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Vinayagam R, Tanner C, Harley D, Karatela S, Brooker K. "My Autism is Linked with Everything": at the Crossroads of Autism and Diabetes. J Autism Dev Disord 2024; 54:3122-3132. [PMID: 37480434 PMCID: PMC11300468 DOI: 10.1007/s10803-023-06033-3] [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] [Accepted: 05/30/2023] [Indexed: 07/24/2023]
Abstract
Autistic adults experience stark health disparities and difficulties accessing health care. Their realities of managing complex health conditions are unknown. Our research explored the experience of Autistic adults self-managing diabetes. Interviews with Autistic adults with diabetes and their support people were thematically analysed to identify three key themes. The Autistic experience influenced diabetes self-management, including autism-unique challenges and strengths. Participants prioritised avoiding Autistic burnout over diabetes self-management; mitigating the psychosocial pressures of neurotypical systems took precedence. Health professionals often separated autism and diabetes subsequently overlooking key factors impacting diabetes self-management. To better meet the needs of Autistic adults, diabetes care and health management more broadly should be considered within the context of autism, including supports for self-management during Autistic burnout.
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Affiliation(s)
- Ritwika Vinayagam
- Queensland Centre for Intellectual and Developmental Disability (QCIDD), Mater Research Institute-UQ, The University of Queensland, Level 2, 39 Annerley Rd, South Brisbane, QLD, 4101, Australia.
- The Cooperative Research Centre for Living with Autism (Autism CRC), Level 3, Foxtail Building UQ Long Pocket Campus, 80 Meiers Rd, Indooroopilly, QLD, 4068, Australia.
| | - Christopher Tanner
- Queensland Centre for Intellectual and Developmental Disability (QCIDD), Mater Research Institute-UQ, The University of Queensland, Level 2, 39 Annerley Rd, South Brisbane, QLD, 4101, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Level 3, Foxtail Building UQ Long Pocket Campus, 80 Meiers Rd, Indooroopilly, QLD, 4068, Australia
| | - David Harley
- UQ Centre for Clinical Research, Royal Brisbane & Women's Hospital Campus, Building 71/918, Herston, QLD, 4029, Australia
| | - Shamshad Karatela
- School of Pharmacy, The University of Queensland, Level 4/20 Cornwall St, Woolloongabba, QLD, 4102, Australia
- Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, Building 48 1 James Cook Drive, Douglas, QLD, 4811, Australia
| | - Katie Brooker
- Queensland Centre for Intellectual and Developmental Disability (QCIDD), Mater Research Institute-UQ, The University of Queensland, Level 2, 39 Annerley Rd, South Brisbane, QLD, 4101, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Level 3, Foxtail Building UQ Long Pocket Campus, 80 Meiers Rd, Indooroopilly, QLD, 4068, Australia
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Domarecki P, Plata-Nazar K. The Assessment of Comprehensive Care for Autistic Children Provided by Polish Primary Healthcare Physicians in Parental View. Glob Pediatr Health 2024; 11:2333794X241258657. [PMID: 39086597 PMCID: PMC11289814 DOI: 10.1177/2333794x241258657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 08/02/2024] Open
Abstract
Objectives. Important factor in caring for ASD patients is the successful cooperation between the physician and the parent. Methods. The online survey has been conducted. For statistical analysis the t-student test and the U-Mann Whitney test were performed to compare 2 variables, then the Kruskal-Wallis test or ANOVA as well as The Pearson correlation and Sperman's rank correlation were performed. Results. 80.5% of respondent's PHPs did not notice the child's developmental difficulties. 22.02% of respondents can speak to their PHP about a child's difficulties. PHPs take different strategies to make patient contact with the healthcare system easier. We discovered statistically significant differences in the assessment of PHPs' abilities depending on the physicians' specialty, the children's age, the age at ASD diagnosis. Conclusion. The care for autistic patients provided by Polish PHPs is insufficient and the topic needs to be addressed immediately.
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Affiliation(s)
| | - Katarzyna Plata-Nazar
- Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Medical University of Gdańsk, Poland
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3
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Talley M, Brown C, Wingo N, Conway J, Maha J, Kong M. Neurodivergent patient experience in a tertiary children's hospital-a qualitative analysis. Front Pediatr 2024; 12:1427433. [PMID: 39081926 PMCID: PMC11286462 DOI: 10.3389/fped.2024.1427433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/03/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Sensory processing challenges are commonly encountered in pediatric patients, particularly in those who are neurodivergent. We previously developed a novel clinical pathway (named "Sensory Pathway") which aimed at improving patient care for those with sensory barriers via staff training, provision of sensory toolkits and early integration of families throughout the hospital stay. We hypothesized that utilization of this pathway will result in improved patient experience and provide valuable feedback to improve care. Methods A voluntary survey was made available to all patients who utilized this resource as part of our hospital wide patient satisfaction survey. Qualitative data was coded using open coding as part of the constant comparison method data using NVivo 12 for Windows software for analysis. Software was used to create word clouds and clusters for visualization, which confirmed the themes and patterns that were noted from initial open coding. Results Between 2021 and 2022, surveys were obtained from 160 patients who utilized the Sensory Pathway. More than 50% reported that the most helpful components of the pathway were the approach by the staff and sensory tools. The three major themes identified from the survey were (1) Tools and techniques that benefited their children; (2) Positive interactions and communication with the hospital staff, and (3) Suggestions for future improvement. Conclusion The survey results highlight the importance of having tools readily available to aid with sensory regulation and comfort of patients during healthcare encounters, the value of a positive patient and staff encounter, as well as opportunities for improvement.
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Affiliation(s)
- Michele Talley
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Chelsea Brown
- Children’s of Alabama, Birmingham, AL, United States
| | - Nancy Wingo
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States
| | | | | | - Michele Kong
- Children’s of Alabama, Birmingham, AL, United States
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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Harrison AJ, Naqvi NC, Smit AK, Kumar PN, Muhammad NA, Saade S, Yu L, Cappe E, Low HM, Chan SJ, de Bildt A. Assessing Autism Knowledge Across the Global Landscape Using the ASK-Q. J Autism Dev Disord 2024; 54:1897-1911. [PMID: 36892718 DOI: 10.1007/s10803-023-05936-5] [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] [Accepted: 02/13/2023] [Indexed: 03/10/2023]
Abstract
Substantial variability exists with regard to autism service provision around the world. Service disparities observed in many low- and middle-income countries may be driven, in part, by limited autism knowledge; however, measurement limitations have made it difficult to quantify autism knowledge across countries. The current study uses the autism stigma and knowledge questionnaire (ASK-Q) to quantify autism knowledge and stigma between different countries and demographics. The current study compiled data from 6830 participants collected using adapted versions of the ASK-Q administered in 13 different countries, representing four different continents. Structural equation modeling was used to examine how autism knowledge varied across country and individual factors. Results reveal cross country variability with a large, 17-point difference between the countries with the highest knowledge (Canada) and the lowest knowledge (Lebanon). As expected, countries with higher economies had higher levels of knowledge. We also documented differences based on country worldview, participant occupation, gender, age, and education level. These results help to identify specific regions and populations that might most need greater information about autism.
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Affiliation(s)
- Ashley J Harrison
- Educational Psychology Department, University of Georgia, Athens, GA, 30606, USA.
- Department of Educational Psychology, University of Georgia, Aderhold Hall 110 Carlton Street, Athens, GA, 30602, USA.
| | - Nilofer C Naqvi
- Department of Psychology, Iona University, New Rochelle, NY, 10801, USA
| | - Anne K Smit
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Accare Child Study Center, Groningen, The Netherlands
| | - Prisha Nanda Kumar
- Educational Psychology Department, University of Georgia, Athens, GA, 30606, USA
| | - Noor Azimah Muhammad
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia. Jalan Yaacob Latiff, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Sabine Saade
- Psychology Department, American University of Beirut, Beirut, 1107 2020, Lebanon
| | - Luodi Yu
- Center for Autism Research, School of Education, Guangzhou University, Wenyi Bldg, Guangzhou, China
| | - Emilie Cappe
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, 92100, Boulogne-Billancourt, France
- Institut Universtaire de France (IUF), Paris, France
| | - Hui Min Low
- School of Education Studies, Universiti Sains Malaysia, Penang, Malaysia
| | - Sarah-Jane Chan
- Manggatal Health Clinic, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Annelies de Bildt
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Accare Child Study Center, Groningen, The Netherlands
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5
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Hoang AQ, Lerman DC, Nguyen JT. Virtual Training of Medical Students to Promote the Comfort and Cooperation of Patients with Neurodevelopmental Disabilities. J Autism Dev Disord 2024; 54:1249-1263. [PMID: 36648564 PMCID: PMC9844946 DOI: 10.1007/s10803-023-05896-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] [Subscribe] [Scholar Register] [Accepted: 01/08/2023] [Indexed: 01/18/2023]
Abstract
Patients with neurodevelopmental disabilities generally have less access to necessary medical care compared to those without disabilities. Barriers to adequate care include patient fear and uncooperative behavior during routine medical procedures and inadequate preparation of medical professionals to treat this population. Researchers have identified multiple behavior-analytic procedures for promoting comfort and cooperation during medical treatments. Efficient, cost-effective training programs are needed to widely disseminate behavior-analytic procedures to medical students and professionals. The purpose of this study was to assess the efficacy of a virtual training to prepare medical students to implement behavioral procedures that could be easily incorporated into typical wellness examinations. Seven medical students received behavioral skills training (BST) delivered remotely via the Internet. Results showed that the training successfully increased students' correct implementation of the procedures in roleplay with the experimenter and with patients with neurodevelopmental disabilities. Responding also maintained at high levels 2 weeks after the training. These findings suggest that virtual BST is an efficient, practical approach for training health care professionals to implement general behavior management strategies to increase the comfort and cooperation of patients with NDD.
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Affiliation(s)
- Andrea Q Hoang
- Clinical, Health, and Applied Sciences, University of Houston-Clear Lake, 2700 Bay Area Blvd., Campus Box 245, Houston, TX, 77058, USA
| | - Dorothea C Lerman
- Clinical, Health, and Applied Sciences, University of Houston-Clear Lake, 2700 Bay Area Blvd., Campus Box 245, Houston, TX, 77058, USA.
| | - Jennifer Trang Nguyen
- Clinical, Health, and Applied Sciences, University of Houston-Clear Lake, 2700 Bay Area Blvd., Campus Box 245, Houston, TX, 77058, USA
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Bitektine E, Hintermayer MA, Chen A, Ko A, Rodriguez C. Medical students' perceptions on preparedness and care delivery for patients with autism or intellectual disability. CANADIAN MEDICAL EDUCATION JOURNAL 2024; 15:37-47. [PMID: 38528903 PMCID: PMC10961132 DOI: 10.36834/cmej.76338] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Introduction To provide competent care to patients with autism spectrum disorder (ASD) or intellectual developmental disorder (IDD), healthcare professionals must recognize the needs of neurodivergent populations and adapt their clinical approach. We assessed the perceived preparedness of medical students to adapt care delivery for patients with ASD/IDD, as well as their perceptions on neurodiversity education. Methods We conducted a sequential explanatory mixed-methods study on undergraduate medical students at McGill University during the academic year 2020-2021. We administered an online survey, followed by semi-structured interviews. We analyzed data using descriptive statistics and thematic analysis. We integrated findings at the interpretation level. Results We included two-hundred-ten survey responses (~29% of class), and 12 interviews. Few students felt prepared to adjust care for patients with ASD/IDD despite most indicating doing so was important. Ninety-seven percent desired more training regarding care accommodation for neurodivergent patients. Thematic analysis unveiled the perception of current insufficient education, and the value of experiential learning. Discussion/Conclusions This study highlights low perceived preparedness of medical students to accommodate care for neurodivergent patients, and a desire for more instruction. Incorporating interactive training in medical school curricula regarding modifying care delivery for neurodivergent individuals may improve the perceived preparedness of medical trainees to work with these patients and care quality.
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Affiliation(s)
- E Bitektine
- Department of Medicine and Dentistry, McGill University, Quebec, Canada
| | - M A Hintermayer
- Department of Medicine and Dentistry, McGill University, Quebec, Canada
- Montreal Neurological Institute, McGill University, Quebec, Canada
| | - A Chen
- Department of Medicine and Dentistry, McGill University, Quebec, Canada
| | - A Ko
- Department of Medicine and Dentistry, McGill University, Quebec, Canada
| | - C Rodriguez
- Department of Family Medicine, School of Medicine, Faculty of Medicine and Health Sciences, McGill University, Quebec, Canada
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Quebec, Canada
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Soares N, VanDerKolk K, Hasan MS, Burge SK, Graves L. Family Medicine Residency Program Directors' Perception of Curricular Elements Related to Autism: A CERA Study. Fam Med 2024; 56:94-101. [PMID: 38055853 DOI: 10.22454/fammed.2023.160547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
BACKGROUND AND OBJECTIVES The family medicine (FM) approach to health care across the life span is well-suited to providing care for persons living with autism spectrum disorder (ASD). Little is known about ASD curricula in FM residency training and the characteristics of FM residency programs that prepare their residents to care for persons with this disorder. METHODS Our study questions were part of a larger omnibus survey by the Council of Academic Family Medicine Educational Research Alliance (CERA) with data collection from November 16 to December 18, 2022, from FM residency program directors (PDs). ASD curricula were investigated using 10 questions, with descriptive analyses and nonparametric comparisons between program variables and ASD curriculum. RESULTS The response rate was 42.18%, with FM PDs reporting that their programs were preparing residents in the care of youth (71.53%) and adults (68.33%) with ASD, but to a lesser extent (58.89%) in facilitating transitions of care. Programs with faculty champions, access to published curricula, sufficient patients with ASD, and engagement of interprofessional faculty reported a higher proportion of resident preparedness. PDs of community-based programs were most confident in their ability to teach ASD care and transitions of care. CONCLUSIONS Most FM PDs modestly agreed that they are preparing residents to provide care to patients with ASD and their families. PDs of programs with greater access to resources (ie, published curriculum, faculty champions, sufficient patients with ASD, interprofessional faculty experts) believed that their residents were more prepared. Community-based FM educators may help lead the way in providing models for care and education in this regard.
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Affiliation(s)
- Neelkamal Soares
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI
| | - Kristi VanDerKolk
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI
| | | | | | - Lisa Graves
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI
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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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Sohl K, Levinstein L, James A, Greer S, Boles K, Curran AB, Mahurin M, Mazurek MO, Nanclares V. ECHO (Extension for Community Healthcare Outcomes) Autism STAT: A Diagnostic Accuracy Study of Community-Based Primary Care Diagnosis of Autism Spectrum Disorder. J Dev Behav Pediatr 2023; 44:e177-e184. [PMID: 36978232 DOI: 10.1097/dbp.0000000000001172] [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: 03/30/2023]
Abstract
OBJECTIVE Children can be reliably diagnosed with autism spectrum disorder (ASD) by a highly trained clinician as early as 12 to 24 months of age, but recent estimates indicate that the average age of diagnosis is 4.4 years. We hypothesized that trained primary care physicians and practitioners can reliably and accurately diagnose children 14 to 48 months with unambiguous symptoms of ASD. METHODS Through this diagnostic accuracy study, 20 patients diagnosed with ASD by clinicians trained through the ECHO (Extension for Community Healthcare Outcomes) Autism STAT program participated in an independent gold-standard evaluation at a regional autism center. Caregiver perceptions of the diagnostic process were also assessed. RESULTS Of the 20 patients who received a diagnosis of ASD by a trained clinician and completed the study, 19 diagnoses were confirmed by a gold-standard evaluation. Caregivers indicated that undergoing diagnosis in their local community rather than an autism specialty center was helpful (4.8/5 on a 5-point Likert scale, n = 19). Results of this study demonstrate that primary care clinicians can be trained to reliably diagnose ASD in children 14 to 48 months with unambiguous symptoms. CONCLUSION Diagnosis in the primary care setting may lead to earlier diagnosis and quicker connection to evidence-based therapies and interventions. Given the potential impact of increasing access to high-quality diagnostic services, the role of primary care clinicians in the diagnosis of ASD should be further evaluated.
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Affiliation(s)
- Kristin Sohl
- University of Missouri, School of Medicine, Columbia, MO
- Department of Child Health, University of Missouri, Columbia, MO
| | | | - Alexandra James
- University of Missouri, School of Medicine, Columbia, MO
- Department of Child Health, University of Missouri, Columbia, MO
| | - Sophia Greer
- University of Missouri, School of Medicine, Columbia, MO
| | - Katrina Boles
- Department of Child Health, University of Missouri, Columbia, MO
| | | | - Melissa Mahurin
- Department of Child Health, University of Missouri, Columbia, MO
| | - Micah O Mazurek
- University of Virginia, School of Education and Human Development, Charlottesville, VA
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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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11
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Positive Healthcare Encounters for Children With Autism Spectrum Disorder: Accommodations During Surgical Procedures. J Perianesth Nurs 2023; 38:6-11. [PMID: 35970662 DOI: 10.1016/j.jopan.2022.05.070] [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: 11/15/2021] [Revised: 04/16/2022] [Accepted: 05/13/2022] [Indexed: 01/28/2023]
Abstract
Children with autism spectrum disorder have unique needs during medical procedures involving anesthesia. However, with early patient identification, provider champions can adapt their practice to better serve this population, thereby improving patient satisfaction and outcomes. This article describes a novel protocol developed by an anesthesia resource center to modify care for children with autism spectrum disorder and their families. This information serves as a template for perianesthesia nurses and advanced care providers to implement practice accommodations. Two case examples, based on parent interviews and chart review, are presented to exemplify this protocol.
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Gallaher L, Butler C, Banerjee S, Wright J, White A, Daley S. Medical student perceptions of autism education: A qualitative study. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1096117. [PMID: 36926183 PMCID: PMC10011116 DOI: 10.3389/fresc.2023.1096117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/13/2023] [Indexed: 03/06/2023]
Abstract
Background The global prevalence of autism is reported to be at least 1% and is rising. Autistic people have a range of comorbidities resulting in a high use of health services. Doctors of nearly all specialties are likely to encounter autistic people in their practice. Autistic people report dissatisfactory care and encounter disproportionately worse health-related outcomes than non-autistic people, which in part has been attributed to a lack of skill and awareness in the medical workforce. At present, autism education is not always included in undergraduate medical curricula. In England, the Department of Health and Social Care has mandated that autism education should be included in all undergraduate medical curricula but current evidence relating to the delivery and receipt of autism education is poor. A greater understanding of medical student perceptions of autism education is required to inform curriculum development. This qualitative study sought to explore the perceptions of autism education in final year medical students at a medical school in South-East England by 1) assessing their perceived preparedness to care for autistic people once they have graduated from medical school and 2) determining their perceived acceptability of a new undergraduate education programme, Time for Autism (TfA). Materials and methods A purposeful sample of ten final-year medical students were recruited. Students completed in-depth, individual interviews. Data was analysed using thematic analysis. Results Four key themes were identified: Learning environment, Exposure, Relevance and Curricular priority. The findings of this study indicate that medical students perceived greatest value in autism education when it was directly relevant to developing preparedness for practice. Value was influenced by the perceived curricular priority attached to autism education. The new autism programme, Time for Autism was perceived to add relevance and priority to autism education in the existing curriculum in this medical school setting. Discussion The study findings shed new light on medical education literature, emphasising the importance of congruence between the provision of autism education and the prioritisation of autism education within the curriculum. Consideration of relevance and curricular priority can be used to support the development of autism education in future medical curricula.
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Affiliation(s)
- Laura Gallaher
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Ceri Butler
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Juliet Wright
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Ann White
- Department of Community Paediatrics, Sussex Community NHS Trust, Brighton, United Kingdom
| | - Stephanie Daley
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, United Kingdom
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Dursun OB, Turan B, Öğütlü H, Binici NC, Örengül AC, Alataş E, Özdemir RM, Taşlıbeyaz E, Karaman S, Mukaddes NM, on behalf of Turkish Autism Workgroup, Alkaşi A, Bozkurt A, Güneş A, Çevikaslan A, Erol A, Kiliçoğlu AG, Karayağmurlu A, Beşenek AM, Aral A, Adanir AS, Birdir A, Mustan AT, Karaboğa AEÇ, Çiçek AU, Arman A, Ayaz AB, Büyükaslan A, Ay B, Ayik B, Karabucak B, Şahin B, Kalayci BM, Ocakoğlu BK, Özgür BG, Özcan BG, Karakpici B, Tumba C, İnce C, Tanıdır C, Mutlu C, Ceylan C, Kaya C, Achmet CCC, Aslan C, Yalvaç ÇT, Yektaş Ç, Bilginer Ç, Çildir DA, Yıldız D, Sapmaz D, Ayyıldız D, Varmış DA, Güntepe D, Yılmaz D, Kaba D, Karagöz D, Kınay D, Türe ES, Topçu E, Şentürk E, İşeri E, Özen E, Taşyürek E, Atabay E, Çöp E, Güney E, Güzel E, Aşıkhasanoglu EÖ, Demirdöğen EŞ, Çelebi F, Özbek F, Durmuş FB, Ari F, Yıldırım F, Gümüştaş F, Güven G, Yücel Gİ, Coşun GN, Ulaş G, Bulut GÇ, Ayaz G, Karaçetin G, Dinç GŞ, Kara H, Harmancı H, Toz Hİ, Aykutlu HC, Kandemir H, Güneş H, Genç HA, Gül H, Doğru H, Adaletli H, Kılıç HT, Aktaş H, Esin İS, Erdoğan İ, Kaya İ, Çimen İD, Kirtil İY, Nalbant K, Tarakçıoğlu MC, Çakır M, Kara MZ, Kinik MF, Karadağ M, Sertçelik M, Şahin M, Keleş M, Topal M, Terzioğlu MA, Çolpan M, Demirtaş ME, Onat M, Usta MB, Coşkun M, Gülşen M, Erkan MC, Bahalı MK, Demir N, Çetin NK, Kilit N, Ayaz N, Çetin NY, Nilüfer, Aliyev O, Demir N, Şimşek NE, Ünaldi N, Soylu N, Bilgin N, Fındık OTP, Yüzügüldü O, Demir O, Kocaman O, Tuncer ÖF, Küçük Ö, Üneri Ö, Çoban ÖG, Yalçin Ö, Hekim Ö, Keskiner Ö, Uzun Ö, Algedik P, Yılmaz R, Bostan R, Sanberk S, Gün SE, Yilmaz S, Aksu S, Özkan S, Hesapçioğlu ST, Erden S, Arslan SC, Çelenay S, Kala S, Nasiroğlu S, Karakoç S, Çiçek S, Hocaoğlu S, Avcil S, Derin S, Yilmaz SS, Fırat S, Eray Ş, Kilinçel Ş, Coşkun Ş, Uysal T, Kadak T, Karaosman T, Mutluer T, Soylemez TE, Kalyoncu T, Fidan T, Kaytanli U, Gündoğdu Ü, Gündüz Y, Torun YT, Yulaf Y, Güleş Z, Babadaği Z. A new model for recognition, referral, and follow‐up of autism spectrum disorder: A nationwide program. Autism Res 2022. [DOI: 10.1002/aur.2813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Onur Burak Dursun
- General Directorate of Health Services, Autism, Mental Special Needs and Rare Diseases Department Turkish Ministry of Health Ankara Turkey
| | - Bahadır Turan
- Department of Child and Adolescent Psychiatry Karadeniz Technical University Trabzon Turkey
| | - Hakan Öğütlü
- Department of Child and Adolescent Psychiatry Ankara City Hospital Ankara Turkey
| | - Nagihan Cevher Binici
- Department of Child and Adolescent Psychiatry Dr. Behcet Uz Child Disease and Pediatric Surgery Training and Research Hospital Izmır Turkey
| | | | - Esra Alataş
- General Directorate of Public Health Turkish Ministry of Health Ankara Turkey
| | - Rabia Madan Özdemir
- General Directorate of Health Services, Autism, Mental Special Needs and Rare Diseases Department Turkish Ministry of Health Ankara Turkey
| | - Elif Taşlıbeyaz
- Faculty of Computer and Instructional Technologies Education Erzincan University Erzincan Turkey
| | - Selçuk Karaman
- Department of Management and Information Systems Hacı Bayram Veli University Ankara Turkey
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Dhuga Y, Feeney Y, Gallaher L, White A, Wright J, Banerjee S, Daley S. Developing undergraduate autism education for medical students: a qualitative study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001411. [PMID: 36053627 PMCID: PMC9345079 DOI: 10.1136/bmjpo-2022-001411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/13/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Autistic adults and children experience considerable health inequalities and have high rates of premature mortality, hospital admissions and emergency department visits. This is in part due to a lack of autism awareness in the healthcare and social care workforce. A new educational programme, Time for Autism (TfA), for medical students is being developed to address this challenge. This qualitative study was undertaken to support the development of the new programme in order to (1) understand the medical care experiences of parents of autistic children and (2) assess their views on the acceptability of the new TfA programme and willingness to be involved. METHODS A convenience sample of 11 parents of autistic children were recruited across the South of England. The ages of the autistic children ranged from 3 to 17 years. Semistructured interviews were completed between October and December 2019. Interview transcripts were analysed using thematic analysis. RESULTS Three key themes were identified: diagnosis, experiences of doctors and TfA considerations. There was support for and willingness to take part in a dedicated autism education programme for medical students, and constructive feedback to inform and improve its delivery. CONCLUSION The findings from this study provide insights into the medical care experiences of parents/carers of autistic children. Understanding how parents/carers of autistic children would like medical care to be improved can be used to develop TfA and other autism programmes. Parental/carer support for the development of and involvement in an autism medical education programme enhances the feasibility of the new programme.
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Affiliation(s)
- Yasmin Dhuga
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Yvonne Feeney
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Laura Gallaher
- School of Media Arts and Humanities, University of Sussex, Brighton, UK
| | - Ann White
- Sea Side View, Child Development Centre, Sussex Community NHS Foundation Trust, Brighton, UK
| | - Juliet Wright
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Sube Banerjee
- Faculty of Health and Human Sciences, University of Plymouth, Plymouth, UK
| | - Stephanie Daley
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
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Clarke L, Fung LK. The impact of autism-related training programs on physician knowledge, self-efficacy, and practice behavior: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1626-1640. [PMID: 35698749 DOI: 10.1177/13623613221102016] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Autism spectrum disorder is estimated to impact 1.5 million children and almost 5.5 million adults. However, most physicians do not receive training on how to provide care to this increasingly large group of people. After performing a systematic review of the literature and screening over 4,500 unique articles focused on the effectiveness of autism-specific training programs designed for physicians and physician trainees, we determined that 17 studies met the pre-determined criteria for inclusion in this systematic review. The results reported by these studies suggest that by completing specialized training programs related to autism, physicians were more knowledgeable on topics related to the condition, more confident in their ability to provide care to autistic individuals, and more likely to screen their patients for autism spectrum disorder. However, further studies with higher quality data are needed to validate these findings and provide additional insight on the ability of these programs to improve physician behavior and patient outcomes. We are therefore advocating that medical educators develop and evaluate specialized autism training programs with an increased focus on improving physician behavior related to all aspects of providing care to autistic people.
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Tackling healthcare access barriers for individuals with autism from diagnosis to adulthood. Pediatr Res 2022; 91:1028-1035. [PMID: 33767375 PMCID: PMC7993081 DOI: 10.1038/s41390-021-01465-y] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/21/2020] [Accepted: 02/23/2021] [Indexed: 02/04/2023]
Abstract
Most individuals with autism spectrum disorder (ASD)-a complex, life-long developmental disorder-do not have access to the care required to address their diverse health needs. Here, we review: (1) common barriers to healthcare access (shortage/cost of services; physician awareness; stigma); (2) barriers encountered primarily during childhood (limited screening/diagnosis; unclear referral pathways), transition to adulthood (insufficient healthcare transition services; suboptimal physician awareness of healthcare needs) and adulthood (shortage of services/limited insurance; communication difficulties with physicians; limited awareness of healthcare needs of aging adults); and (3) advances in research/program development for better healthcare access. A robust understanding of barriers to accessing healthcare across the lifespan of autistic individuals is critical to ensuring the best use of healthcare resources to improve social, physical, and mental health outcomes. Stakeholders must strengthen healthcare service provision by coming together to: better understand healthcare needs of underserved populations; strengthen medical training on care of autistic individuals; increase public awareness of ASD; promote research into/uptake of tools for ASD screening, diagnosis, and treatment; understand specific healthcare needs of autistic individuals in lower resource countries; and conduct longitudinal studies to understand the lifetime health, social, and economic impacts of ASD and enable the evaluation of novel approaches to increasing healthcare access. IMPACT: Despite the growing body of evidence, our understanding of barriers to healthcare encountered by individuals with ASD remains limited, particularly beyond childhood and in lower resource countries. We describe current and emerging barriers to healthcare access encountered by individuals with ASD across the lifespan. We recommend that stakeholders develop evidence-informed policies, programs, and technologies that address barriers to healthcare access for individuals with ASD and consider broad, equitable implementation to maximize impact.
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Rahbar MH, Dobrescu I, Gillani S, Hessabi M, Kim S, Stancu M, Rad F. Construct validity for the self-reported competency and sub-construct associated characteristics of Romanian physicians in autism spectrum disorder. BMC MEDICAL EDUCATION 2021; 21:588. [PMID: 34801018 PMCID: PMC8605522 DOI: 10.1186/s12909-021-02999-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 10/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Lack of physicians' knowledge regarding mental health, including Autism Spectrum Disorder (ASD) could have adverse effects on affected individuals' health and quality of life. The purpose of this study was to provide construct validity for a modified questionnaire in order to determine the self-reported competency for underlying sub-constructs in ASD, make inferences on perceived competence in ASD based on a sample of Romanian physicians, and identify physicians' characteristics associated with these sub-domains of competency. METHODS For this survey, we modified a questionnaire that was used in Pakistan and Turkey, and administered it to a sample of 383 practicing physicians in Romania to assess their perceived competency regarding ASD. Exploratory factor analysis on 12 knowledge questions revealed five sub-domains: stigma, potential causes, children's behavior, misconceptions, and educational needs associated with ASD knowledge. Using General Linear Models, we determined physicians' characteristics that predict the total competency score and various competency sub-scores. RESULTS Seventy-five percent of the responding physicians were female and 30% had over 30 years practicing medicine. The majority (73-94%) of physicians have correctly responded to some basic questions regarding knowledge about ASD. We also found that younger physicians were more knowledgeable about potential causes of ASD than older physicians (Adjusted Mean Score (AMS): 2.90 vs. 2.18, P < 0.01), while older physicians knew more about the behavior of children with ASD (AMS: 0.64 vs. 0.37, P = 0.02). We found a significant interaction (P < 0.01) between television as source of ASD knowledge and city where the clinic is located in relation to knowledge of the physicians regarding stigma related to ASD. However, the total score was not associated with the variables associated with sub-domains. CONCLUSION Using factor analysis, we demonstrated construct validity of five sub-domains related to Romanian physicians' knowledge about ASD that include stigma, potential causes, behavior in ASD children, special education needs, and misconceptions related to ASD. The lack of significant association of the knowledge of physicians on ASD neither with the Psychiatry nor the Pediatric ward rotations at medical school may support the need for improving the curriculum on ASD in Romanian medical schools.
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Affiliation(s)
- Mohammad H. Rahbar
- Division of Clinical and Translational Sciences, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6410 Fannin Street, Suite 1100.05, UT Professional Building, Houston, TX 77030 USA
- Biostatistics/Epidemiology/Research Design (BERD) core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, 6410 Fannin Street, Suite 1100.05, UT Professional Building, Houston, TX 77030 USA
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler Street, Houston, TX 77030 USA
| | - Iuliana Dobrescu
- Child and Adolescent Psychiatry Department, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Child and Adolescent Psychiatry, “Prof. Dr.Alex. Obregia” Psychiatry Hospital, Bucharest, Romania
| | - Shezeen Gillani
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler Street, Houston, TX 77030 USA
| | - Manouchehr Hessabi
- Biostatistics/Epidemiology/Research Design (BERD) core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, 6410 Fannin Street, Suite 1100.05, UT Professional Building, Houston, TX 77030 USA
| | - Sori Kim
- Biostatistics/Epidemiology/Research Design (BERD) core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, 6410 Fannin Street, Suite 1100.05, UT Professional Building, Houston, TX 77030 USA
- Department of Biostatistics & Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX USA
| | - Mihaela Stancu
- Child and Adolescent Psychiatry Department, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Child and Adolescent Psychiatry, “Prof. Dr.Alex. Obregia” Psychiatry Hospital, Bucharest, Romania
| | - Florina Rad
- Child and Adolescent Psychiatry Department, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Child and Adolescent Psychiatry, “Prof. Dr.Alex. Obregia” Psychiatry Hospital, Bucharest, Romania
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Autism-friendly MRI: Improving radiography practice in the UK, a survey of radiographer practitioners. Radiography (Lond) 2021; 28:133-141. [PMID: 34565680 DOI: 10.1016/j.radi.2021.09.003] [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: 05/28/2021] [Revised: 08/11/2021] [Accepted: 09/06/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Autistic individuals undergoing magnetic resonance imaging (MRI) examinations may face significant challenges, mainly due to sensory overload and MRI environment-related limitations. This study aimed to explore radiographers' perspectives and experiences regarding MRI scanning of autistic individuals. METHODS Data collection was achieved using a specifically designed mixed methods questionnaire on Qualtrics. The snowball technique was used. This UK-wide survey was electronically distributed by three main recruitment agencies between December 2020 and February 2021. RESULTS 130 valid responses were received. A lack of relevant training and knowledge related to autism was noted. Effective communication, optimisation and customisation of the MRI examination, and MRI environment adjustments facilitated the completion of a safe and effective MRI examination. Poor patient-radiographer communication, unavailability of Special Educational Needs (SEN) experts, lack of specialised radiographer training and lack of specific guidelines were identified as the main barriers to successful MRI examinations. CONCLUSION Although routine MRI safety and patient care rules will apply, MRI scanning of autistic individuals requires customisation and reasonable adjustments in communication, environment, and training of clinical teams. In addition, guidelines should be established to be used as a reference point to improve clinical practice. The adjustments proposed by radiographers were all consistent with the interventions in the wider literature. IMPLICATIONS FOR PRACTICE MRI practice for personalised care of autistic individuals should be aligned with current evidence, to customise communication and offer workflow and environmental adjustments. Formal training related to autism, integrated within radiography academic curricula and better co-ordination and communication of interdisciplinary teams would provide the necessary skill mix to deliver safe, high quality MRI scans with optimal experience for autistic service users and their carer(s).
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Çitil G, Çöp E, Açıkel SB, Sarı E, Karacan CD, Şenel S. Assessment of the knowledge and awareness of pediatric residents and pediatricians about autism spectrum disorder at a single center in Turkey. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:2264-2275. [PMID: 34191315 DOI: 10.1002/jcop.22646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 06/13/2023]
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder and pediatricians play a critical role in early diagnosis. This study was conducted to evaluate the knowledge, beliefs, and experiences of pediatric residents and pediatricians about ASD. A 35-item questionnaire consisting of two sections was administered. The diagnostic features section consisted of questions measuring the level of knowledge about diagnostic criteria of ASD. The general knowledge and beliefs section consisted of questions about beliefs and experiences regarding ASD. The study consisted of 101 participants. Mean score obtained by all participants from the diagnostic features section was 5.78 ± 1.65. The mean scores obtained by residents and pediatricians from the diagnostic features section were 5.35 ± 1.5 and 6.31 ± 1.68. Pediatricians obtained higher scores significantly than residents from diagnostic features section (t = -2.99, p = 0.004). The mean scores obtained by residents and pediatricians from section of general knowledge and beliefs were 13.69 ± 3 and 14.48 ± 3.15. This difference was not significant (t = -1.27, p = 0.225). This study suggests that participants' knowledge and awareness about ASD was insufficient and while pediatricians knew more about the diagnostic criteria, their awareness and approach regarding ASD were no different from pediatric residents in general practice.
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Affiliation(s)
- Gülce Çitil
- Department of Pediatrics, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Esra Çöp
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Ankara, Turkey
| | - Sadettin Burak Açıkel
- Department of Child and Adolescent Psychiatry, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Eyüp Sarı
- Department of Pediatrics, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Can Demir Karacan
- Department of Pediatrics, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
- Department of Pediatrics, School of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Saliha Şenel
- Department of Pediatrics, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
- Department of Pediatrics, School of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
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Shawahna R, Jaber M, Yahya N, Jawadeh F, Rawajbeh S. Are medical students in Palestine adequately trained to care for individuals with autism spectrum disorders? A multicenter cross-sectional study of their familiarity, knowledge, confidence, and willingness to learn. BMC MEDICAL EDUCATION 2021; 21:424. [PMID: 34376162 PMCID: PMC8356397 DOI: 10.1186/s12909-021-02865-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Medical students are the future workforce of physicians in primary, secondary, tertiary, and highly specialized care centers. The present study was undertaken to assess familiarity, knowledge, confidence, of medical students with regard to autism spectrum disorders (ASDs). METHODS This multicenter study was conducted in a cross-sectional design among medical students in the 3 main universities in Palestine. In addition to the sociodemographic and academic details, the questionnaire measured familiarity (8-items), knowledge (12-items), confidence and willingness to learn (5-items) with regard to ASDs. RESULTS The questionnaire was completed by309 medical students (response rate = 77.3 %). The median familiarity, knowledge, and confidence scores were 50 % (42.5 %, 57.5 %), 50 % (41.7 %, 66.7 %), and 60.0 % (54.0 %, 68.0 %), respectively. There was a positive moderate correlation between familiarity and knowledge scores (Spearman's rho = 0.29, p-value < 0.001) and familiarity and confidence scores (Spearman's rho = 0.34, p-value < 0.001). Medical students who have received a course on autism were 3.08-fold (95 % C.I. of 1.78-5.31) more likely to score ≥ 50 % on the familiarity items compared to those who did not receive a course. The medical students who were in their clinical academic stage, who received a course on ASDs, and those who interacted with individuals with ASDs were 2.36-fold (95 % C.I. of 1.34-4.18), 2.66-fold (95 % C.I. of 1.52-4.65), and 2.59-fold (95 % C.I. of 1.44-4.63) more likely to score ≥ 50 % on the knowledge items. Medical students who reported high satisfaction with their social life were 2.84-fold (95 % C.I. of 1.15-7.00) more likely to score ≥ 50 % on the confidence items. CONCLUSIONS The present study identified considerable awareness and knowledge gaps among medical students with regard to ASDs. Medical students in this study reported low confidence in their ability to provide healthcare services to individuals with ASDs. Appropriately designed educational interventions might improve familiarity, knowledge, and confidence of medical students. More studies are still needed to investigate if such interventions can improve healthcare services for individuals with ASDs.
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Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, New Campus, Building: 19, Office: 1340, Nablus, Palestine.
- An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine.
| | - Mohammad Jaber
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- An-Najah National University Hospital, An-Najah National University, Nablus, Palestine
| | - Nourhan Yahya
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Firdaous Jawadeh
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Shahd Rawajbeh
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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A Systematic Review of Healthcare Professionals’ Knowledge, Self-Efficacy and Attitudes Towards Working with Autistic People. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00263-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AbstractHealthcare professionals play a vital role in identifying and supporting autistic people. This study systematically reviewed empirical research examining healthcare professionals’ knowledge, self-efficacy and attitudes towards working with autistic people. Thirty-five studies were included. The included studies sampled a range of countries and professional backgrounds. A modified quality assessment tool found the quality of the included studies was moderately good. Narrative synthesis indicated that healthcare professionals report only moderate levels of autism knowledge and self-efficacy, and often lack training. Variation within and between countries and professional background was not explained by demographic factors. The reviewed evidence suggests health professionals’ limited knowledge and self-efficacy in working with autistic people is a challenge to the provision of healthcare for autistic individuals.
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Walls M, Zuckerman KE, Broder-Fingert S. Recommendations for Improving the Family Experience for Hospitalized Children With Autism. Hosp Pediatr 2021; 11:e101-e103. [PMID: 33972348 DOI: 10.1542/hpeds.2020-005090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Morgan Walls
- Division of Academic General Pediatrics, Atrium Health, Charlotte, North Carolina
| | - Katharine E Zuckerman
- Division of General Pediatrics, Oregon Health & Sciences University, Portland, Oregon; and
| | - Sarabeth Broder-Fingert
- Division of General Academic Pediatrics, Boston Medical Center and Boston University, Boston, Massachusetts
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Gupta N, Brown C, Deneke J, Maha J, Kong M. Utilization of a Novel Pathway in a Tertiary Pediatric Hospital to Meet the Sensory Needs of Acutely Ill Pediatric Patients. Front Pediatr 2019; 7:367. [PMID: 31555627 PMCID: PMC6742947 DOI: 10.3389/fped.2019.00367] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/22/2019] [Indexed: 11/13/2022] Open
Abstract
Objective: To identify pediatric patients with sensory sensitivities during a hospital visit, and to implement a clinical pathway that can meet their sensory needs. The goal is to remove barriers to care delivery that is related to the sensory need for pediatric patients who present with an acute medical illness. Methods: The clinical pathway (identified as 'Sensory Pathway') was developed as a joint effort between key stakeholders within the community and medical providers. The pathway was conducted in a tertiary pediatric hospital from September 2016-April 2019. The main components of this pathway included- 1. Staff training; 2. Provision of sensory toolkits and story board; 3. Early collaboration with allied professionals; and 4. Early and continuous parental involvement. The Sensory Pathway was implemented first in the emergency department, followed by inpatient units. Patients triggered the pathway through caregiver or staff identification. Demographic of patients who triggered the pathway was extracted. A detailed qualitative analysis of any parents' feedback received was performed. Results: A cohort of patients with sensory needs was identified amongst pediatric patients who presented to the hospital with an acute illness. The most common comorbidity associated with sensory sensitivity/need was Autism Spectrum Disorder (48%), followed by cerebral palsy (22.8%) and Attention-Deficit/Hyperactivity Disorder (16%). 1337 patients (51.8%) had a single comorbidity while 45.9% patients had more than one comorbidity. Only 1.3% patients had a known diagnosis of sensory processing disorder. The pathway was triggered in 2,580 patient visits with 1643 patients and 937 repeat visits. The vast majority of patients who triggered the pathway had a medical presenting complaint (vs. behavioral). The following themes emerged from the parents' feedback: 1. Additional help received specific to the child's sensory needs; 2. Feeling of comfort; and 3. Improved overall experience. Conclusion: The Sensory Pathway identified a unique profile of pediatric patients who have sensory needs during their hospital stay. The pathway was successfully implemented for children with sensory need in our hospital across a wide range of demographic and with varied medical illness.
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Affiliation(s)
- Neha Gupta
- Department of Pediatrics, University of Alabama at Birmingham, CPPI Suite, Birmingham, AL, United States
| | - Chelsea Brown
- Children's of Alabama, Birmingham, AL, United States
| | | | | | - Michele Kong
- Department of Pediatrics, University of Alabama at Birmingham, CPPI Suite, Birmingham, AL, United States
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