as an escape or wanting to work more. CONCLUSION As more individuals with ASD reach adulthood, often relying to varying extents on their families for daily support, parental employment will continue to be impacted as they juggle their career with caregiving responsibilities. Economically, one or more family members typically need to work to sustain the family's needs and employment support should be considered. As a society, families often need to make choices even with an adult child with ASD of who will work, how, and when.
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Affiliation(s)
- Christina N Marsack-Topolewski
- School of Social Work, Eastern Michigan University, 206H Everett L. Marshall Building, Ypsilanti, Ypsilanti, MI, 48197, USA.
| | - Preethy S Samuel
- College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Avenue, Detroit, MI, 48201, USA
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7
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Chan DV, Doran JD. Mental health counseling is rated as most helpful by autistic adults: Service perspectives in adulthood. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1190-1202. [PMID: 37679948 PMCID: PMC10918044 DOI: 10.1177/13623613231197446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
LAY ABSTRACT The number of autistic adults is growing, but there are fewer services to support them in adulthood. Many autistic adults need some support services to lead successful adult lives. We know a lot about the services autistic adults use and some of the problems with using these services, but we do not know which services are most helpful to them and how the services they use relate to how they interact with their communities. Forty autistic adults took part in a study about service use and community participation. They completed surveys, interviews, and carried a global positioning system tracker. They answered questions about which services are most helpful in adulthood, things that make it hard to use services, and what services they needed. Most participants used two services in the past 2 years, most frequently mental health and employment services. Adults who were currently seeing a mental health counselor were more likely to be working full-time and visit more locations in the community compared to those who were not seeing a counselor. Mental health services were reported as the most helpful service they received as adults, followed by employment services. We often focus on the importance of employment services after high school, but our findings show a need for both mental health and employment services for autistic adults.
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Affiliation(s)
- Dara V Chan
- University of North Carolina at Chapel Hill, USA
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Tsai JM, Bhat AN. Demographic differences in access to health/therapeutic services over first year of the pandemic: a SPARK COVID-19 impact survey analysis. FRONTIERS IN HEALTH SERVICES 2024; 4:1343636. [PMID: 38745995 PMCID: PMC11091302 DOI: 10.3389/frhs.2024.1343636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/09/2024] [Indexed: 05/16/2024]
Abstract
Introduction This analysis examined changes in services received and service recovery one-year post-pandemic compared to pre-pandemic levels in children with ASD aged between 19 months and 17 years in various subgroups based on factors such as age, income, race/ethnicity, geographic location, and sex. Methods An online, parent report survey was completed by the parents of children with ASD in the SPARK study cohort (N = 6,393). Descriptive statistics, chi-square analyses, and Spearman correlations were performed to study associations between various factors and service access, pre-pandemic and one-year, post-pandemic. Results One year after pandemic, the lag in service recovery in children with ASD was greatest for PT/OT services followed by SLT. ABA services only recovered in half of the subgroups. In contrast, SES fully recovered and MH and MED services superseded pre-pandemic levels. Across majority of the timepoints, younger children received more SLT, PT/OT, and ABA services whereas older children received more SES, MH, and MED services. Higher income families accessed more SES, SLT, and ABA whereas lower income families received more MH services. White families received less SLT compared to non-white families. Hispanic families received more SLT services compared to non-Hispanic families. Compared to rural families, urban families received more ABA services at baseline which also recovered one year after the pandemic. Certain counterintuitive findings may be attributed to home/remote schooling leading to reduced access to related services. Conclusions Future research and policy changes are needed to address the American healthcare vulnerabilities when serving children with ASD by enhancing the diversity of healthcare formats for continued service access during future pandemics and other similar crises.
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Affiliation(s)
- J.-M. Tsai
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States
| | - A. N. Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States
- Biomechanics & Movement Science Program, University of Delaware, Newark, DE, United States
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, United States
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9
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Adams D. Brief Report: Single-Session Interventions for Mental Health Challenges in Autistic People: An (Almost) Empty Systematic Review. J Autism Dev Disord 2024:10.1007/s10803-024-06313-6. [PMID: 38605188 DOI: 10.1007/s10803-024-06313-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 04/13/2024]
Abstract
Single-session interventions (specific, structured programs that intentionally involve just one visit or encounter with a clinic, provider, or program) have been proven to prevent or reduce mental health challenges and reduce barriers to access. This review aimed to identify and synthesise literature on the acceptability, feasibility, effectiveness, or efficacy of (non-pharmacological) single-session interventions for autistic people. Four databases (Scopus, MEDLINE, PsycINFO, and ProQuest) were searched in 12.7.2023, with no date restrictions. Search terms were selected to identify articles reporting on single-session interventions in autistic people. Two raters screened titles/abstracts of 286 articles and full text of 17 articles, resulting in just two included articles, reporting on 46 participants. Risk of bias was assessed with the Quality Assessment with Diverse Studies (QuADS). The two included papers report on specific techniques taught within a single visit to a clinic using pre- and immediate post-intervention questionnaires. One study also reported on cortisol levels pre and post. Neither study reported on acceptability or feasibility of single-session interventions. However, there was insufficient quality evidence to evaluate the effectiveness or efficacy of single-session interventions for autistic people. Although there is substantial research on single-session interventions in the broader population, there is a lack of research into such approaches for autistic people. This is a missed opportunity to evaluate a potential means of support for those at elevated risk of mental health challenges and unmet mental health service need. Future research should co-produce and co-evaluate such approaches as a priority.
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Affiliation(s)
- Dawn Adams
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD, 4122, Australia.
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD, 4122, Australia.
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Newell V, Townsend E, Richards C, Cassidy S. Measurement properties of tools used to assess self-harm in autistic and general population adults. Clin Psychol Rev 2024; 109:102412. [PMID: 38503029 DOI: 10.1016/j.cpr.2024.102412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/29/2024] [Accepted: 03/08/2024] [Indexed: 03/21/2024]
Abstract
Autistic people are at increased risk of experiencing self-harm compared to the general population. However, it is unclear which tools are being used to assess self-harm in autistic people, or whether existing tools need to be adapted for this group. This two-stage systematic review aimed to identify tools used to assess self-harm in autistic and general population adults, evaluate these tools on their measurement properties, and make recommendations for their appropriate use in research and clinical practice. Four databases were systematically searched (PsycINFO, Embase, MEDLINE and Web of Science). Eight frequently used self-harm assessment tools were identified and assessed for risk of bias, criteria for good measurement properties, and quality of evidence using the COSMIN checklist. Of these, two tools had sufficient evidence of internal consistency (ISAS, QNSSI), and one had been frequently used with autistic adults (NSSI-AT). These three tools may have potential for use with autistic adults but require further investigation for content validity and measurement properties in the autistic population. More research and potential adaptations to current self-harm assessment tools are recommended in order to better conceptualise and understand self-harm and its measurement in autism.
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Affiliation(s)
- Victoria Newell
- School of Psychology, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom.
| | - Ellen Townsend
- School of Psychology, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
| | - Caroline Richards
- School of Psychology, University of Birmingham, 52 Pritchatts Road, Birmingham B15 2TT, United Kingdom
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
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Carey ME, Ardeleanu K, Marcus SC, Tao S, Mandell D, Epstein AJ, Shea LL. Short report on navigating access to care for Medicaid-enrolled autistic youth and young adults: Examining accrual of intellectual disability diagnoses in adolescence. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:780-785. [PMID: 37272053 PMCID: PMC10696126 DOI: 10.1177/13623613231177559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
LAY ABSTRACT What is known? In most states, Medicaid waivers provide individuals with an intellectual disability diagnosis generous healthcare coverage throughout adulthood. By comparison, fewer Medicaid programs are available for autistic individuals, and they are more likely to experience disruptions, or gaps, in Medicaid coverage and subsequently not re-enroll.What this paper adds? One in five autistic individuals with Medicaid coverage between ages 8 and 25 accrued a new intellectual disability diagnosis. The probability of a new intellectual disability diagnosis was higher among those who had previous disruptions in Medicaid coverage.Implications for research and policy. Expanding Medicaid to cover autistic people of all ages could decrease the need for intellectual disability diagnosis accrual. Input from autistic individuals and their families regarding their health insurance access and healthcare experiences is critically important to understanding next steps for research.
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Affiliation(s)
| | | | | | - Sha Tao
- Drexel University, Philadelphia, PA, USA
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Shea LL, Wong MY, Song W, Kaplan K, Uppal D, Salzer MS. Autistic-Delivered Peer Support: A Feasibility Study. J Autism Dev Disord 2024; 54:409-422. [PMID: 36369602 PMCID: PMC9652131 DOI: 10.1007/s10803-022-05816-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2022] [Indexed: 11/13/2022]
Abstract
Peer support has been an undeveloped pathway for filling the service gap and to generate employment opportunities for autistic individuals. Peer supports have been deployed widely in mental health and among veterans and understanding the utility of this service modality among autistic individuals illuminates opportunities for research, policy, and practice. This study examined characteristics of participants in an autistic-delivered peer support program and reports on use of and satisfaction with the program. Half of autistic participants had a co-occurring mental health diagnosis. Participants reported multiple areas of unmet needs and participant satisfaction with the program was high (90%). The findings of this study point toward autistic-delivered peer support as a promising avenue for future development.
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Affiliation(s)
- Lindsay L Shea
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA.
| | - Mi-Yeet Wong
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
| | - Wei Song
- College of Public Health, Temple University, 1101 W Montgomery Avenue, Philadelphia, PA, 19122, USA
| | - Katy Kaplan
- Community Behavioral Health, 801 Market St, Philadelphia, PA, 19107, USA
| | - Disha Uppal
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
| | - Mark S Salzer
- College of Public Health, Temple University, 1101 W Montgomery Avenue, Philadelphia, PA, 19122, USA
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Li H, Dodd-Butera T, Beaman ML, Burtea R. Immediate Caregiving Environment of Young Children with Autism: Findings from the U.S. National Survey of Children's Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:12. [PMID: 38276800 PMCID: PMC10815337 DOI: 10.3390/ijerph21010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024]
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental disability that negatively affects children's learning, motor behavior, social communication, and interaction. It was estimated that, in 2020, 1 in 36 children aged 8 years in the United States had ASD. Caring for children with ASD might exert significant psychological and emotional distress on parents. Receiving parental emotional support and fostering positive parent-child interactions at home have been identified as beneficial for the immediate caregiving environment for children with ASD. The current secondary analysis of the 2019-2020 National Survey of Children's Health examined parent-child interactions and accessible sources of emotional support for parents caring for 3-5-year-old children diagnosed with ASD (N = 243). Children with the following characteristics had higher odds of having ASD: male gender; having no private insurance or uninsured; and having less than excellent general health. Among parents, higher odds of caring for children with ASD were associated with accessing emotional support from various sources, especially from healthcare professionals and peers, and spending more time telling stories and/or singing to their children. Given these significant health disparities, educational interventions and strategies are needed to foster a positive home caregiving environment for young children with ASD, including equitable access to parent resources.
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Affiliation(s)
- Hong Li
- Department of Doctoral Studies, Institute of Health Research, School of Nursing, Azusa Pacific University, 606 E Huntington Dr., Room 235, Monrovia, CA 91016, USA
| | - Teresa Dodd-Butera
- Departments of Public Health and Doctoral Studies, Institute of Health Research, School of Nursing, Azusa Pacific University, San Diego, CA 92108, USA;
| | - Margaret L. Beaman
- Department of Nursing, California State University, San Bernardino, CA 92407, USA
| | - Rebecca Burtea
- Department of Mathematics, Physics, and Statistics, Azusa Pacific University, Azusa, CA 91702, USA;
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Long KA, LaRochelle J, Gordillo M, Pariseau EM, DeCelle MG, Orsmond G. Siblings FORWARD: Development of a New Program to Engage Siblings of Autistic Adults in Future Planning. J Autism Dev Disord 2023:10.1007/s10803-023-06178-1. [PMID: 38117420 DOI: 10.1007/s10803-023-06178-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/21/2023]
Abstract
The adult service system does not adequately meet the needs of autistic adults, prompting families to continue their supportive roles. Siblings frequently assume these roles when parents are no longer able to do so, often without preparation or planning. We received feedback on the proposed Siblings FORWARD (Focusing on Relationships, Well-being, and Responsibility aheaD) program concept, which would involve 6-7 individualized sessions over ~ 3 months and would facilitate siblings' proactive future planning involvement with their autistic family member. Siblings FORWARD would bolster siblings' skills, knowledge, and self-efficacy to engage in future planning with their family members. We report on perceived need for a sibling program and feedback on the proposed program goals, content, and design. Adult siblings (n = 13), autistic adults (n = 6), and service providers (n = 17) participated in individual interviews or focus groups. Data were systematically coded and analyzed using directed content analysis. Siblings, autistic adults, and service providers expressed high enthusiasm for the Siblings FORWARD concept. Participants indicated that the combination of skill-building and education would promote continued, collaborative future planning that persists after the formal program ends. They had positive impressions of the program concept, goals, content, and design, including the telehealth delivery model. Siblings and autistic adults reported wanting to participate in Siblings FORWARD. This uniform, strong enthusiasm for the Siblings FORWARD concept warrants moving forward to examine preliminary acceptability and feasibility. Ultimately, greater sibling involvement in family future planning may improve autistic adults' functioning through improved continuity of care and support across adulthood.
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Affiliation(s)
- Kristin A Long
- Department of Psychological & Brain Sciences, Program in Clinical Psychology, Boston University, 900 Commonwealth Ave., Second Floor, Boston, MA, USA.
| | - Jade LaRochelle
- Department of Occupational Therapy, Boston University, Boston, MA, USA
- Newton Wellesley Hospital, Newton, MA, USA
| | - Monica Gordillo
- Department of Psychological & Brain Sciences, Program in Clinical Psychology, Boston University, 900 Commonwealth Ave., Second Floor, Boston, MA, USA
- Nemours Children's Health, Delaware, Wilmington, DE, USA
| | - Emily M Pariseau
- Department of Psychological & Brain Sciences, Program in Clinical Psychology, Boston University, 900 Commonwealth Ave., Second Floor, Boston, MA, USA
- Nemours Children's Health, Delaware, Wilmington, DE, USA
| | - Melissa G DeCelle
- Department of Occupational Therapy, Boston University, Boston, MA, USA
- Boston Children's Hospital, Boston, MA, USA
| | - Gael Orsmond
- Department of Occupational Therapy, Boston University, Boston, MA, USA
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15
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Corbett BA, Key AP, Klemencic ME, Muscatello RA, Jones D, Pilkington J, Burroughs C, Vandekar S. Investigating Social Competence in a Pilot Randomized Clinical Trial of a Theatre-Based Intervention Enhanced for Adults with Autism Spectrum Disorder. J Autism Dev Disord 2023:10.1007/s10803-023-06214-0. [PMID: 38109034 PMCID: PMC11182891 DOI: 10.1007/s10803-023-06214-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
Autism spectrum disorder (ASD) is characterized by challenges in social competence that persist in adulthood, yet few treatment options exist. A pilot randomized clinical trial (RCT) of a peer-mediated, theatre-based intervention with established efficacy in youth with ASD was examined in autistic adults. The final sample consisted of forty-seven 18-to-40-year-old participants randomized to the experimental (EXP N = 23) or waitlist control (WLC N = 24) condition. A multimodal, social interdependent model was employed to examine social competence changes in brain (incidental face memory (IFM) using event-related potentials), cognition (Wechsler Memory Scale-III), behavior (Contextual Assessment of Social Skills) and function (Social Responsiveness Scale (SRS); Adaptive Behavior Assessment Scale (ABAS) Social Composite). Using analysis of covariance in which pretest was controlled in the model, posttest between-group differences were observed on IFM (p = 0.016, η2 = 0.139, d = 0.79) and several social and adaptive functional (SRS, ABAS) outcomes in social communication and interaction (SCI) (p = 0.019, η2 = 0.121, d = -00.45), communication (p = 0.044 η2 = 0.09, d = -00.31), and motivation (p = 0.001, η2 = 0.229, d = -0.79) domains. At two-month follow-up, gains in social motivation remained (p = 0.041, η2 = 0.100, d = -0.77). The results offer preliminary support for a unique theatre-based social skills intervention for autistic adults who have few treatment options to enhance social competence. The trial was pre-registered with ClinicalTrials.gov (Identifier: NCT04349644).
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA.
- Department of Psychology, Vanderbilt University, Nashville, TN, USA.
| | - Alexandra P Key
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mark E Klemencic
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rachael A Muscatello
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA
| | - Dorita Jones
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA
| | - Jennifer Pilkington
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christina Burroughs
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
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16
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Hughes MM, Shaw KA, DiRienzo M, Durkin MS, Esler A, Hall-Lande J, Wiggins L, Zahorodny W, Singer A, Maenner MJ. The Prevalence and Characteristics of Children With Profound Autism, 15 Sites, United States, 2000-2016. Public Health Rep 2023; 138:971-980. [PMID: 37074176 PMCID: PMC10576490 DOI: 10.1177/00333549231163551] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
OBJECTIVES Autism spectrum disorder (autism) is a heterogeneous condition that poses challenges in describing the needs of individuals with autism and making prognoses about future outcomes. We applied a newly proposed definition of profound autism to surveillance data to estimate the percentage of children with autism who have profound autism and describe their sociodemographic and clinical characteristics. METHODS We analyzed population-based surveillance data from the Autism and Developmental Disabilities Monitoring Network for 20 135 children aged 8 years with autism during 2000-2016. Children were classified as having profound autism if they were nonverbal, were minimally verbal, or had an intelligence quotient <50. RESULTS The percentage of 8-year-old children with profound autism among those with autism was 26.7%. Compared with children with non-profound autism, children with profound autism were more likely to be female, from racial and ethnic minority groups, of low socioeconomic status, born preterm or with low birth weight; have self-injurious behaviors; have seizure disorders; and have lower adaptive scores. In 2016, the prevalence of profound autism was 4.6 per 1000 8-year-olds. The prevalence ratio (PR) of profound autism was higher among non-Hispanic Asian/Native Hawaiian/Other Pacific Islander (PR = 1.55; 95 CI, 1.38-1.73), non-Hispanic Black (PR = 1.76; 95% CI, 1.67-1.86), and Hispanic (PR = 1.50; 95% CI, 0.88-1.26) children than among non-Hispanic White children. CONCLUSIONS As the population of children with autism continues to change, describing and quantifying the population with profound autism is important for planning. Policies and programs could consider the needs of people with profound autism across the life span to ensure their needs are met.
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Affiliation(s)
- Michelle M. Hughes
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Commissioned Corps, US Public Health Service, Rockville, MD, USA
| | - Kelly A. Shaw
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Commissioned Corps, US Public Health Service, Rockville, MD, USA
| | - Monica DiRienzo
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Maureen S. Durkin
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Amy Esler
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Jennifer Hall-Lande
- College of Education and Human Development, University of Minnesota, Minneapolis, MN, USA
| | - Lisa Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Walter Zahorodny
- Pediatrics Department, Rutgers New Jersey Medical School, Newark, NJ, USA
| | | | - Matthew J. Maenner
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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17
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Ljungberg M, Schön UK. Who cares? A scoping review about the experiences of parental caregivers of autistic adults. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:929-939. [PMID: 37264729 DOI: 10.1111/jar.13126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND The autistic population is growing and ageing and this also applies to the parents. Despite this, research about parental experiences is still relatively scarce. Even though studies show, compared with adults with other disabilities, parents of autistic adolescents and adults report a decrease in well-being and that caregiving is often a lifelong commitment. METHOD This scoping review maps, synthesises and identifies gaps in previous research as regards the experiences of parental caregivers of adult autistic children. The review was based on Arksey and Malley's framework and six databases were searched. RESULTS The results show how the research has focused on the well-being and consequences of daily caregiving for an American middle-class mother who co-resides with an adult son. CONCLUSION To enhance knowledge about formal services and service needs, more research is necessary on different welfare regimes and social contexts.
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Affiliation(s)
- Malin Ljungberg
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Ulla-Karin Schön
- Department of Social Work, Stockholm University, Stockholm, Sweden
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18
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Hughes MM, Shaw KA, Patrick ME, DiRienzo M, Bakian AV, Bilder DA, Durkin MS, Hudson A, Spivey MH, DaWalt LS, Salinas A, Schwenk YD, Lopez M, Baroud TM, Maenner MJ. Adolescents With Autism Spectrum Disorder: Diagnostic Patterns, Co-occurring Conditions, and Transition Planning. J Adolesc Health 2023; 73:271-278. [PMID: 36849336 PMCID: PMC10450089 DOI: 10.1016/j.jadohealth.2022.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/14/2022] [Accepted: 12/18/2022] [Indexed: 03/01/2023]
Abstract
PURPOSE The objectives of this study were to describe child characteristics associated with later autism spectrum disorder (ASD) identification and the health status and educational transition plans of adolescents with ASD. METHODS Longitudinal population-based surveillance cohort from the Autism Developmental Disabilities Monitoring Network during 2002-2018 in five catchment areas in the United States. Participants included 3,148 children born in 2002 whose records were first reviewed for ASD surveillance in 2010. RESULTS Of the 1,846 children identified in the community as an ASD case, 11.6% were first identified after age 8 years. Children who were more likely to have ASD identified at older ages were Hispanic; were born with low birth weight; were verbal; had high intelligence quotient or adaptive scores; or had certain co-occurring neuropsychological conditions by age 8 years. By age 16 years, neuropsychological conditions were common with more than half of the adolescents with ASD having a diagnosis of attention-deficit/hyperactivity disorder or anxiety. Intellectual disability (ID) status was unchanged for the majority (>80%) of children from ages 8-16 years. A transition plan was completed for over 94% of adolescents, but disparities were observed in planning by ID status. DISCUSSION A high percentage of adolescents with ASD have co-occurring neuropsychological conditions, markedly higher than at age 8. While most adolescents had transition planning, this occurred less often for those with ID. Ensuring access to services for all people with ASD during adolescence and transition to adulthood may help to promote overall health and quality of life.
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Affiliation(s)
- Michelle M Hughes
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Kelly A Shaw
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary E Patrick
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Monica DiRienzo
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Maureen S Durkin
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin
| | - Allison Hudson
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - Leann S DaWalt
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin
| | - Angelica Salinas
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin
| | - Yvette D Schwenk
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Maya Lopez
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Thaer M Baroud
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Matthew J Maenner
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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19
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Hughes MM, Kirby AV, Davis J, Bilder DA, Patrick M, Lopez M, DaWalt LS, Pas ET, Bakian AV, Shaw KA, DiRienzo M, Hudson A, Schwenk YD, Baroud TM, Washington A, Maenner MJ. Individualized Education Programs and Transition Planning for Adolescents With Autism. Pediatrics 2023; 152:e2022060199. [PMID: 37345494 PMCID: PMC10911052 DOI: 10.1542/peds.2022-060199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 06/23/2023] Open
Abstract
OBJECTIVES The study objectives were to examine the contents of individualized education programs (IEPs) of adolescents with autism spectrum disorder (ASD), including postsecondary transition goals, services, and changes in special education classification over time. METHODS This study involved a longitudinal population-based surveillance cohort from the Autism Developmental Disabilities Monitoring Network from 2002 to 2018 in 3 catchment areas in the United States. The sample included 322 adolescents who were born in 2002, identified with ASD, and had an IEP available for review at ages 15-16 years. RESULTS We found that 297 (92%) adolescents with ASD had an IEP including a transition plan. Those without intellectual disability (ID) were more likely to have postsecondary education and employment goals and have those goals be to pursue higher education or competitive employment compared with those with ID. Forty-one percent of adolescents with ASD had a postsecondary living arrangement goal. Although 28% of adolescents with ASD received school-based mental health services, none of these adolescents were Black; additionally, 15% of those with ID received mental health services compared with 34% without ID. The percentage of adolescents with ASD served under an autism classification increased from 44% at age 8 years to 62% by age 16. CONCLUSIONS We identified gaps and disparities in school-based postsecondary transition planning. Working with education partners, families, and adolescents will be important to identify what challenges contribute to these findings and what supports are needed to improve the equity and quality of the transition planning process for adolescents with ASD so they are prepared for adulthood.
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Affiliation(s)
- Michelle M. Hughes
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - John Davis
- University of Texas at San Antonio, San Antonio, Texas
| | | | - Mary Patrick
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maya Lopez
- University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - Elise T. Pas
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Kelly A. Shaw
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Monica DiRienzo
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Allison Hudson
- University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - Thaer M. Baroud
- University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Anita Washington
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Matthew J. Maenner
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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20
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DeVries L, Dempsey J, Wilson R. Improving Access to Diagnostic Evaluations for Developmental Disabilities Through an Initial Assessment Model. J Dev Behav Pediatr 2023; 44:e345-e349. [PMID: 37099646 DOI: 10.1097/dbp.0000000000001190] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 03/20/2023] [Indexed: 04/28/2023]
Abstract
OBJECTIVE This study aimed to evaluate a novel model of care to improve access to diagnostic evaluations for autism spectrum disorder and/or developmental delays for school-age children. METHODS An "initial assessment" (IA) model for children aged 7 to 9 years was implemented at a large regional pediatric hospital. Referral patterns and the number of patients evaluated with the IA model were obtained through the electronic health record (EHR). Referral patterns from the EHR were checked against clinician surveys. RESULTS Total IA volume had a strong negative association with school-age WL volume ( r (22) = -0.92, p < 0.001), indicating that as IA volume increased, the WL volume declined. Evaluation of referral patterns after IAs revealed that approximately 1 in 3 children seen for IA did not require further evaluation and could be immediately removed from the WL. CONCLUSION Results indicate that implementation of a novel IA model was strongly associated with a decrease in WL volume for neurodevelopmental evaluations of school-age children. These findings support a "right-fit" approach to optimize clinical resources and improve access to neurodevelopmental evaluations.
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Affiliation(s)
- Lindsey DeVries
- Division of Developmental and Behavioral Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Center, Aurora, CO
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21
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Hotez E, Rava JA, Shea L, Kuo A. Developing "Adulting for Health": Investigating the Health Needs of Neurodivergent Emerging Adults. Cureus 2023; 15:e41102. [PMID: 37519609 PMCID: PMC10375927 DOI: 10.7759/cureus.41102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/24/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION Neurodivergent emerging adults - defined as individuals between the ages of 18 and 30 with intellectual and/or developmental disabilities (e.g., attention-deficit hyperactivity disorder (ADHD), autism, cerebral palsy, learning disabilities, seizures, developmental delays, with or without intellectual impairment) and physical and/or sensory disabilities (e.g., blindness or hearing impairment) - experience poor mental and physical health outcomes. Existing interventions are insufficient because they are not based on the self-reported and developmental needs of this population. METHODS The current study is an exploratory pilot study that features a multidimensional health-based needs assessment of self-identified neurodivergent emerging adults with ADHD, learning disabilities, autism, and other conditions, mean (M) age = 22.8; standard deviation (SD) = 3.4; n = 26). This research used validated measures. The assessment - administered via Qualtrics to the participants in two sites - included the Mental Health Continuum-Short Form, Kessler-6 Psychological Distress Scale, Project EAT (Eating and Activity over Time)-IV (with the intuitive eating, weight-related control, emotional eating, and physical activity subscales), and an original health-focused needs assessment developed by interdisciplinary healthcare professionals and neurodivergent individuals. RESULTS The sample reported low positive mental health, with only 3% reportedly "flourishing." The sample also reported high psychological distress according to clinical and psychometric cut-off scores; varied intuitive eating and weight-control behaviors and attitudes; and distinct needs related to integrating the principles of health promotion into daily life, navigating the healthcare system, and learning from healthcare professionals. Based on these findings, we present an initial conceptualization of "Adulting for Health," a potential virtual education program to promote health-related knowledge and capacities for this population. CONCLUSIONS The results from this exploratory pilot study can be incorporated into existing programs and spur efforts to develop and test new interventions that can ameliorate health disparities for neurodivergent emerging adults.
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Affiliation(s)
- Emily Hotez
- General Internal Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA
| | - Julianna A Rava
- Public Health, University of California Los Angeles Fielding School of Public Health, Los Angeles, USA
| | - Lindsay Shea
- Health Policy, Drexel University AJ Drexel Autism Institute, Philadelphia, USA
| | - Alice Kuo
- Division of Medicine-Pediatrics, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA
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22
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Marquis S, Lunsky Y, McGrail KM, Baumbusch J. Population level administrative data evidence of visits to the emergency department by youth with intellectual/developmental disabilities in BC, Canada. Am J Emerg Med 2023; 69:52-57. [PMID: 37058981 DOI: 10.1016/j.ajem.2023.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 04/16/2023] Open
Abstract
INTRODUCTION The literature indicates that youth with intellectual/developmental disabilities (IDD) have poor health and that access to health services decreases as they transition from pediatric to adult services. At the same time their use of emergency department services increases. The objective of this study was to compare use of emergency department services by youth with IDD to youth without IDD, with particular emphasis on the transition period from pediatric to adult health care services. METHODS This research used a population level administrative health data base for the province of British Columbia Canada for 2010-2019 to examine the use of emergency departments by youth with IDD (N = 20,591) compared to a population group of youth without IDD (N = 1,293,791). Using the ten years of data, odds ratios for visits to the emergency department were calculated adjusting for sex, income and geographical area within the Province. In addition, difference-in-differences analyses were calculated for age matched subsets of the two cohorts. RESULTS Over the ten year period, 40.60% of youth with IDD visited an emergency department at least once, compared to 29.10% of youth without IDD. Youth with IDD had an odds ratio of visiting an emergency department 1.697 (1.649, 1.747) times that of youth without IDD. However, when odds were adjusted for a diagnosis of either psychotic illness or anxiety/depression, the odds for youth with IDD visiting emergency compared to youth without IDD were reduced to 1.063 (1.031, 1.096). Use of emergency services increased as youth aged. Type of IDD also affected use of emergency services. Youth with Fetal Alcohol Syndrome had the greatest odds of using emergency services compared to youth with other types of IDD. DISCUSSION The findings from this study indicate that youth with IDD have higher odds of using emergency services than youth without IDD although these increased odds appear to be largely driven by mental illness. In addition, use of emergency services increases as the youth age and transition from pediatric to adult health services. Better treatment of mental health issues within this population may reduce their use of emergency services.
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Affiliation(s)
- Sandra Marquis
- School of Nursing University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, CAMH, 1025 Queen St West, Toronto, ONT M6J 1H4, Canada.
| | - Kimberlyn M McGrail
- Centre for Health Services and Policy Research, The University of British Columbia, 201-2206 East Mall, Vancouver, BC V6T 1Z3, Canada.
| | - Jennifer Baumbusch
- School of Nursing University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.
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23
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Donnelly LJ, Cervantes PE, Guo F, Stein CR, Okparaeke E, Kuriakose S, Filton B, Havens J, Horwitz SM. Changes in Attitudes and Knowledge after Trainings in a Clinical Care Pathway for Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:606-614. [PMID: 33201422 DOI: 10.1007/s10803-020-04775-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 12/12/2022]
Abstract
Caring for individuals with autism spectrum disorder (ASD) can be complicated, especially when challenging behaviors are present. Providers may feel unprepared to work with these individuals because specialized training for medical and social service providers is limited. To increase access to specialized training, we modified an effective half-day ASD-Care Pathway training (Kuriakose et al. 2018) and disseminated it within five different settings. This short, focused training on strategies for preventing and reducing challenging behaviors of patients with ASD resulted in significant improvements in staff perceptions of challenging behaviors, increased comfort in working with the ASD population, and increased staff knowledge for evidence-informed practices. Implications, including the impact of sociodemographic characteristics on pre/post changes, and future directions are discussed.
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Affiliation(s)
- Lauren J Donnelly
- Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone, New York, NY, 10016, USA.
| | - Paige E Cervantes
- Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone, New York, NY, 10016, USA
| | - Fei Guo
- Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone, New York, NY, 10016, USA
- Division of Biostatistics, Department of Population Heath, NYU Langone, New York, NY, USA
| | - Cheryl R Stein
- Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone, New York, NY, 10016, USA
| | - Eugene Okparaeke
- Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone, New York, NY, 10016, USA
- Child and Adolescent Psychiatry, Bellevue Hospital Center, New York, NY, USA
| | - Sarah Kuriakose
- Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone, New York, NY, 10016, USA
- New York State Office of Mental Health, Albany, NY, USA
| | - Beryl Filton
- Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone, New York, NY, 10016, USA
- Child and Adolescent Psychiatry, Bellevue Hospital Center, New York, NY, USA
| | - Jennifer Havens
- Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone, New York, NY, 10016, USA
- Office of Behavioral Health, NYC Health and Hospitals, New York, NY, USA
| | - Sarah M Horwitz
- Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone, New York, NY, 10016, USA
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24
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Berg KA, Ishler KJ, Lytle S, Kaplan R, Wang F, Olgac T, Miner S, Edguer MN, Biegel DE. "Don't Promise Something You can't Deliver:" Caregivers' Advice for Improving Services to Adolescents and Young Adults with Autism. AUTISM RESEARCH AND TREATMENT 2023; 2023:6597554. [PMID: 36998713 PMCID: PMC10049841 DOI: 10.1155/2023/6597554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 02/01/2023] [Accepted: 02/14/2023] [Indexed: 04/01/2023]
Abstract
Approximately 50,000 youths with autism spectrum disorders (ASD) exit U.S. high schools yearly to enter adult systems of care, many of whom remain dependent on family for day-to-day care and service system navigation. As part of a larger study, 174 family caregivers for adolescents or young adults with ASD were asked what advice they would give service providers about how to improve services for youth with ASD. Reflexive thematic analysis identified a framework of five directives: (1) provide a roadmap to services; (2) improve service access; (3) fill gaps to address unmet needs; (4) educate themselves, their families, and society about autism; and (5) operate from a relationship-building paradigm with families. Education, health, and social service providers, as well as policymakers, can use these directives to better assist youth with ASD and their families in the transition to adulthood.
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Affiliation(s)
- Kristen A. Berg
- 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
- 2Center for Health Care Research and Policy, The MetroHealth System, 2500 MetroHealth Dr, Cleveland, OH 44109, USA
| | - Karen J. Ishler
- 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
| | - Sarah Lytle
- 3University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, USA
| | - Ronna Kaplan
- 4Cleveland State University, College of Health, 2121 Euclid Ave, Cleveland, OH 44115, USA
| | - Fei Wang
- 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
| | - Tugba Olgac
- 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
| | - Stacy Miner
- 3University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, USA
- 5Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
| | - Marjorie N. Edguer
- 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
| | - David E. Biegel
- 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
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Gonzalez M, Zeidan J, Lai J, Yusuf A, Wright N, Steiman M, Karpur A, Shih A, Elsabbagh M, Shikako K. Socio-demographic disparities in receipt of clinical health care services during the COVID-19 pandemic for Canadian children with disability. BMC Health Serv Res 2022; 22:1434. [PMID: 36443767 PMCID: PMC9706900 DOI: 10.1186/s12913-022-08672-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 10/04/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Little is known about the experience of receiving in-person and virtual clinical health care services during the COVID-19 pandemic for Canadian children with developmental disabilities and delays facing multiple layers of vulnerability (e.g., low income, low educational attainment families). We examined the relationship between socio-demographic factors and the receipt of these services (physical and mental health services) during COVID-19 for Canadian children with these conditions. METHODS Data collected in Canada for the Global Report on Developmental Delays, Disorders and Disabilities were used. The survey: (1) was developed and disseminated in collaboration with caregivers of children with disabilities, (2) included topics such as response to the pandemic and receipt of services and supports, and (3) documented the experiences of a non-random convenience sample of caregivers of children (any age) with these conditions during and prior to the pandemic. We used four logistic regression models to assess the association between socio-demographic factors and receipt of services. RESULTS Being a single parent, having low educational attainment (high school or less), having low income (making less than $40,000 per year), working less than full time (working part-time, working reduced hours due to COVID, retired, stay home parent or student), as well as male gender and older age of the child with disability were factors associated with decreased likelihood of receiving services. CONCLUSION Our findings point to the need for tailoring services for families of children with disabilities, particularly low socioeconomic status families, to ensure continuity of care during public health emergencies.
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Affiliation(s)
- Miriam Gonzalez
- Faculty of Medicine, Montreal Neurological Institute-Hospital, McGill University, Rue University, 3775, H3A 2B4, Montréal, Canada. .,Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, H4A 3J1, Montréal, Canada.
| | - Jinan Zeidan
- Faculty of Medicine, Montreal Neurological Institute-Hospital, McGill University, Rue University, 3775, H3A 2B4, Montréal, Canada
| | - Jonathan Lai
- Autism Alliance of Canada, 1111-23 Sheppard Ave E, M2N OC8, Toronto, ON, Canada
| | - Afiqah Yusuf
- Faculty of Medicine, Montreal Neurological Institute-Hospital, McGill University, Rue University, 3775, H3A 2B4, Montréal, Canada.,Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, H4A 3J1, Montréal, Canada
| | - Nicola Wright
- Department of Biostatistics and Health Informatics, King's College London, WC2R 2LS, London, UK
| | - Mandy Steiman
- Faculty of Medicine, Montreal Neurological Institute-Hospital, McGill University, Rue University, 3775, H3A 2B4, Montréal, Canada.,Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, H4A 3J1, Montréal, Canada
| | - Arun Karpur
- Autism Speaks, 1060 State Rd #1446, 08540, Princeton, Princeton, NJ, NJ, USA
| | - Andy Shih
- Autism Speaks, New York 1 E 33rd St, 10016, New York, NY, USA
| | - Mayada Elsabbagh
- Faculty of Medicine, Montreal Neurological Institute-Hospital, McGill University, Rue University, 3775, H3A 2B4, Montréal, Canada.,Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, H4A 3J1, Montréal, Canada
| | - Keiko Shikako
- Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, H4A 3J1, Montréal, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montréal, Canada
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Aleman‐Tovar J, Burke MM, Monárrez E. Mexican–American
caregivers' perceptions of a
culturally adapted
transition planning program for youth with autism. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2022. [DOI: 10.1111/jppi.12442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Meghan M. Burke
- Department of Special Education University of Illinois Urbana‐Champaign Champaign Illinois USA
| | - Edwin Monárrez
- Department of Special Education University of Illinois Urbana‐Champaign Champaign Illinois USA
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Elliott T, Floyd James K, Coleman KJ, Skrine Jeffers K, Nau CL, Choi K. Cross-sectional Comparison of Disparities by Race Using White vs Hispanic as Reference Among Children and Youths With Developmental Disabilities Referred for Speech Therapy. JAMA Netw Open 2022; 5:e2234453. [PMID: 36194413 PMCID: PMC9533182 DOI: 10.1001/jamanetworkopen.2022.34453] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
IMPORTANCE Health care research on racial disparities among children and youths has historically used the White race as a reference category with which other racial and ethnic groups are compared, which may inadvertently set up Whiteness as a standard for health. OBJECTIVE To compare 2 interpretations of an analysis of racial disparities in speech therapy receipt among children and youths with developmental disabilities: a traditional, White-referenced analysis and a Hispanic majority-referenced analysis. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used multiple logistic regression to analyze speech therapy referrals for children, adolescents, and transition age youths in an integrated health care system in Southern California from 2017 to 2020. Eligible participants were children and youths up to age 26 years with 1 or more diagnosed intellectual or developmental disability (eg, autism spectrum disorder, speech or language delay, developmental delay, Down syndrome, and others). EXPOSURES Child or youth race and ethnicity as reported by parents or caregivers (Asian, Black and African American, Hispanic and Latinx, American Indian or Alaskan Native, Native Hawaiian or Pacific Islander, White, multiple, and other). MAIN OUTCOMES AND MEASURES Receipt of speech therapy within 1 year of referral. RESULTS A total 66 402 referrals were included; 65 833 referrals (99.1%) were for children under age 17 years, 47 323 (71.3%) were for boys, and 39 959 (60.2%) were commercially insured. A majority of participants were identified as Hispanic (36 705 [55.3%]); 6167 (9.3%) were identified as Asian, 4810 (7.2%) as Black, and 14 951 (22.5%) as White. In the traditional racial disparities model where the reference category was White, referrals of children and youths who identified as Hispanic, Black, Pacific Islander, and other had lower odds of actual receipt of speech therapy compared with referrals for White children and youths (Hispanic: OR, 0.79; 95% CI, 0.75-0.83; Black: OR, 0.72; 95% CI, 0.66-0.78; Pacific Islander: OR, 0.74; 95% CI, 0.57-0.98). When using the majority race group (Hispanic) as the reference category, referrals for children and youths who identified as White (OR, 1.26; 95% CI, 1.20-1.30), Asian (OR, 1.21; 95% CI, 1.12-1.30), and multiracial (OR, 1.35; 95% CI, 1.08-1.71) had higher odds of resulting in actual service receipt in comparison with referrals for Hispanic children and youths. CONCLUSIONS AND RELEVANCE The cross-sectional study demonstrates the value of decentering Whiteness in interpreting racial disparities research and considering racial differences against multiple referents. Racial disparities researchers should consider investigating multiple between-group differences instead of exclusively using White as the default reference category.
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Affiliation(s)
- Thomas Elliott
- Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Kortney Floyd James
- Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Karen J. Coleman
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena
- Southern California Permanente Medical Group, Kaiser Permanente Southern California, Pasadena
| | | | - Claudia L. Nau
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Kristen Choi
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena
- School of Nursing, University of California, Los Angeles
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles
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28
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Shea L, Tao S, Marcus SC, Mandell D, Epstein AJ. Medicaid Disruption Among Transition-Age Youth on the Autism Spectrum. Med Care Res Rev 2022; 79:525-534. [PMID: 34632834 PMCID: PMC10775849 DOI: 10.1177/10775587211051185] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Enrollment in Medicaid facilitates access to needed services among transition-age youth on the autism spectrum and youth with intellectual disability (ID). There are long-standing programs to ensure that individuals with ID remain enrolled as they age; similar programs for autistic youth are newer, not as widespread, and may not be as effective. We compared Medicaid disenrollment and re-enrollment between transition-age youth on the autism spectrum, youth with ID, and youth with both diagnoses using a national claims-based prospective cohort study from 2008 through 2012. Autistic youth were most likely to disenroll and least likely to re-enroll. Disenrollment peaked for all three groups at ages 19 and 21. Transition-age youth on the autism spectrum experience more disruptions in access to Medicaid-reimbursed services than youth with ID. More equitable Medicaid enrollment options for autistic individuals are needed to ensure their access to critical health care as they age.
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Affiliation(s)
| | - Sha Tao
- Drexel University, Philadelphia, PA, USA
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29
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Byrne K, Sterrett K, Elias R, Bal VH, McCauley JB, Lord C. Trajectories of Seizures, Medication Use, and Obesity Status into Early Adulthood in Autistic Individuals and Those with Other Neurodevelopmental Conditions. AUTISM IN ADULTHOOD 2022; 4:110-119. [PMID: 36605975 PMCID: PMC9242707 DOI: 10.1089/aut.2020.0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background Physical and psychiatric health conditions affect the lives of many autistic adults. However, relatively little is known about individual trajectories in autistic individuals' physical and mental health from adolescence to adulthood. Methods This study uses a well-characterized longitudinal sample (n = 253) to investigate rates of seizures, medication use, and obesity, from early adolescence (age 10 years) into adulthood (age 30 years). Within this sample, 196 participants were diagnosed with autism spectrum disorder (ASD), whereas the remaining 57 participants never received an ASD diagnosis, but, rather, were diagnosed with other neurodevelopmental conditions. Data were collected through parent report questionnaires and in-person interviews and assessments. Results Seizure onset continued well into adulthood, with two individuals experiencing their first seizure at the age of 25 years. Seizures and neuropsychiatric medication use were both higher for those with lower intelligence quotient (IQs). In addition, medication use increased over time for these individuals, whereas those with higher IQs saw a reduction in medication use with age. Between the ages of 15 to 30 years, the predicted probability of medication use increased from 82% to 88% for those with lower IQs and decreased from 37% to 13% for those with higher IQs. Collectively, almost 70% of all participants in this study were classified as either overweight or obese. Body mass index (BMI) increased throughout adulthood, especially for those with higher IQs. The steepest increase in BMI over time occurred for those with higher IQs who also took antipsychotic medications. Conclusion Overall, continued risk for developing seizures, high rates of neuropsychiatric medication use, and significant and increasing rates of obesity from adolescence to adulthood underscore the importance of monitoring health issues in autistic individuals and those diagnosed with other neurodevelopmental conditions throughout the lifespan.
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Affiliation(s)
- Katherine Byrne
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, USA.,Address correspondence to: Katherine Byrne, BA, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza 68-217, Los Angeles, CA 90024, USA
| | - Kyle Sterrett
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, USA
| | - Rebecca Elias
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, USA
| | - Vanessa H. Bal
- Graduate School of Applied and Professional Psychology, Rutgers University–New Brunswick, New Brunswick, New Jersey, USA
| | - James B. McCauley
- Department of Psychology, St. Mary's College of California, Moraga, California, USA
| | - Catherine Lord
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, USA
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30
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Stewart GR, Corbett A, Ballard C, Creese B, Aarsland D, Hampshire A, Charlton RA, Happé F. Self-harm and Suicidality Experiences of Middle-Age and Older Adults With vs. Without High Autistic Traits. J Autism Dev Disord 2022:10.1007/s10803-022-05595-y. [PMID: 35616817 DOI: 10.1007/s10803-022-05595-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
Suicide has been identified as a leading cause of premature death in autistic populations. Elevated autistic traits have also been associated with higher rates of self-harm, suicidal ideation, and suicidal self-harm in the general population, but this has yet to be examined in older age. Using baseline cross-sectional data from the PROTECT study, middle-age and older adults with high autistic traits (n = 276) had significantly higher rates of suicidal ideation, deliberate self-harm, and suicidal self-harm than an age/sex-matched comparison group (n = 10,495). These differences represented a 5- to 6-fold increase in likelihood for self-harming and suicidality. These findings, which remained when controlling for depression symptoms, suggest that middle-age and older adults with high autistic traits may be particularly at risk of self-harm and suicidal behaviours.
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Affiliation(s)
- Gavin R Stewart
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK.
| | - Anne Corbett
- College of Medicine and Health, University of Exeter, Exeter, EX1 2LU, UK
| | - Clive Ballard
- College of Medicine and Health, University of Exeter, Exeter, EX1 2LU, UK
| | - Byron Creese
- College of Medicine and Health, University of Exeter, Exeter, EX1 2LU, UK
| | - Dag Aarsland
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Adam Hampshire
- Department of Medicine, Imperial College London, London, SW7 2AZ, UK
| | - Rebecca A Charlton
- Department of Psychology, Goldsmiths University of London, London, SE14 6NW, UK
| | - Francesca Happé
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
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Shea LL, Becker A, Lee BK, Miller KK, Cooper D, Anderson K, Salzer MS, Vanness DJ. Self-reported COVID-19 vaccination acceptance and hesitancy among autistic adults. Vaccine 2022; 40:3288-3293. [PMID: 35484038 PMCID: PMC9023320 DOI: 10.1016/j.vaccine.2022.04.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 04/11/2022] [Accepted: 04/15/2022] [Indexed: 01/17/2023]
Abstract
Identifying factors associated with COVID-19 vaccination acceptance among vulnerable groups, including autistic individuals, can increase vaccination rates and support public health. The purpose of this study was to determine differences among autistic adults who reported COVID-19 vaccination acceptance from those who did not. In this study we describe COVID-19 vaccination status and self-reported preferences among autistic adults and identify related factors. Vaccine accepters were more likely to report increased loneliness during COVID-19, lived in more populous counties (p = 0.02), and lived in counties won by President Biden in the 2020 US presidential election (p < 0.001). Positive correlations were found between desire to protect others, concern about contracting COVID-19, and trusting vaccine safety (p < 0.001). Concern about vaccine safety was common among the vaccine hesitant, while lack of concern about COVID-19 overall was not. Identifying health promotion strategies based on self-reported, lived experiences about COVID-19 among vulnerable groups is key for public health impact.
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Affiliation(s)
- Lindsay L Shea
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, United States.
| | - Alec Becker
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, United States.
| | - Brian K Lee
- Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, PA 19104, United States.
| | - Kaitlin Koffer Miller
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, United States.
| | - Dylan Cooper
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, United States.
| | - Kristy Anderson
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, United States.
| | - Mark S Salzer
- College of Public Health, Temple University, 1101 W Montgomery Avenue, Philadelphia, PA 19122, United States.
| | - David J Vanness
- College of Health and Human Development, Penn State University, 325 Health and Human Development Building, University Park, PA 16802, United States.
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Song W, Nonnemacher SL, Miller KK, Anderson K, Shea LL. Living arrangements and satisfaction of current arrangement among autistic adults reported by autistic individuals or their caregivers. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1174-1185. [DOI: 10.1111/jar.13003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 02/18/2022] [Accepted: 04/25/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Wei Song
- College of Public Health Temple University Philadelphia Pennsylvania USA
| | - Stacy L. Nonnemacher
- Pennsylvania Department of Human Services, Office of Developmental Programs Bureau of Supports for Autism and Special Populations Harrisburg Pennsylvania USA
| | - Kaitlin Koffer Miller
- A.J. Drexel Autism Institute, Policy and Analytics Center Drexel University Philadelphia Pennsylvania USA
| | - Kristy Anderson
- A.J. Drexel Autism Institute, Drexel University Philadelphia Pennsylvania USA
| | - Lindsay L. Shea
- A.J. Drexel Autism Institute, Drexel University Philadelphia Pennsylvania USA
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Barbaro D, Shankardass K. Work-Related Social Skills Interventions for Individuals with Autism Spectrum Disorder Throughout the Life Course. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00317-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kuo AA, Hotez E, Rosenau KA, Gragnani C, Fernandes P, Haley M, Rudolph D, Croen LA, Massolo ML, Holmes LG, Shattuck P, Shea L, Wilson R, Martinez-Agosto JA, Brown HM, Dwyer PSR, Gassner DL, Onaiwu MG, Kapp SK, Ne'eman A, Ryan JG, Waisman TC, Williams ZJ, DiBari JN, Foney DM, Ramos LR, Kogan MD. The Autism Intervention Research Network on Physical Health (AIR-P) Research Agenda. Pediatrics 2022; 149:e2020049437D. [PMID: 35363290 DOI: 10.1542/peds.2020-049437d] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES In the United States, autistic individuals experience disproportionate physical and mental health challenges relative to non-autistic individuals, including higher rates of co-occurring and chronic conditions and lower physical, social, and psychological health-related quality of life. The Autism Intervention Research Network on Physical Health (AIR-P) is an interdisciplinary, multicenter research network for scientific collaboration and infrastructure that aims to increase the life expectancy and quality of life for autistic individuals, with a focus on underserved or vulnerable populations. The current paper describes the development of the AIR-P Research Agenda. METHODS Development of the research agenda involved an iterative and collaborative process between the AIR-P Advisory Board, Steering Committee, and Autistic Researcher Review Board. The methodology consisted of 3 phases: (1) ideation and design, (2) literature review and synthesis; and (3) network engagement. RESULTS Six core research priorities related to the health of autistic individuals were identified: (1) primary care services and quality, (2) community-based lifestyle interventions, (3) health systems and services, (4) gender, sexuality, and reproductive health, (5) neurology, and (6) genetics. Specific topics within each of these priorities were identified. Four cross-cutting research priorities were also identified: (1) neurodiversity-oriented care, (2) facilitating developmental transitions, (3) methodologically rigorous intervention studies, and (4) addressing health disparities. CONCLUSIONS The AIR-P Research Agenda represents an important step forward for enacting large-scale health-promotion efforts for autistic individuals across the lifespan. This agenda will catalyze autism research in historically underrepresented topic areas while adopting a neurodiversity-oriented approach to health-promotion.
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Affiliation(s)
- Alice A Kuo
- Departments of Medicine and
- Pediatrics
- Graduate School of Education and Information Studies, University of California, Los Angeles, Los Angeles, California
| | | | - Kashia A Rosenau
- Graduate School of Education and Information Studies, University of California, Los Angeles, Los Angeles, California
| | | | | | | | - Dawn Rudolph
- Association of University Centers on Disabilities, Silver Spring, Maryland
| | - Lisa A Croen
- Kaiser Permanente Northern California, Los Angeles, California
| | - Maria L Massolo
- Kaiser Permanente Northern California, Los Angeles, California
| | | | | | - Lindsay Shea
- AJ Drexel Autism Institute, Philadelphia, Pennsylvania
| | | | | | | | - Patrick S R Dwyer
- Center for Mind and Brain
- Department of Psychology, University of California Davis, Davis, California
| | - Dena L Gassner
- School of Social Work, Adelphi University, Garden City, New York
- Department of Health Sciences, Towson University, Towson, Maryland
| | | | - Steven K Kapp
- Department of Psychology, University of Portsmouth, Portsmouth, United Kingdom
| | - Ari Ne'eman
- Harvard University, Cambridge, Massachusetts
| | - Jacalyn G Ryan
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - T C Waisman
- University of Calgary, Calgary, Alberta, Canada
| | - Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, Tennessee
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Brain Institute
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, Tennessee
| | - Jessica N DiBari
- Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, Maryland
| | - Dana M Foney
- Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, Maryland
| | | | - Michael D Kogan
- Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, Maryland
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Cheak-Zamora N, Tait A, Coleman A. Assessing and Promoting Independence in Young Adults with Autism Spectrum Disorder. J Dev Behav Pediatr 2022; 43:130-139. [PMID: 34636359 DOI: 10.1097/dbp.0000000000001021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Quality of life, independence, and employment outcomes are poor for young adults with autism spectrum disorder (YA-ASD). This study explored the desires and experiences of YA-ASD as they transition into adulthood. METHODS Fifteen YA-ASD, age 18 to 25 years, were recruited from autism spectrum disorder centers, participant registries, and social media advertising. Interested individuals completed a survey and individual interview. Semistructured interview guides included questions about transition experiences, current independence, and future goals. Interview transcripts were analyzed using thematic analysis. RESULTS The desire of young adults with autism spectrum disorder for independence was shown within 4 themes. YA-ASD described their vision of adulthood along with their need for improved skills in driving, living independently, and decision-making. CONCLUSION The findings indicate YA-ASD desire to be independent but lack the specific support services to get there.
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Affiliation(s)
- Nancy Cheak-Zamora
- Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, MO
| | - Andrew Tait
- Department of Biological Sciences, College of Arts and Science, University of Missouri, Columbia, MO
| | - Ann Coleman
- Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, MO
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36
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Song W, Salzer MS, Nonnemacher SL, Shea L. Lifespan service receipt and unmet needs among individuals on the autism spectrum. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2022; 49:694-705. [PMID: 35320442 DOI: 10.1007/s10488-022-01192-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 01/18/2023]
Abstract
Timely data on service use and needs across the lifespan are essential to developing an effective and efficient service delivery system that is responsive to developmental issues. This study uses data from one of the largest statewide surveys conducted between 2017 and 2018 to compare service use and unmet needs among individuals on the autism spectrum across the lifespan. A statewide sample of 5792 caregivers of autistic children and adults were included in the study. Logistic regressions were conducted to compare service use and need among six age groups ranging from early childhood (0-5 years) to later adulthood (31+) while adjusting for sociodemographic characteristics. We found that the transition-age adult group (18-21 years) was less likely to receive services, including speech/language therapy, occupational therapy, one-on-one support, and social skill training, than adolescents. However, case management and mental health services increased with age. Young adults (22-30 years) were more likely to report unmet needs than both adolescents and transition-age adult groups. The use of services overall decrease and service needs increased compared to results from an earlier statewide survey that was conducting in 2009-2010. These results can be used to inform developmentally appropriate autism-related healthcare policies and service development and delivery. This study offers a more detailed look at differences between adult age subgroups that are novel. Further research is needed about the prevalence of ASD in adulthood, clinical trajectories, and outcomes in order to support autistic adults in getting the appropriate services and supports.
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Affiliation(s)
- Wei Song
- College of Public Health, Temple University, 1700 N. Broad St., Suite 313, 19122, Philadelphia, PA, USA.
| | - Mark S Salzer
- Temple University Collaborative on Community Inclusion of Individuals with, Psychiatric Disabilities, 1700 N. Broad St., Suite 304, 19122, Philadelphia, PA, USA
| | - Stacy L Nonnemacher
- Bureau of Supports for Autism and Special Populations, Department of Human Services, 801 Market St, 19107, Philadelphia, Pennsylvania, PA, USA
| | - Lindsay Shea
- Policy and Analytics Center, A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, 19104, Philadelphia, PA, USA
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Brede J, Cage E, Trott J, Palmer L, Smith A, Serpell L, Mandy W, Russell A. “We Have to Try to Find a Way, a Clinical Bridge” - autistic adults' experience of accessing and receiving support for mental health difficulties: A systematic review and thematic meta-synthesis. Clin Psychol Rev 2022; 93:102131. [DOI: 10.1016/j.cpr.2022.102131] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 12/04/2021] [Accepted: 01/28/2022] [Indexed: 12/28/2022]
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Rothman EF, Graham Holmes L, Caplan R, Chiang M, Haberer B, Gallop N, Kadel R, Person M, Sanchez A, Quinn E, Wharmby P. Healthy Relationships on the Autism Spectrum (HEARTS): A feasibility test of an online class co-designed and co-taught with autistic people. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:690-702. [PMID: 35000417 DOI: 10.1177/13623613211069421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT The Healthy Relationships on the Autism Spectrum class is unique because autistic people helped to develop it and co-taught it. It is an online, six-session class. The class was piloted in 2020-2021 with 55 autistic people who were ages 18-44 years old. This feasibility study found that most people who took the class liked it. Surveys filled out by the students before and after the class showed that they became less sensitive to rejection, used more positive thinking skills, and were more interested in being social. However, the class may not have made them feel less lonely. The team that invented the class is using the feedback to improve it. The class holds promise for improving the quality of friendships and dating relationships for autistic adults and should be tested further.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Emily Quinn
- Boston University School of Public Health, USA
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Pillay S, Duncan M, de Vries PJ. "We are doing the best we can to bridge the gap" - service provider perspectives of educational services for autism spectrum disorder in South Africa. Front Psychiatry 2022; 13:907093. [PMID: 35928780 PMCID: PMC9343733 DOI: 10.3389/fpsyt.2022.907093] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/24/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The South African education system is increasingly unable to meet the growing needs of children with autism spectrum disorder (ASD). Recent studies in the Western Cape, one of the better resourced provinces in South Africa, showed that the pathway to care for children with ASD was an inconsistent and lengthy process, and that many children with ASD waited for extended periods to get access to an appropriate school placement. It is therefore clear that scalable and sustainable solutions are required to improve access to appropriate education for children with ASD. METHODS Here we performed a qualitative study using thematic analysis of ten multi-sectorial ASD service provider interviews in the Western Cape Province to examine provider perspectives and proposed solutions to meet the educational needs of children with ASD. RESULTS Provider perspectives were grouped in three categories: "bridging the gap across the spectrum and lifespan", "gaps to bridge", and "building bridges". The first category captured provider perspectives of the service-related needs inherent to a diagnosis of ASD. The second category summarized service provider views of the challenges associated with providing services to children with ASD and the third category captured provider perspectives on potential actions to improve ASD education services delivery in the province. The overarching theme that emerged was "We're doing the best we can to bridge the gap". CONCLUSION Participants provided ten key recommendations for service strengthening that may lead to contextually relevant innovations to meet the educational needs of children with ASD in the province. Findings from this study has direct relevance to other South African provinces and may have relevance to improve pathways and reduce service delivery gaps also in other low-and-middle-income countries.
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Affiliation(s)
- Sarosha Pillay
- Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa.,Centre for Autism Research in Africa, Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Madeleine Duncan
- Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
| | - Petrus J de Vries
- Centre for Autism Research in Africa, Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
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Benevides TW, Tao S, Becker A, Verstreate K, Shea L. Occupational Therapy Service Delivery Among Medicaid-Enrolled Children and Adults on the Autism Spectrum and With Other Intellectual Disabilities. Am J Occup Ther 2022; 76:7601180100. [PMID: 35030249 PMCID: PMC8865574 DOI: 10.5014/ajot.2022.049202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Rates of occupational therapy service utilization among people with autism spectrum disorder (ASD) or intellectual disability (ID) have not been explored in population-based samples. OBJECTIVE To describe occupational therapy services delivered to Medicaid-eligible persons younger than age 65 yr identified as having ASD, ID, or both and to evaluate demographic factors associated with occupational therapy service utilization in this population. DESIGN Retrospective, case-control, cohort study using claims records from Medicaid Analytic eXtract files (2009-2012). SETTING Data from all 50 states and Washington, DC. PARTICIPANTS Beneficiaries identified as having ASD only, ASD+ID, or ID only who were younger than age 18 yr (N = 664,214) and ages 18-64 yr (N = 702,338). Outcomes and Measures: We analyzed Current Procedural Terminology® and Healthcare Common Procedure Coding System procedure codes, Medicaid Statistical Information System type of service codes, and Center for Medicare & Medicaid Services provider specialty codes. RESULTS Only 3.7% to 6.3% of eligible adult beneficiaries received occupational therapy; in contrast, 20.5% to 24.2% of children received occupational therapy. Significant predictors of service use varied by group; however, differences by race-ethnicity, eligibility on the basis of poverty, and geographic location were observed. Among children, the most frequent billing code was for "therapeutic activities" (43%-60%); among adults, it was "community/work reintegration training" (29%-39%). CONCLUSIONS AND RELEVANCE Billed procedure code patterns do not consistently reflect the unique occupational focus that occupational therapy providers deliver to people with developmental disabilities. Disparities in occupational therapy receipt warrant further attention to understand the social and structural factors affecting service delivery. What This Article Adds: Occupational therapy services paid for by Medicaid are used more frequently by children with ASD and ID than by adults with these diagnoses. Greater understanding of the intersectional factors that drive service delivery and disparities is needed.
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Affiliation(s)
- Teal W Benevides
- Teal W. Benevides, PhD, MS, OTR/L, is Associate Professor, Department of Occupational Therapy, College of Allied Health Sciences, Augusta University, Augusta, GA;
| | - Sha Tao
- Sha Tao, MPH, is Data Analyst, A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA
| | - Alec Becker
- Alec Becker, MAS, is Data Analyst, A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA
| | - Kate Verstreate
- Kate Verstreate, MPH, is Data Analyst, A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA
| | - Lindsay Shea
- Lindsay Shea, DrPH, MS, is Associate Professor, A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA
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Ghanouni P, Quirke S, Blok J, Casey A. Independent living in adults with autism spectrum disorder: Stakeholders' perspectives and experiences. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 119:104085. [PMID: 34600352 DOI: 10.1016/j.ridd.2021.104085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
UNLABELLED Independent living is a basic human right that enables individuals with disabilities to determine where they live, who they live with and what kind of support that they receive. Limited research exists regarding the challenges that adults with autism spectrum disorder (ASD) may face when attempting to live independently. Given the importance of independent living for adults with ASD, this study aimed to examine the perspectives of stakeholders about independent living among adults with ASD. METHODS We recruited a total of 19 stakeholders including adults with ASD and parents of adults with ASD from Canadian provinces. In-depth, semi-structured interviews were conducted to identify factors affecting independent living among adults with ASD. Interviews were transcribed and analyzed using thematic analysis to identify overarching themes. RESULTS Three themes emerged in our findings, including: a) Psychophysical stability and daily living; b) Financial management and planning; and c) Integrated community living and independence. CONCLUSION The findings from this study suggest that adults with ASD face several challenges related to independent living. Factors related to psychophysical stability and daily living, financial management, and integrated community living and housing were all found to influence the ability of adults with ASD to live independently. By exploring stakeholders' perspectives of independent living for adults with ASD, this study provides some insight that can help inform the development of programs and services to facilitate independent living for adults with ASD.
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Affiliation(s)
- Parisa Ghanouni
- Department of Occupational Therapy, Dalhousie University, Halifax, Canada.
| | - Stephanie Quirke
- Department of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Jennifer Blok
- Department of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Amanda Casey
- Department of Human Kinetics, St. Francis Xavier University, Canada
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Jose C, George-Zwicker P, Bouma A, Tardif L, Pugsley D, Bélanger M, Robichaud M, Gaudet J. The Associations Between Clinical, Social, Financial Factors and Unmet Needs of Autistic Adults: Results from an Observational Study. AUTISM IN ADULTHOOD 2021; 3:266-274. [PMID: 36605370 PMCID: PMC8992900 DOI: 10.1089/aut.2020.0027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Autism is a developmental disability that affects how individuals experience the world. Each Autistic individual experiences Autism in their own way, meaning that the level and type of assistance in their everyday lives vary widely. A shortage of programs and services tailored to Autistic adults exists worldwide, and the current gap between needs and services is likely to worsen as the growing number of Autistic children being diagnosed reach adulthood. This research sought to determine priorities in terms of health and social service needs of Autistic adults and to examine factors influencing whether or not these services were being received. Methods Through a multistakeholder approach, researchers and Autistic adults codeveloped the Maritime Provinces Needs Assessment Survey and collected data from August 2017 to February 2018. The research team engaged Autistic adult partners, including one that was project colead, as full partners. We recruited survey respondents from three Maritime Provinces using mainly social media and local Autism networks. We used Poisson regression analyses to identify factors most strongly associated with the number of unmet needs reported by Autistic adults. Results In total, 260 respondents completed the needs assessment survey: 77 self-reporting Autistic adults (aged 19-55 years), 87 Autistic adults (aged 18-63 years) whose information was provided by a proxy respondent, and 96 professionals working in the field of Autism. Autistic adults reported a mean of 2.1 ± 1.5 (self-reported) and 2.8 ± 2.1 (proxy-reported) services wanted but not received. The number of mental health and neurodevelopmental conditions, unemployment, and perception that government support is insufficient were positively related to unmet needs. Conclusions Overall, the results of this study highlight considerable gaps among the support needs of Autistic adults. The identification of factors associated with a higher number of unmet needs helps identify potential subgroups requiring more attention. Lay summary Why was this study done?: There is currently a shortage of programs and services for Autistic adults. Little is known about which services are most important to Autistic adults and which factors are associated with not receiving them.What was the purpose of this study?: Our goals were (1) to determine the service need priorities of Autistic adults and (2) to examine factors associated with unmet needs.What did the researchers do?: The researchers invited health professionals, service providers, policy makers, Autism advocates, as well as Autistic adults and caregivers of Autistic adults to participate as part of the project team. In the early phases of the project, we named an Autistic adult colead of the project. In doing so, we acknowledged that conducting relevant research on the Autistic adult community implies not only hearing their voices and concerns, but also providing an opportunity for equal say on the research itself.We adapted previously used surveys to align them with our objectives of focusing only on Autistic adults. We launched the survey online and promoted it using various media and community channels, many of them direct suggestions from Autistic adult team members. We made paper copies available and provided a phone number for those who needed support filling out the survey.What were the results of the study?: More than 25% of Autistic adults identified 12 different services as priority needs.Autistic adults who (1) reported more mental health and neurodevelopmental conditions, (2) perceived their mental health as poor, or (3) felt that government support was insufficient were at greater risk of having unmet needs.What do these findings add to what was already known?: Similar to previous studies, we found that the service needs of Autistic adults are varied, and that many are not receiving the services they consider a priority. Our study also went one step further by identifying factors that are associated with a higher number of unmet needs.What are potential weaknesses in the study?: Our sample does not necessarily reflect the Autistic adult community as a whole, since we were unable to guarantee that hard-to-reach segments had access to our survey. In addition, we are unable to know how our results may change over time, as our survey was filled out on one occasion only. Finally, we did not measure Autistic traits and therefore are unable to estimate how different types of traits are associated with certain needs.How will these findings help autistic adults now or in the future?: Our results may help bring attention to subgroups of Autistic adults who need more help receiving the services they require.
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Affiliation(s)
- Caroline Jose
- Maritime Strategy for Patient Oriented Research Support Unit, Université de Moncton, Moncton, New Brunswick, Canada.,Research Laboratory on Chronic Disease Prevention, Centre de formation médicale du Nouveau-Brunswick, Moncton, New Brunswick, Canada.,Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Patricia George-Zwicker
- Patient Partner, CONNECT Project, Maritime Strategy for Patient Oriented Research Support Unit, Université de Moncton, Moncton, New Brunswick, Canada.,Autistics Aloud, Halifax, Nova Scotia, Canada
| | - Aaron Bouma
- Patient Partner, CONNECT Project, Maritime Strategy for Patient Oriented Research Support Unit, Université de Moncton, Moncton, New Brunswick, Canada
| | - Louise Tardif
- Patient Partner, CONNECT Project, Maritime Strategy for Patient Oriented Research Support Unit, Université de Moncton, Moncton, New Brunswick, Canada
| | - Darlene Pugsley
- Patient Partner, CONNECT Project, Maritime Strategy for Patient Oriented Research Support Unit, Université de Moncton, Moncton, New Brunswick, Canada
| | - Mathieu Bélanger
- Research Laboratory on Chronic Disease Prevention, Centre de formation médicale du Nouveau-Brunswick, Moncton, New Brunswick, Canada.,Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada.,Vitalité Health Network, Centre Hospitalier Universitaire Dr. Georges-L.-Dumont/Dr. Georges-L.-Dumont University Hospital Centre, Moncton, New Brunswick, Canada
| | - Marc Robichaud
- Maritime Strategy for Patient Oriented Research Support Unit, Université de Moncton, Moncton, New Brunswick, Canada.,Research Laboratory on Chronic Disease Prevention, Centre de formation médicale du Nouveau-Brunswick, Moncton, New Brunswick, Canada
| | - Jeffrey Gaudet
- Maritime Strategy for Patient Oriented Research Support Unit, Université de Moncton, Moncton, New Brunswick, Canada.,Research Laboratory on Chronic Disease Prevention, Centre de formation médicale du Nouveau-Brunswick, Moncton, New Brunswick, Canada.,Address correspondence to: Jeffrey Gaudet, MSc, Maritime Strategy for Patient Oriented Research Support Unit, Université de Moncton, Campus de Moncton, 18 Antonine-Maillet Ave, Moncton, NB E1A 3E9, Canada.
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Shea LL, Koffer Miller KH, Verstreate K, Tao S, Mandell D. States' use of Medicaid to meet the needs of autistic individuals. Health Serv Res 2021; 56:1207-1214. [PMID: 34251042 DOI: 10.1111/1475-6773.13671] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess the use of Medicaid programs, including waivers, to address the needs of aging autistic individuals. DATA SOURCES We gathered data on Medicaid programs in place between 2004 and 2015 for 50 states and the District of Columbia from the Centers for Medicare and Medicaid Services website, by contacting state Medicaid administrators and advocacy groups, and by reviewing the Medicaid Analytic eXtract Waiver Crosswalk. STUDY DESIGN This retrospective analysis classified each Medicaid program and documented state changes over time in eligibility criteria: those serving autism spectrum disorder only, autism spectrum disorder or intellectual disability, and intellectual disability only. DATA COLLECTION/EXTRACTION METHODS We captured age and diagnosis eligibility criteria for Medicaid programs serving any of the three target groups. PRINCIPAL FINDINGS A total of 269 Medicaid programs met our criteria and most programs (51%) were 1915(c) waivers. The number of autism-specific 1915(c) waivers grew more than fivefold during the study period, outpacing increases in waivers serving individuals with intellectual disability. CONCLUSIONS States varied in their use of Medicaid to address the needs of the aging autism population. Further study of characteristics of states that changed their Medicaid programs, and of the health care use and outcomes associated with these changes, are needed to identify opportunities to replicate effective approaches to meeting the needs of this population.
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Affiliation(s)
- Lindsay Lawer Shea
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Kate Verstreate
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Sha Tao
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - David Mandell
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Hand BN, Gilmore D, Coury DL, Darragh AR, Moffatt-Bruce S, Hanks C, Garvin JH. Effects of a Specialized Primary Care Facility on Preventive Service Use Among Autistic Adults: a Retrospective Claims Study. J Gen Intern Med 2021; 36:1682-1688. [PMID: 33469770 PMCID: PMC8175546 DOI: 10.1007/s11606-020-06513-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 11/17/2020] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND While in some studies, the patient-centered medical home has been linked with increased receipt of preventive services among other populations, there is a paucity of literature testing the effectiveness of medical homes in serving the healthcare needs of autistic adults. OBJECTIVE To compare the receipt of preventive services by patients at a patient-centered medical home specifically designed for autistic adults (called the Center for Autism Services and Transition "CAST") to US national samples of autistic adults with private insurance or Medicare. DESIGN Retrospective study of medical billing data. SAMPLE The study sample included CAST patients (N = 490) who were propensity score matched to Medicare-enrolled autistic adults (N = 980) and privately insured autistic adults (N = 980) using demographic characteristics. The median age of subjects was 21 years old, 79% were male, and the median duration of observation was 2.2 years. MAIN MEASURES The primary outcome measure was the receipt of any preventive service, as defined by the Medicare Learning Network and AAPC (formerly the American Academy of Professional Coders). Secondary outcome measures included receipt of specific preventive service types (i.e., general health and wellness services, screenings, counseling and therapies, vaccinations, and sexual/reproductive health services). KEY RESULTS CAST patients had significantly greater odds of receiving any preventive service than Medicare-enrolled (OR = 10.3; 95% CI = 7.6-13.9) and privately insured (OR = 3.1; 95% CI = 2.3-4.2) autistic adults. CAST patients were also significantly more likely to receive screenings and vaccinations than either Medicare beneficiaries (screenings OR = 20.3; 95% CI = 14.7-28.0; vaccinations OR = 5.5; 95% CI = 4.3-7.0) or privately insured beneficiaries (screenings OR = 2.0; 95% CI = 1.6-2.5; vaccinations OR = 3.3; 95% CI = 2.6-4.1). CONCLUSIONS Autistic adults receiving care through CAST were significantly more likely to recieve preventive care services than national samples of autistic adults. Future comparative effectiveness trials are needed to rigorously assess the impact of primary care-based initiatives to improve care for autistic adults.
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Affiliation(s)
| | | | - Daniel L Coury
- The Ohio State University, Columbus, OH, USA
- Nationwide Children's Hospital, Columbus, OH, USA
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Benevides TW, Carretta HJ, Rust G, Shea L. Racial and ethnic disparities in benefits eligibility and spending among adults on the autism spectrum: A cohort study using the Medicare Medicaid Linked Enrollees Analytic Data Source. PLoS One 2021; 16:e0251353. [PMID: 34032811 PMCID: PMC8148358 DOI: 10.1371/journal.pone.0251353] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/24/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Research on children and youth on the autism spectrum reveal racial and ethnic disparities in access to healthcare and utilization, but there is less research to understand how disparities persist as autistic adults age. We need to understand racial-ethnic inequities in obtaining eligibility for Medicare and/or Medicaid coverage, as well as inequities in spending for autistic enrollees under these public programs. METHODS We conducted a cross-sectional cohort study of U.S. publicly-insured adults on the autism spectrum using 2012 Medicare-Medicaid Linked Enrollee Analytic Data Source (n = 172,071). We evaluated differences in race-ethnicity by eligibility (Medicare-only, Medicaid-only, Dual-Eligible) and spending. FINDINGS The majority of white adults (49.87%) were full-dual eligible for both Medicare and Medicaid. In contrast, only 37.53% of Black, 34.65% Asian/Pacific Islander, and 35.94% of Hispanic beneficiaries were full-dual eligible for Medicare and Medicare, with most only eligible for state-funded Medicaid. Adjusted logistic models controlling for gender, intellectual disability status, costly chronic condition, rural status, county median income, and geographic region of residence revealed that Black beneficiaries were significantly less likely than white beneficiaries to be dual-eligible across all ages. Across these three beneficiary types, total spending exceeded $10 billion. Annual total expenditures median expenditures for full-dual and Medicaid-only eligible beneficiaries were higher among white beneficiaries as compared with Black beneficiaries. CONCLUSIONS Public health insurance in the U.S. including Medicare and Medicaid aim to reduce inequities in access to healthcare that might exist due to disability, income, or old age. In contrast to these ideals, our study reveals that racial-ethnic minority autistic adults who were eligible for public insurance across all U.S. states in 2012 experience disparities in eligibility for specific programs and spending. We call for further evaluation of system supports that promote clear pathways to disability and public health insurance among those with lifelong developmental disabilities.
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Affiliation(s)
- Teal W. Benevides
- Department of Occupational Therapy, College of Allied Health Sciences, Augusta University, Augusta, GA, United States of America
| | - Henry J. Carretta
- College of Medicine, Florida State University, Tallahassee, FL, United States of America
| | - George Rust
- College of Medicine, Florida State University, Tallahassee, FL, United States of America
| | - Lindsay Shea
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, United States of America
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Schott W, Nonnemacher S, Shea L. Service Use and Unmet Needs Among Adults with Autism Awaiting Home- and Community-Based Medicaid Services. J Autism Dev Disord 2021; 51:1188-1200. [PMID: 32671666 DOI: 10.1007/s10803-020-04593-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Autistic adults in need of long-term services and supports spend months on waiting lists before receiving such services through Medicaid. Data from a state-wide survey of adults and their caregivers on a waiting list for autism waivers suggest that the majority have unmet needs for functional skills services (63.6%), employment or vocation services (62.1%), and mental and behavioral health services (52.8%). Almost a third require case management services (28.3%). Predictors of greater service need are African American race and the number of physical and behavioral health diagnoses. Predictors of greater service receipt were employment status, housing type, and school enrollment; there was lower service receipt for African American race, Hispanic ethnicity, over age 21 years, and college completion.
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Affiliation(s)
- Whitney Schott
- Policy and Analytics Center, A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA.
| | - Stacy Nonnemacher
- Bureau of Supports for Autism and Special Populations, Pennsylvania Department of Human Services, 801 Market St., Philadelphia, PA, 19107, USA
| | - Lindsay Shea
- Policy and Analytics Center, A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
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Srinivasan S, Ekbladh A, Freedman B, Bhat A. Needs assessment in unmet healthcare and family support services: A survey of caregivers of children and youth with autism spectrum disorder in Delaware. Autism Res 2021; 14:1736-1758. [PMID: 33876563 DOI: 10.1002/aur.2514] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/24/2021] [Accepted: 04/01/2021] [Indexed: 11/08/2022]
Abstract
The study aimed to collect data from families of children and youth with Autism Spectrum Disorder (ASD) in the state of Delaware, USA to understand their ongoing needs and challenges in accessing child healthcare and family support services. We analyzed responses from 263 caregivers of children and youth with ASD from 3 to 24 years using a statewide needs assessment survey. Over 50% caregivers indicated having unmet needs relative to both child/youth healthcare services and family support services. Between 24 and 38% caregivers expressed unmet needs for healthcare services such as social skills training, speech-language therapy, behavioral intervention, and occupational therapy for their child and 20-24% expressed needs for family support services such as respite care, parent/sibling support groups, counseling, and babysitting support. Additionally, number of prior early interventions received, limitations in accessing healthcare services, and unmet needs for family support services significantly predicted child/youth unmet healthcare needs. Greater ASD severity and difficulties accessing child/youth healthcare services predicted participant's functional dependence on caregivers for activities of daily living. Together, these findings call for designing holistic, family-centered interventions that address needs of both children and youth with ASD and their families. LAY SUMMARY: A statewide needs assessment survey of caregivers of children and youth with ASD revealed that 50% responders had unmet needs relative to both child/youth healthcare services and family support services. Number of prior services received, limitations in accessing healthcare, and unmet needs for family support are linked to child/youth unmet healthcare needs. Severity of autism and difficulties accessing child/youth healthcare are associated with participant's functional dependence. Together, these findings call for placing the family at the heart of the service system in ASD.
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Affiliation(s)
- Sudha Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA.,Institute for Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA.,The Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Annalisa Ekbladh
- Center for Disabilities Studies, University of Delaware, Newark, Delaware, USA
| | - Brian Freedman
- Center for Disabilities Studies, University of Delaware, Newark, Delaware, USA
| | - Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.,Biomechanics & Movement Sciences Program, University of Delaware, Newark, Delaware, USA.,Behavioral Neuroscience Division, Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA
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Marsack-Topolewski CN. Receipt of Social Support among Compound and Noncompound Caregivers of Adults with Autism. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2021; 64:175-189. [PMID: 33048663 DOI: 10.1080/01634372.2020.1834045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/03/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
For parents of adult children with autism spectrum disorder (ASD), caregiving can be ongoing, beginning at diagnosis and continuing throughout adulthood. As parental caregivers age, many may be faced with additional caregiving responsibilities, such as caring for another loved one. This study examined differences in formal and informal social support used by caregivers providing care to more than one person with at least one being an adult child with ASD (compound caregivers) and those caring for a single adult child with ASD (noncompound caregivers). A nationwide sample of 320 parents (age 50 or older) of adult children with ASD completed a web-based survey to understand use of formal and informal social support. Fisher's exact probability tests were used to determine significant differences in the extent to which the services were used by the two groups of caregivers. Results indicated that 4 of the 12 formal and 2 of the 6 informal social support services differed significantly between compound and noncompound caregivers. Given that both groups of caregivers were aging, future research should focus on understanding what services are anticipated to be needed as these changes occur and as changes to future care plans are needed, to best support their care-recipients.
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Bemmer ER, Boulton KA, Thomas EE, Larke B, Lah S, Hickie IB, Guastella AJ. Modified CBT for social anxiety and social functioning in young adults with autism spectrum disorder. Mol Autism 2021; 12:11. [PMID: 33557903 PMCID: PMC7871647 DOI: 10.1186/s13229-021-00418-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/21/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND There is a strong research imperative to investigate effective treatment options for adolescents and adults with autism spectrum disorder (ASD). Elevated social anxiety, difficulties with social functioning and poor mental health have all been identified as core treatment targets for this group. While theoretical models posit a strong bidirectionality between social anxiety and ASD social functioning deficits, few interventions have targeted both domains concurrently. Of the two group interventions previously conducted with adolescents and adults with ASD, significant results have only been observed in either social anxiety or social functioning, and have not generalised to changes in overall mood. The aim of this study was to evaluate the potential benefit, tolerability and acceptability of a group cognitive-behaviour therapy (CBT) intervention in young adults with ASD. Primary treatment outcomes were social anxiety symptoms and social functioning difficulties; secondary outcomes were self-reported mood and overall distress. METHOD Ten groups of participants completed an eight-week, modified group CBT intervention targeting both social anxiety and social functioning, that included social skills training, exposure tasks and behavioural experiment components. Seventy-eight adolescents and young adults with ASD, without intellectual impairment, aged between 16 and 38 (M = 22.77; SD = 5.31), were recruited from the community, Headspace centres and the Autism Clinic for Translational Research at the Brain and Mind Centre, University of Sydney. Outcomes (social anxiety, social functioning and mood) were measured pre- and post-intervention via self-report questionnaires (administered either online or through the return of hard-copy booklets), and participants were invited to provide anonymous feedback on the intervention (at the mid-point and end of the intervention). RESULTS Participants demonstrated statistically significant improvements on all outcome measures in response to the intervention. Specifically, social anxiety symptoms decreased (p < .001), and specific subdomains of social functioning improved post-intervention, particularly in social motivation (p = .032) and restricted interests and repetitive behaviours (p = .025). Self-reported symptom improvements also generalised to mood (depression, anxiety and stress; p < .05). All improvements demonstrated small effect sizes. Participant feedback was positive and indicated strong satisfaction with the program. LIMITATIONS The absence of a control group and follow-up measures, reliance on self-report instruments as outcome measures and the exclusion of those with intellectual disability represent significant limitations to this study. CONCLUSIONS These findings indicate that a group CBT intervention appears to be a beneficial intervention for self-reported social anxiety, social functioning and overall mental health in adolescents and young adults with ASD. The stand-alone nature of the intervention combined with positive participant feedback indicates it was well tolerated, has potential clinical utility and warrants further study in a randomised-controlled, follow-up design.
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Affiliation(s)
- Emily R. Bemmer
- Autism Clinic for Translational Research, Brain and Mind Centre, Child Neurodevelopment and Mental Health Team, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia
- School of Psychology, University of Sydney, Sydney, 2050 Australia
| | - Kelsie A. Boulton
- Autism Clinic for Translational Research, Brain and Mind Centre, Child Neurodevelopment and Mental Health Team, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050 Australia
| | - Emma E. Thomas
- Autism Clinic for Translational Research, Brain and Mind Centre, Child Neurodevelopment and Mental Health Team, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia
| | - Ben Larke
- Autism Clinic for Translational Research, Brain and Mind Centre, Child Neurodevelopment and Mental Health Team, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia
| | - Suncica Lah
- School of Psychology, University of Sydney, Sydney, 2050 Australia
| | - Ian B. Hickie
- Autism Clinic for Translational Research, Brain and Mind Centre, Child Neurodevelopment and Mental Health Team, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia
| | - Adam J. Guastella
- Autism Clinic for Translational Research, Brain and Mind Centre, Child Neurodevelopment and Mental Health Team, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050 Australia
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Embedded research approaches to address the needs of the increasing, aging autistic population. HEALTHCARE-THE JOURNAL OF DELIVERY SCIENCE AND INNOVATION 2021; 9:100517. [PMID: 33436313 DOI: 10.1016/j.hjdsi.2020.100517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 08/30/2020] [Accepted: 12/22/2020] [Indexed: 11/23/2022]
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