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Hamdan SZ, Bennett A. Autism-Friendly Healthcare: A Narrative Review of the Literature. Cureus 2024; 16:e64108. [PMID: 39114203 PMCID: PMC11305600 DOI: 10.7759/cureus.64108] [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: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Disparities in healthcare access, delivery, and outcomes exist between autistic and non-autistic individuals. Autism-friendly healthcare initiatives aim to facilitate and improve the healthcare experience of autistic individuals by addressing commonly encountered challenges. While there is no consensus regarding the definition of autism-friendly healthcare, in this narrative review, we examine previously published research to determine the most important components of autism-friendly healthcare. Patient-related factors, provider-related factors, and system-related factors should be addressed. Proactivity, flexibility, and collaboration should guide the process of transforming the healthcare system. Finally, multiple strategies can be utilized as appropriate to the setting and individuals.
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Affiliation(s)
- Samar Z Hamdan
- Department of Pediatrics, College of Medicine and Surgery, King Abdulaziz University, Jeddah, SAU
| | - Amanda Bennett
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
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2
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Weitzman C, Nadler C, Blum NJ, Augustyn M. Health Care for Youth With Neurodevelopmental Disabilities: A Consensus Statement. Pediatrics 2024; 153:e2023063809. [PMID: 38596852 DOI: 10.1542/peds.2023-063809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 04/11/2024] Open
Abstract
Individuals with a neurodevelopmental disability (NDD) face significant health care barriers, disparities in health outcomes, and high rates of foregone and adverse health care experiences. The Supporting Access for Everyone (SAFE) Initiative was developed to establish principles of health care to improve equity for youth with NDDs through an evidence-informed and consensus-derived process. With the Developmental Behavioral Pediatric Research Network, the SAFE cochairs convened a consensus panel composed of diverse professionals, caregivers, and adults with NDDs who contributed their varied expertise related to SAFE care delivery. A 2-day public forum (attended by consensus panel members) was convened where professionals, community advocates, and adults with NDDs and/or caregivers of individuals with NDDs presented research, clinical strategies, and personal experiences. After this, a 2-day consensus conference was held. Using nominal group technique, the panel derived a consensus statement (CS) on SAFE care, an NDD Health Care Bill of Rights, and Transition Considerations. Ten CSs across 5 topical domains were established: (1) training, (2) communication, (3) access and planning, (4) diversity, equity, inclusion, belonging, and anti-ableism, and (5) policy and structural change. Relevant and representative citations were added when available to support the derived statements. The final CS was approved by all consensus panel members and the Developmental Behavioral Pediatric Research Network steering committee. At the heart of this CS is an affirmation that all people are entitled to health care that is accessible, humane, and effective.
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Affiliation(s)
| | - Cy Nadler
- Children's Mercy Kansas City, Kansas City, Missouri
| | - Nathan J Blum
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Marilyn Augustyn
- Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, Boston, Massachusetts
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3
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Pettersson E, Christensen BM, Berglund IG, Nylander E, Huus K. Children with autism spectrum disorder in high technology medicine environments; a qualitative systematic review of parental perspectives. Syst Rev 2024; 13:34. [PMID: 38238824 PMCID: PMC10795331 DOI: 10.1186/s13643-023-02440-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 12/20/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Children with autism spectrum disorders are frequent visitors to high technology environments, and their needs may differ from those of their typically developed peers. Procedures in high technology environments can constitute a challenge for these children and their parents since the environment presents many challenges relevant to the child's impairments. This systematic review aimed to explore the experiences of children with autism spectrum disorders and their parents during procedures in a high technology environment. METHODS The following sources were searched for this systematic review: Cochrane CENTRAL Trials, CINAHL, Dentistry and Oral Sciences Source, MEDLINE, PsycINFO, Scopus, and Web of Science Core Collection. The search terms included variants of the following concepts: (1) children with autism spectrum disorder and/or their parents and (2) anesthesia or radiographic departments. Publications were not limited by date or study design. RESULT Out of 13,389 bibliographic records, nine studies were eligible for synthesis. After another search in October 2022, one additional study was eligible for synthesis.None of the studies reported children's experiences, and all ten reported their parents' experiences. Only one study was conducted in a radiographic context. Parents' experiences were both positive and negative and were categorized into two main categories: (1) challenges in a new environment and (2) health care professionals' approaches. CONCLUSION Studies describing children's experiences with procedures in high technology environments are lacking. The parents described a need for health care professionals to work in structured ways with their child and to be able to make suitable adaptations. SYSTEMATIC REVIEW REGISTRATION This systematic review was registered in advance on the Open Science Framework, https://doi.org/10.17605/OSF.IO/5TXWJ .
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Affiliation(s)
- Emelie Pettersson
- CHILD Research Group, Nursing Department, School of Health and Welfare, Jönköping University, P.O. Box 1026, 551 11, Jönköping, Sweden.
| | - Berit Møller Christensen
- CHILD Research Group, Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Ingalill Gimbler Berglund
- CHILD Research Group, Nursing Department, School of Health and Welfare, Jönköping University, P.O. Box 1026, 551 11, Jönköping, Sweden
| | | | - Karina Huus
- CHILD Research Group, Nursing Department, School of Health and Welfare, Jönköping University, P.O. Box 1026, 551 11, Jönköping, Sweden
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4
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Dalton EM, Doupnik SK. Envisioning Zero: A Path to Eliminating Restraint Use in Children's Hospitals. Pediatrics 2024; 153:e2023064054. [PMID: 38073327 PMCID: PMC10752823 DOI: 10.1542/peds.2023-064054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 12/30/2023] Open
Affiliation(s)
- Evan M. Dalton
- Section of Pediatric Hospital Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
| | - Stephanie K. Doupnik
- Division of General Pediatrics, Clinical Futures and PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Leonard Davis Institute of Health Economics and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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5
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Stogiannos N, Pavlopoulou G, Papadopoulos C, Walsh G, Potts B, Moqbel S, Gkaravella A, McNulty J, Simcock C, Gaigg S, Bowler D, Marais K, Cleaver K, Lloyd JH, Dos Reis CS, Malamateniou C. Strategies to improve the magnetic resonance imaging experience for autistic individuals: a cross-sectional study exploring parents and carers' experiences. BMC Health Serv Res 2023; 23:1375. [PMID: 38062422 PMCID: PMC10704820 DOI: 10.1186/s12913-023-10333-w] [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] [Received: 08/29/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Autistic individuals encounter numerous barriers in accessing healthcare, including communication difficulties, sensory sensitivities, and a lack of appropriate adjustments. These issues are particularly acute during MRI scans, which involve confined spaces, loud noises, and the necessity to remain still. There remains no unified approach to preparing autistic individuals for MRI procedures. METHODS A cross-sectional online survey was conducted with parents and carers of autistic individuals in the UK to explore their experiences, barriers, and recommendations concerning MRI scans. The survey collected demographic information and experiential accounts of previous MRI procedures. Quantitative data were analysed descriptively, while key themes were identified within the qualitative data through inductive thematic analysis. RESULTS Sixteen parents/carers participated. The majority reported difficulties with communication, inadequate pre-scan preparation, and insufficient adjustments during MRI scans for their autistic children. Key barriers included an overwhelming sensory environment, radiographers' limited understanding of autism, and anxiety stemming from uncertainties about the procedure. Recommended improvements encompassed accessible communication, pre-visit familiarisation, noise-reduction and sensory adaptations, staff training on autism, and greater flexibility to meet individual needs. CONCLUSIONS There is an urgent need to enhance MRI experiences for autistic individuals. This can be achieved through improved staff knowledge, effective communication strategies, thorough pre-scan preparation, and tailored reasonable adjustments. Co-producing clear MRI guidelines with the autism community could standardise sensitive practices. An individualised approach is crucial for reducing anxiety and facilitating participation. Empowering radiographers through autism-specific education and incorporating insights from autistic individuals and their families could transform MRI experiences and outcomes.
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Affiliation(s)
- Nikolaos Stogiannos
- Department of Midwifery & Radiography, School of Health and Psychological Sciences, City, University of London, London, UK
- Medical Imaging Department, Corfu General Hospital, Corfu, Greece
| | - Georgia Pavlopoulou
- Department of Psychology and Human Development, University College London, Institute of Education Group for Research in Relationships in NeuroDiversity-GRRAND, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Chris Papadopoulos
- Institute for Health Research, University of Bedfordshire, Putteridge Bury Campus, Luton, UK.
| | - Gemma Walsh
- Department of Midwifery & Radiography, School of Health and Psychological Sciences, City, University of London, London, UK
| | - Ben Potts
- Department of Midwifery & Radiography, School of Health and Psychological Sciences, City, University of London, London, UK
- Southampton General Hospital, University Hospitals Southampton Foundation Trust, Southampton, UK
| | - Sarah Moqbel
- Anna Freud National Centre for Children and Families, London, UK
| | | | - Jonathan McNulty
- School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Clare Simcock
- Institute of Child Health, Great Ormond Street Hospital for Children NHS Foundation Trust, University College London, London, UK
| | - Sebastian Gaigg
- Department of Psychology, School of Health and Psychological Sciences, City, University of London, London, UK
| | - Dermot Bowler
- Department of Psychology, School of Health and Psychological Sciences, City, University of London, London, UK
| | - Keith Marais
- Community Involvement, University of London, London, UK
| | - Karen Cleaver
- Faculty of Education, Health & Human Sciences, University of Greenwich, London, UK
| | - Jane Harvey Lloyd
- Department of Specialist Science Education, University of Leeds, Leeds, UK
| | - Cláudia Sá Dos Reis
- School of Health Sciences (HESAV), University of Applied Sciences Western Switzerland (HES- SO), Lausanne, CH, Switzerland
| | - Christina Malamateniou
- Department of Midwifery & Radiography, School of Health and Psychological Sciences, City, University of London, London, UK
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6
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Pettersson E, Christensen BM, Berglund IG, Huus K. Healthcare professionals' experiences of situations during a procedure with a child with autism spectrum disorder in the high-technology environment. Child Care Health Dev 2023; 49:1087-1095. [PMID: 37009780 DOI: 10.1111/cch.13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 02/24/2023] [Accepted: 03/17/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND High technological environments can be challenging for children with autism spectrum disorders (ASD), because they can be sensitive to new environments, new faces and changes in daily routines. Those children are frequent visitors in those settings, and due to their heightened healthcare needs and their comorbidities, it could constitute a challenge for healthcare professionals to encounter those children. Exploring the healthcare professionals' experiences can contribute to facilitate the procedure for a child with ASD. METHOD A qualitative descriptive retrospective design with a critical incident technique has been used to capture the situations. Twenty healthcare professionals were interviewed about situations affecting the procedure in the high-technology environments, defined as anaesthesia and radiology departments. RESULT The findings revealed both favourable situations and unfavourable situations affecting the procedure in the high-technology environment. The situations described by the healthcare professionals often involved their interactions with the child and the parents. The interactions were influenced by the parents' attitudes to the procedure and also the healthcare professionals and the parents' different expectations on the procedure. Other experiences described by the healthcare professionals were the unpredictability in different situations. Those situations were related to the child's unpredictable behaviour in those environments and also to the unpredictable effect of premedication provided to the child. Moreover, the result revealed the organizational prerequisites for facilitating a procedure, such as not feeling any time pressure when leading a child through a procedure. CONCLUSIONS Interactions between healthcare professionals, children with ASD and parents in the high-technology environment are complex. Unpredictability characterizes situations when leading a child with ASD through a procedure. This place demands on the healthcare professional, the environment and the organization.
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Affiliation(s)
- Emelie Pettersson
- CHILD Research Group, Nursing Department, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Berit Møller Christensen
- CHILD Research Group, Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Ingalill Gimbler Berglund
- CHILD Research Group, Nursing Department, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Karina Huus
- CHILD Research Group, Nursing Department, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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7
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Haywood M, Patel L. Physical Restraint Use in the Pediatric Emergency Department. Pediatr Emerg Care 2023; 39:807-810. [PMID: 37773613 DOI: 10.1097/pec.0000000000003045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
ABSTRACT Children and adolescents can present to the emergency department with acute agitation and aggression due to various physical and/or mental health conditions. With acute agitation/aggression, these patients may present a risk of injury to themselves, their caregivers, or emergency department providers/staff. It is imperative for providers to understand how to safely care for these children. When initial deescalating interventions fail or an underlying etiology for the behavior change cannot be found, the use of physical restraints may be required. Without proper training or preparation, physical restraints can lead to significant morbidity and mortality. Given these potential risks, strict guidelines have been set out by the Center for Medicare and Medicaid Services and the Joint Commission regarding the use of physical restraints in the pediatric population. This article will review approaches to the acutely agitated/aggressive patient, the appropriate use of physical restraints, and recommended assessment/documentation of restraints in the acutely agitated/aggressive pediatric patient.
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Affiliation(s)
- Mary Haywood
- From the Fellow, Department of Pediatrics, Division of Emergency Medicine, Children's Mercy Hospital, Kansas City, MO
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8
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Al-Jabri B, Alnuwaiser S, Abdulghaffar H, Almuhanna R, Salaam S, Brika R, Addas A, Bedaiwi H. Healthcare Experience of Pediatric Patients with Autism Spectrum Disorders in Saudi Arabia: A Cross-Sectional Study. Pediatr Rep 2023; 15:452-461. [PMID: 37606446 PMCID: PMC10443268 DOI: 10.3390/pediatric15030042] [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: 06/24/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/23/2023] Open
Abstract
Children with autism spectrum disorder (ASD) face several challenges in the healthcare setting. This study defines the challenges experienced by children with autism in hospitals in Saudi Arabia. A cross-sectional study was conducted using a questionnaire for guardians of autistic children in outpatient clinics, autism support groups, and rehabilitation centers. A total of 199 participants were included. The medical procedures causing the most anxiety to children were injections and getting their blood drawn (68.3%), vital sign measurement (41.6%), and height and weight measurement (37.8%). Long waiting hours (44.1%), increased sensory stimuli (33.2%), and overcrowding of hospital staff (27.9%) were stress-inducing in the healthcare environment. The guardians recommended that loud noises (44.7%), crowdedness (41.2%), and long waiting hours (42.1%) be avoided. The nonverbal children experienced significantly higher levels (p < 0.001) of agitation, irritability, and outbursts during doctor visits than their verbal counterparts. The children with intellectual disabilities were more tense and unresponsive during doctor visits (33.3%) than their intellectually able counterparts, who more frequently were calm and responsive (44.9%) during visits. Most patients with ASD face hardships during hospital visits. Nonverbal patients and those with intellectual disabilities have a higher tendency for hospital setting anxiety-induced outbursts, which may be eased by avoiding loud noise and overcrowding.
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Affiliation(s)
- Basma Al-Jabri
- Pediatric Department, Faculty of Medicine, King Abdulaziz University, King Abdulaziz University Hospital, Jeddah 21589, Saudi Arabia;
| | - Sara Alnuwaiser
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Haifa Abdulghaffar
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Rahaf Almuhanna
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Shaimaa Salaam
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Raval Brika
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Alia Addas
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Hala Bedaiwi
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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9
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Schenk K, Weimer AA, Warnell KR. Assessing Child Life Specialists' Management of Challenging Behaviors in Autistic Pediatric Patients. J Autism Dev Disord 2023:10.1007/s10803-023-06032-4. [PMID: 37421588 DOI: 10.1007/s10803-023-06032-4] [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: 05/30/2023] [Indexed: 07/10/2023]
Abstract
Given that autistic children are hospitalized at higher rates than neurotypical peers, it is important to understand the autism-specific preparedness of healthcare providers. Certified Child Life Specialists (CCLSs) play a crucial role in pediatric hospitalizations by providing socioemotional support and coping strategies. The present study assessed perceived competency and comfort levels among 131 CCLSs regarding the management of challenging behaviors exhibited by autistic pediatric patients, including aggression and self-injury. All participants reported experiences providing care to autistic children who exhibited challenging behaviors, but very few reported both high perceived competency and high comfort in managing these behaviors. Autism-specific training positively correlated with perceived competency and comfort. These results have implications for providing autistic children high quality hospital care.
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Affiliation(s)
- Kaitlyn Schenk
- School of Family and Consumer Sciences, Texas State University, San Marcos, TX, 78666, USA
| | - Amy A Weimer
- School of Family and Consumer Sciences, Texas State University, San Marcos, TX, 78666, USA
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10
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Heyming TW, Knudsen-Robbins C, Davis K, Moreno T, Martin SR, Shelton SK, Ehwerhemuepha L, Kain ZN. Caregiver Satisfaction with Emergency Department Care for Pediatric Patients with Neurodevelopmental Disorders. J Dev Behav Pediatr 2023; 44:e388-e393. [PMID: 37205728 DOI: 10.1097/dbp.0000000000001193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/08/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Children with neurodevelopmental disorders (NDDs) often encounter increased adversity when navigating the health care system. In this study, we explored the pediatric emergency department (PED) experience for patients with NDDs and their caregivers compared with that of patients without NDDs. METHODS Data for this study were obtained from National Research Corporation patient experience survey questionnaires and electronic medical record (EMR) data for patients presenting to a PED between May 2018 and September 2019. ED satisfaction was determined by the top-box approach; ED ratings of 9/10 or 10/10 were considered to reflect high ED satisfaction. Demographics, Emergency Severity Index, ED length of stay, time from arrival to triage, time to provider assessment, and diagnoses were extracted from the EMR. Patients with NDDs were identified based on International Classification of Diseases, Tenth Revision codes; patients with intellectual disabilities, pervasive and specific developmental disorders, or attention-deficit/hyperactivity disorders were included in the NDD cohort. One-to-one propensity score matching between patients with and without NDDs was performed, and a multivariable logistic regression model was built on the matched cohort. RESULTS Patients with NDDs represented over 7% of survey respondents. Matching was successful for 1162 patients with NDDs (99.5%), resulting in a matched cohort sample size of 2324. Caregivers of patients with NDDs had 25% lower odds of reporting high ED satisfaction (95% confidence interval [CI], 0.62-0.91, p = 0.004). CONCLUSION Caregivers of patients with NDDs make up a significant proportion of survey respondents and are more likely to rate the ED poorly than caregivers of patients without NDDs. This suggests an opportunity for targeted interventions in this population to improve patient care and experience.
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Affiliation(s)
- Theodore W Heyming
- Department of Emergency Medicine, CHOC Children's, Orange, CA
- Department of Emergency Medicine, University of California, Irvine, CA
| | | | - Konnor Davis
- University of California, Irvine, School of Medicine, Irvine, CA
| | - Tatiana Moreno
- Department of Information Systems, CHOC Children's, Orange, CA
| | - Sarah R Martin
- CHOC Children's, Orange, CA
- Center on Stress & Health, University of California, Irvine, Irvine, CA
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA
| | | | - Louis Ehwerhemuepha
- Department of Information Systems, CHOC Children's, Orange, CA
- School of Computational and Data Sciences, Chapman University, Orange, CA
| | - Zeev N Kain
- Department of Information Systems, CHOC Children's, Orange, CA
- Center on Stress & Health, University of California, Irvine, Irvine, CA
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA
- Department of Pediatrics, CHOC Children's, Orange, CA; and
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Criss SD, Kakulamarri S, Xu RF, Fajardo M, Keeney T, Tolchin DW, May CJ. The Healthcare Experience of Autistic Patients in Orthopaedic Surgery and Closely Related Fields: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050906. [PMID: 37238454 DOI: 10.3390/children10050906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
Orthopaedic and related care has the potential to present unique obstacles for patients with a range of autism manifestations. In this review, we aim to describe and analyze the literature on autistic patients' experience within orthopaedics and closely related fields. This literature search utilized the PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature databases. Three major concepts were built into the search terms: (1) patients on the autism spectrum; (2) patient experience; and (3) movement sciences, including orthopaedics, physical medicine and rehabilitation (PM&R), occupational therapy (OT), and physical therapy (PT). Our search yielded 35 topical publications, with the major topic areas addressed as follows: (1) clinical and perioperative management, (2) therapy interventions, (3) participation in exercise and social play, (4) sensory management and accommodations, (5) caregiver/parent training and involvement in care, (6) healthcare needs and barriers to care, and (7) utilization of technology. In the current literature, there are no studies that attempt to directly assess autistic patient experience with care practices and clinical environments in orthopaedics. Rigorous, direct examination of the experience of autistic patients within clinical orthopaedic settings is urgently needed to address this gap.
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Affiliation(s)
| | | | - Raylin F Xu
- Harvard Medical School, Boston, MA 02115, USA
| | - Maya Fajardo
- Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA 02115, USA
| | - Tamra Keeney
- Mongan Institute, Massachusetts General Hospital, Boston, MA 02114, USA
- Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Dorothy W Tolchin
- Department of Physical Medicine and Rehabilitation, Mass General Brigham, Boston, MA 02114, USA
- Spaulding Rehabilitation Hospital, Charlestown, MA 02129, USA
| | - Collin J May
- Harvard Medical School, Boston, MA 02115, USA
- Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA 02115, USA
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12
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Mbatha NL, Mokwena KE. Parental Stress in Raising a Child with Developmental Disabilities in a Rural Community in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3969. [PMID: 36900985 PMCID: PMC10001439 DOI: 10.3390/ijerph20053969] [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: 01/25/2023] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Although acceptable levels of parental stress are experienced by all parents who raise children, this stress is substantially higher among parents who raise children with developmental disabilities. Sociodemographic determinants further exacerbate parental stress among parents in rural communities, which are disadvantaged in many ways. This study aimed to quantify parental stress among mothers and female caregivers of children with developmental disorders and investigate factors associated with such stress in rural Kwa-Zulu Natal, South Africa. A cross-sectional quantitative survey was used, in which the Parenting Stress Index-Short Form (PSI-SF) and a sociodemographic questionnaire was administered to mothers and caregivers who were raising children aged 1 to 12 years old who were living with developmental disabilities. The PSI-SF scores were used, where a total score of ≤84 percentile was categorised as normal/no parenting stress, 85-89 percentile was categorised as high parental stress, and scores of ≥90 were classified as clinically significant. The sample of 335 participants consisted of 270 (80.6%) mothers and 65 (19.4%) caregivers. Their ages ranged from 19 to 65 years, with a mean of 33.9 (±7.8) years. The children were mostly diagnosed with delayed developmental milestones, communication difficulties, epilepsy, cerebral palsy, autism, ADHD, cognitive impairment, sensory impairments, and learning difficulties. The majority (52.2%) of the participants reported very high-clinically significant stress levels (≥85%ile). The four factors that independently and significantly predicted high parental stress were the advanced age of mothers and caregivers (p = 0.002, OR 2.3, 95% CI 1.34-3.95), caring for a child with multiple diagnoses (p = 0.013, OR 2.0, 95% CI 1.16-3.50), non-school enrolment of the child (p = 0.017, OR 1.9, 95% CI 1.13-3.46), and frequent hospital visits (p = 0.025, OR 1.9, 95% CI 1.09-3.44). At the subscale level, child non-enrolment in a school was found to independently predict parent distress (PD) and parent-child dysfunctional interaction (P-CDI). Frequent hospital visits were statistically and significantly associated with the difficult child (DC) and P-CDI subscales. The study established high parental stress in mothers and caregivers raising children with developmental disabilities. Lack of access to school was an independent factor that consistently increased parental stress. There is a need for support and directed intervention programs aimed at supporting mothers and caregivers of children with developmental disabilities, which will enhance their parenting abilities.
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Affiliation(s)
- Nontokozo Lilian Mbatha
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria 0001, South Africa
| | - Kebogile Elizabeth Mokwena
- NRF Chair in Substance Abuse and Population Mental Health, Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria 0001, South Africa
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13
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The Hospitalized Adolescent. Pediatrics 2023; 151:190500. [PMID: 37184363 DOI: 10.1542/peds.2022-060647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/25/2023] Open
Abstract
This clinical report provides pediatricians evidence-based information on the developmentally appropriate, comprehensive clinical care for hospitalized adolescents. Included in this report are opportunities and challenges facing pediatricians when caring for specific hospitalized adolescent populations. The companion policy statement, “The Hospitalized Adolescent,” includes detailed descriptions of adolescent hospital admission demographics, personnel recommendations, and hospital setting and design advice, as well as sections on educational services, legal and ethical matters, and transitions to adult facilities.
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Wolpert KH, Kodish I, Kim SJ, Uspal NG. Behavioral Management of Children With Autism in the Emergency Department. Pediatr Emerg Care 2023; 39:45-50. [PMID: 36580892 DOI: 10.1097/pec.0000000000002886] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
ABSTRACT Autism spectrum disorder (ASD) is characterized by impaired social communication in conjunction with patterned behaviors. Often associated with emotional dysregulation, irritability, aggression, depression, and suicidality, ASD youth frequently present to the emergency department for behavioral and mental health evaluation. Psychiatric comorbidities, agitation, and depression are commonly encountered. During these visits, practitioners must thoughtfully consider organic etiologies for presenting symptoms, formulate plans to address risk of agitation, and understand how to effectively formulate disposition options in this patient population.
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Affiliation(s)
- Katherine H Wolpert
- From the Assistant Professor (Wolpert) and Associate Professor (Uspal), Division of Emergency Medicine, Department of Pediatrics, University of Washington
| | - Ian Kodish
- Associate Professor (Kim and Kodish), Department of Psychiatry and Behavioral Sciences, University of Washington
| | | | - Neil G Uspal
- From the Assistant Professor (Wolpert) and Associate Professor (Uspal), Division of Emergency Medicine, Department of Pediatrics, University of Washington
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15
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Buranova N, Dampf M, Stevenson B, Sohl K. ECHO Autism: Early Intervention Connecting Community Professionals to Increase Access to Best Practice Autism Intervention. Clin Pediatr (Phila) 2022; 61:518-522. [PMID: 35470694 DOI: 10.1177/00099228221090710] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Autism spectrum disorder (ASD) is estimated to affect 1 in 44 children in the United States. Disparities exist related to socioeconomic, racial/ethnic and geographic demographics. Due to the shortages of autism specialists in diagnosis, treatment and education for people with ASD, novel approaches to improve access to best practices are needed to ensure quality services. ECHO Autism: Early Intervention clinic consists of biweekly sessions focused on early identification and management of evidence-based practices for young children with ASD. It is an adaptation of the ECHO Autism clinic that has been proven effective for primary care providers. The clinic provides a safe, virtual learning environment where diverse professionals who work with children at risk or diagnosed with ASD can collaborate and learn together. ECHO Autism: Early Intervention bridges the care gap between autism specialists, community intervention providers, and children with autism to increase capacity for autism intervention best practices in underserved communities. Through participation in this convenient, web-based small group, the providers get specific case guidance on children at risk or diagnosed with autism and share best practices for autism specific interventions. Finally, the clinic connects participants with community resources, and family/caregiver support. In our article, we address the current challenge of access to quality early intervention specific to ASD in rural and underserved communities and how this issue can be addressed through a virtual ECHO Autism clinic. The aim of this concept article is to describe the innovative ECHO Autism: Early Intervention clinic and discuss its benefits and impact in the field.
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16
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Johnson NL, Lerret S, Polfuss M, Gralton K, Gibson C, Ahamed SI, Riddhiman A, White-Traut R, Brown RL, Sawin KJ. One Size Does Not Fit All: Discharge Teaching and Child Challenging Behaviors. West J Nurs Res 2022; 44:863-873. [PMID: 34044674 PMCID: PMC9842074 DOI: 10.1177/01939459211018829] [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: 01/18/2023]
Abstract
This study compares quality of discharge teaching and care coordination for parents of children with challenging behaviors participating in a nursing implementation project, which used an interactive iPad application, to usual discharge care. Unlike parents in the larger quasi-experimental longitudinal project, parents of children with challenging behaviors receiving the discharge teaching application (n = 14) reported lower mean scores on the quality of discharge teaching scale-delivery subscale (M = 8.2, SD = 3.1) than parents receiving usual care (n = 11) (M = 9.6, SD = 4.7) and lower scores on the Care Transition Measure (M = 2.44, SD = 1.09) than parents receiving usual care (M = 3.02, SD = 0.37), with moderate to large effects (0.554-0.775). The discharge teaching approach was less effective with this subset, suggesting other approaches might be considered for this group of parents. Further study with a larger sample specific to parents of children with challenging behaviors is needed to assess their unique needs and to optimize their discharge experience.
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Affiliation(s)
| | | | - Michele Polfuss
- Children’s Wisconsin, Milwaukee, WI, USA,College of Nursing, University of Wisconsin Milwaukee, Milwaukee, WI, USA
| | | | | | - Sheikh I. Ahamed
- Department of Computer Science, Marquette University, Milwaukee, WI, USA
| | - Adib Riddhiman
- Department of Computer Science, Marquette University, Milwaukee, WI, USA
| | | | - Roger L. Brown
- School of Nursing, University of Wisconsin, Madison, WI, USA
| | - Kathleen J. Sawin
- Children’s Wisconsin, Milwaukee, WI, USA,College of Nursing, University of Wisconsin Milwaukee, Milwaukee, WI, USA
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17
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Wolpert KH, Kim SJ, Kodish I, Uspal NG. Medical Management of Children With Autism in the Emergency Department. Pediatr Emerg Care 2022; 38:332-336. [PMID: 35766926 DOI: 10.1097/pec.0000000000002751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Autism spectrum disorder (ASD) is an increasingly prevalent diagnosis characterized by impairment of social communication and behavioral regulation. Children with ASD seek care more frequently in the emergency department (ED) than their neurotypical peers and the approach to medical evaluation of this population requires heightened attention to a variety of factors. Communication with caregivers, attention to environmental stimulation, identification of accommodation needs, and understanding frequently associated medical conditions are important considerations in ED encounters. Gastrointestinal problems, seizure disorders, and metabolic disease are common causes for ED presentation in children with ASD. A high index of suspicion for underlying medical issues must be maintained, even when children with ASD present primarily for behavioral concerns. Autism spectrum disorder (ASD) is an increasingly prevalent diagnosis characterized by impairment of social communication and behavioral regulation. Children with ASD seek care more frequently in the emergency department (ED) than their neurotypical peers and the approach to medical evaluation of this population requires heightened attention to a variety of factors. Communication with caregivers, attention to environmental stimulation, identification of accommodation needs, and understanding frequently associated medical conditions are important considerations in ED encounters. Gastrointestinal problems, seizure disorders, and metabolic disease are common causes for ED presentation in children with ASD. A high index of suspicion for underlying medical issues must be maintained, even when children with ASD present primarily for behavioral concerns.
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Affiliation(s)
- Katherine H Wolpert
- From the Assistant professor, Division of Emergency Medicine, Department of Pediatrics
| | | | | | - Neil G Uspal
- From the Assistant professor, Division of Emergency Medicine, Department of Pediatrics
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18
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Levin AR, Baumer N, Amaral J, Sargado S, Pawlowski K, Chiujdea M, Schmitt R, Weissman L, Chan E, Sideridis G, Bridgemohan C. Autism Spectrum Disorder Parent Report for Outcome Monitoring: A Preliminary Report of Development and Clinical Utility. J Dev Behav Pediatr 2021; 42:272-282. [PMID: 33394835 DOI: 10.1097/dbp.0000000000000895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 09/30/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Children with autism spectrum disorder (ASD) face challenges across many functional domains. A tool that gathers relevant clinical information before visits, emphasizing symptoms that are likely to change over development and inform clinical interventions, could improve health care quality, allowing for more patient-centered and efficient care. This study evaluated the clinical utility and preliminary psychometrics of the ASD Parent Report for Outcome Monitoring (ASD-PROM), a web-based measure assessing competence in core features of ASD, along with the breadth of concerns and comorbidities that frequently co-occur with ASD. METHODS An interdisciplinary team drafted the ASD-PROM and made iterative revisions based on parent feedback. Parents of 62 children completed the ASD-PROM before their autism-specialty clinical visit, 53 completed the ASD-PROM twice, and 48 completed the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) concurrently. Parents (n = 25) and clinicians (n = 13) completed postvisit surveys to assess utility (phase 1). The ASD-PROM was then released for general clinical use (phase 2). RESULTS On a Likert scale (1 = very poorly, 10 = very well), parents found that ASD-PROM items described their child's abilities well (median = 8.0; interquartile range [IQR]: 7.0-9.5) and had a positive effect on care (median = 8.0; IQR: 7.0-10.0). Clinicians found the ASD-PROM effective in assessing parent-reported patient abilities (median = 9.0, IQR: 7.0-9.0) and felt the ASD-PROM helped make their care more patient-centered and efficient (both median = 8.0, IQR: 6.0-9.0). Two-week test-retest reliability was acceptable (0.95). ASD-PROM scores correlated positively with scores from similar domains on the Vineland-II (Pearson r 0.30-0.50, medium to large effects). CONCLUSION The ASD-PROM is a freely available tool to gather information on developmental and behavioral functioning in children with ASD before autism-specialty clinical visits. Clinical utility and preliminary psychometrics are promising, although limitations (including a low response rate during clinical use and a need for additional in-depth assessments and potential resulting modifications to the tool) remain to be addressed. Ultimately, the ASD-PROM may help promote patient-centered and efficient care for children across a wide range of ages and developmental levels.
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Affiliation(s)
- April R Levin
- Department of Neurology, Boston Children's Hospital, Boston, MA
| | - Nicole Baumer
- Department of Neurology, Boston Children's Hospital, Boston, MA
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Joseph Amaral
- Division of Neuropsychology, Department of Neurology, Children's Hospital of Wisconsin, Milwaukee, MI
| | - Sabrina Sargado
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Katherine Pawlowski
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | | | - Rachel Schmitt
- Department of Neurology, Boston Children's Hospital, Boston, MA
| | - Laura Weissman
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Eugenia Chan
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Georgios Sideridis
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Carolyn Bridgemohan
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA
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19
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Goss M, Afghani B, Piazza CC, Sabapathy T, Key T, Keating S, Nyp SS. Navigating Medical Care for a Young Adult with Developmental Disability. J Dev Behav Pediatr 2021; 42:245-248. [PMID: 33660667 DOI: 10.1097/dbp.0000000000000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
CASE Sam is a 20-year-old young man with intermittent gastritis, autism spectrum disorder, and intellectual disability who was admitted to the hospital because of nutritional concerns. His parents have legal guardianship and report that he has had increasing frequency of refusal to eat, resulting in a 15-pound weight loss over the past 3 months. On admission, a multidisciplinary team including specialists in gastroenterology, nutrition, feeding (behavioral and mechanical), psychiatry, palliative care, and social work was engaged to develop an evaluation and care plan. Sam's nutritional assessment was significant for severe malnutrition. An upper endoscopy was performed and was without abnormalities, including signs of significant gastritis.An upper endoscopy was performed and was without abnormalities, including signs of significant gastritis.A carefully obtained history found that Sam does not have a primary care physician. He was recently hospitalized at another facility because of his weight loss and nutritional concerns but was discharged against medical advice because of parental dissatisfaction with his care. His mother shared that she has tried many strategies to encourage Sam to eat including pushing spoons of food into his mouth, syringe feeding, and verbally pleading with Sam to take a bite, but all of these have been without success.Because of concerns that persistent attempts to verbally and physically coerce Sam to eat may be contributing to his aversion to food/eating, the feeding team provided Sam's parents with education and coaching for utilization of behavioral cues to determine when Sam wanted to eat. Despite parents expressing their understanding of the importance of avoiding physical attempts to "make" Sam eat and the team palliative care physician meeting with Sam's parents to elicit their goals for Sam's care, his nurses reported observing several instances of Sam's mother tapping a loaded spoon on his lips. Because of minimal oral intake, a nasogastric tube was placed for provision of hydration and nutrition. Sam's parents consented to the use of soft restraints and the presence of a bedside patient care assistant because of Sam becoming agitated and pulling at the tube.After 10 days of hospitalization, Sam was taking about 50% of his goal intake by mouth. Unfortunately, Sam removed his NG tube, and his parents refused to allow the tube to be replaced. Sam's parents then discharged him against medical advice, stating that they believed he would recover better at home. What are important considerations in caring for patients like Sam in the hospital setting and beyond?
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Affiliation(s)
- Megan Goss
- UC Irvine/CHOC Children's Hospital of Orange County, Orange, CA
| | - Behnoosh Afghani
- UC Irvine School of Medicine Hospitalist
- Department of Pediatrics, CHOC Children's Hospital of Orange County, Orange, CA
| | - Cathleen C Piazza
- Pediatric Feeding Disorders Program, Children's Specialized Hospital
- Graduate School of Applied and Professional Psychology, Rutgers University, Somerset, NJ
| | - Thusa Sabapathy
- The Center for Autism & Neurodevelopmental Disorders
- University of California Irvine, Santa Ana, CA
| | - Tayler Key
- Children's Hospital of Orange County, Orange, CA
| | | | - Sarah S Nyp
- Division of Developmental and Behavioral Health, Children's Mercy Kansas City
- UMKC School of Medicine, Kansas City, MO
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20
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Caring for Adults With Autism Spectrum Disorder in the Emergency Department: Lessons Learned From Pediatric Emergency Colleagues. J Emerg Nurs 2021; 47:384-389. [PMID: 33637342 DOI: 10.1016/j.jen.2020.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 12/05/2020] [Accepted: 12/27/2020] [Indexed: 11/21/2022]
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21
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Vuattoux D, Colomer-Lahiguera S, Fernandez PA, Jequier Gygax M, Choucair ML, Beck-Popovic M, Diezi M, Manificat S, Latifyan S, Ramelet AS, Eicher M, Chabane N, Renella R. Cancer Care of Children, Adolescents and Adults With Autism Spectrum Disorders: Key Information and Strategies for Oncology Teams. Front Oncol 2021; 10:595734. [PMID: 33552969 PMCID: PMC7856416 DOI: 10.3389/fonc.2020.595734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/07/2020] [Indexed: 11/14/2022] Open
Abstract
Delivering optimal cancer care to children, adolescents and adults with ASD has recently become a healthcare priority and represents a major challenge for all providers involved. In this review, and after consideration of the available evidence, we concisely deliver key information on this heterogenous group of neurodevelopmental disorders, as well as recommendations and concrete tools for the enhanced oncological care of this vulnerable population of patients.
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Affiliation(s)
- Delphine Vuattoux
- Division of Autism Spectrum Disorders and Related Conditions, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Sara Colomer-Lahiguera
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Pierre-Alain Fernandez
- Division of Autism Spectrum Disorders and Related Conditions, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Marine Jequier Gygax
- Division of Autism Spectrum Disorders and Related Conditions, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Marie-Louise Choucair
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, Department “Woman-Mother-Child”, Lausanne University Hospital, Lausanne, Switzerland
| | - Maja Beck-Popovic
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, Department “Woman-Mother-Child”, Lausanne University Hospital, Lausanne, Switzerland
| | - Manuel Diezi
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, Department “Woman-Mother-Child”, Lausanne University Hospital, Lausanne, Switzerland
| | - Sabine Manificat
- Division of Autism Spectrum Disorders and Related Conditions, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Sofiya Latifyan
- Division of Medical Oncology, Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Anne-Sylvie Ramelet
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Department “Woman-Mother-Child”, Lausanne University Hospital, Lausanne, Switzerland
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
- Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Nadia Chabane
- Division of Autism Spectrum Disorders and Related Conditions, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Raffaele Renella
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, Department “Woman-Mother-Child”, Lausanne University Hospital, Lausanne, Switzerland
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22
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Jensen EJ, Geisthardt C, Sarigiani PA. Working with Children with Autism Spectrum Disorder in a Medical Setting: Insights from Certified Child Life Specialists. J Autism Dev Disord 2019; 50:189-198. [PMID: 31583622 DOI: 10.1007/s10803-019-04245-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study aimed to gain an understanding of Certified Child Life Specialists' (CCLS) experiences with and suggestions for working with children with autism spectrum disorder (ASD) in a medical setting. Using a mixed-method design, 118 CCLS completed an online survey and 16 participated in follow-up interviews. Participants believed many medical professionals, including CCLS, are not adequately prepared to work with children with ASD, negatively impacting quality of care. Participants emphasized that outcomes are best for children with ASD when parents and medical staff collaborate to meet the unique needs of each child. CCLS reported working with children with ASD can provide insights for enhancing the quality of care for all children. Participants' suggestions for training and resource development are discussed.
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Affiliation(s)
- Emily J Jensen
- Department of Human Development and Family Studies, College of Education and Human Services, Central Michigan University, Mount Pleasant, MI, USA
| | - Cheryl Geisthardt
- Department of Human Development and Family Studies, College of Education and Human Services, Central Michigan University, Mount Pleasant, MI, USA. .,Department of Human Development and Family Studies, 412B Education and Human Services, Central Michigan University, Mount Pleasant, MI, 48859, USA.
| | - Pamela A Sarigiani
- Department of Human Development and Family Studies, College of Education and Human Services, Central Michigan University, Mount Pleasant, MI, USA
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