scholarly journals Therapists’ Adaptations to an Intervention to Reduce Challenging Behaviors in Children with Autism Spectrum Disorder in Publicly Funded Mental Health Services

2018 ◽  
Vol 49 (3) ◽  
pp. 924-934 ◽  
Author(s):  
Margaret W. Dyson ◽  
Colby Chlebowski ◽  
Lauren Brookman-Frazee
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Challenging Behaviors ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Publicly Funded

scholarly journals Characterizing psychiatric comorbidity in children with autism spectrum disorder receiving publicly funded mental health services

Autism ◽  
2017 ◽  
Vol 22 (8) ◽  
pp. 938-952 ◽  
Author(s):  
Lauren Brookman-Frazee ◽  
Nicole Stadnick ◽  
Colby Chlebowski ◽  
Mary Baker-Ericzén ◽  
William Ganger
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Psychiatric Comorbidity ◽  
Challenging Behaviors ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Publicly Funded ◽  
Oppositional Defiant ◽  
Mental Health Programs

Publicly funded mental health programs play a significant role in serving children with autism spectrum disorder. Understanding patterns of psychiatric comorbidity for this population within mental health settings is important to implement appropriately tailored interventions. This study (1) describes patterns of psychiatric comorbidity in children with autism spectrum disorder who present to mental health services with challenging behaviors and (2) identifies child characteristics associated with comorbid conditions. Data are drawn from baseline assessments from 201 children with autism spectrum disorder who participated in a community effectiveness trial across 29 publicly funded mental health programs. Non-autism spectrum disorder diagnoses were assessed using an adapted Mini-International Neuropsychiatric Interview, parent version. Approximately 92% of children met criteria for at least one non-autism spectrum disorder diagnosis (78% attention deficit hyperactivity disorder, 58% oppositional defiant disorder, 56% anxiety, 30% mood). Logistic regression indicated that child gender and clinical characteristics were differentially associated with meeting criteria for attention deficit hyperactivity disorder, oppositional defiant disorder, an anxiety, or a mood disorder. Exploratory analyses supported a link between challenging behaviors and mood disorder symptoms and revealed high prevalence of these symptoms in this autism spectrum disorder population. Findings provide direction for tailoring intervention to address a broad range of clinical issues for youth with autism spectrum disorder served in mental health settings.

scholarly journals Implementing a Mental Health Care Program and Home-Based Training for Mothers of Children With Autism Spectrum Disorder in an Urban Population in Bangladesh: Protocol for a Feasibility Assessment Study (Preprint)

2017 ◽  
Author(s):  
Aliya Naheed ◽  
Kamrun Nahar Koly ◽  
Helal Uddin Ahmed ◽  
Shaheen Akhter ◽  
MM Jalal Uddin ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Child Care ◽  
Mental Health Services ◽  
Health Services ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Children With Asd ◽  
Home Based ◽  
Dsm Iv

BACKGROUND Mothers of children with autism spectrum disorder (ASD) have reported a higher level of depression than mothers of children with other neurodevelopmental disorders in both developed and developing countries. Mothers are the lifetime caregivers of children with ASD, and a high burden of depression can negatively impact their ability to provide care. However, access to mental health services in primary care is limited, given the scarcity of qualified providers in Bangladesh. OBJECTIVE We aim to pilot the feasibility of integrating mental health services for the mothers of children with ASD attending schools offering ASD care and improve skills of mothers for child care through a home-based training program. METHODS The study will be conducted in two selected schools in Dhaka in Bangladesh that have been offering services for ASD for more than 10 years. A female psychologist will be deployed at the schools to offer nonpharmacological services for all mothers having a depressive episode. Referral for pharmacological treatment will be made at the discretion of supervising psychiatrists. An ASD special educator will provide training to the mothers for enhancing their child care skills at home on a monthly basis. The proposed intervention package will be implemented over a period of 4-6 months, and the feasibility of the intervention will be assessed through a pre- and postintervention evaluation by obtaining the perspectives of various stakeholders involved in the implementation of mental health services and maternal training. The primary outcome will include assessment of acceptability, adaptability, demand, practicality, implementation, and integration of the package intervention in the school settings. The secondary outcomes will include assessment of: 1) the prevalence of maternal depression; 2) children’s behavioral, social, and communication skills; and 3) the intervention participation costs incurred by institutions and families. RESULTS Between February and March 2017, 188 mothers of children with ASD were screened for depression following a written informed consent. Based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), the Structured Clinical Interview for the DSM-IV (SCID-1) was administered to 66 mothers. In-depth interviews were conducted with 10 mothers and 8 various stakeholders. Between January-June 2017, the team finalized a draft psychosocial counseling module and a maternal training module. Between April-May 2017, mental health services were provided by psychologists to 41 mothers who attended the counseling centers at each school. Three special educators have been trained in June 2017 to initiate training of the participating mothers. CONCLUSIONS This is the first study of a mental health intervention for mothers of children with ASD to reduce their burden of depression and improve the outcomes of their children. The findings will inform the provision of services for children with ASD and their mothers in Bangladesh and similar settings.

scholarly journals Gender Differences in Misdiagnosis and Delayed Diagnosis among Adults with Autism Spectrum Disorder with No Language or Intellectual Disability

2021 ◽  
Vol 11 (7) ◽  
pp. 912
Author(s):  
Camilla Gesi ◽  
Giovanni Migliarese ◽  
Sara Torriero ◽  
Martina Capellazzi ◽  
Anna Caterina Omboni ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Diagnostic Delay ◽  
Autism Spectrum ◽  
Verbal Communication ◽  
Spectrum Disorder ◽  
Age At Diagnosis ◽  
Specific Information

Autism Spectrum Disorder (ASD) is often unrecognized, especially in mild forms and in women. Studies evaluating features associated with missed/misdiagnosis in men and women with ASD are warranted. 61 subjects (22 females, 39 males, age 28.5 ± 10.8 years) with ASD with no language/intellectual deficit were enrolled in the service for the treatment of psychiatric comorbidities in adults with ASD of the ASST Fatebenefratelli-Sacco in Milan (Italy). A detailed clinical history was gathered, and two self-report questionnaires (Autism Spectrum Quotient-AQ and Adult Autism Subthreshold Spectrum-AdAS Spectrum) were administered. 75.4% received their ASD diagnosis average eight years later than the first evaluation by mental health services. Compared to males, females showed a significantly greater delay in referral to mental health services and a significantly higher age at diagnosis of ASD. Among men, diagnostic delay inversely correlated with scores on the AdAS Spectrum total, Verbal communication, Empathy and Inflexibility and adherence to routine domains. Among women, diagnostic delay positively correlated with the Attention to detail score while the age at diagnosis of ASD positively correlated with the AdAS Spectrum Verbal communication and Restricted interests and rumination domain scores. Females were less likely to be correctly diagnosed and more likely to be misdiagnosed at first evaluation than men. Females reported significantly higher scores than men in the Hyper/Hyporeactivity to sensory input domain only among subjects who were misdiagnosed. Our findings provide gender-specific information about ASD patients seeking help for comorbid conditions and might be a primary ground for future research.

scholarly journals Experience of transfer from child to adult mental health services of young people with autism spectrum disorder

BJPsych Open ◽  
2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Hannah Merrick ◽  
Chris King ◽  
Helen McConachie ◽  
Jeremy R. Parr ◽  
Ann Le Couteur
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Problems ◽  
Unmet Need ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Adult Mental Health

Background Transition from child-centred to adult mental health services has been reported as challenging for young people. It can be especially difficult for young people with autism spectrum disorder (ASD) as they manage the challenges of adolescence and navigate leaving child and adolescent mental health services (CAMHS). Aims This study examines the predictors of transfer to adult mental health services, and using a qualitative analysis, explores the young people’s experiences of transition. Method A UK sample of 118 young people aged 14–21 years, with ASD and additional mental health problems, recruited from four National Health Service trusts were followed up every 12 months over 3 years, as they were discharged from CAMHS. Measures of mental health and rich additional contextual information (clinical, family, social, educational) were used to capture their experiences. Regression and framework analyses were used. Results Regression analysis showed having an attention-deficit hyperactivity disorder diagnosis and taking medication were predictors of transfer from child to adult mental health services. Several features of young people's transition experience were found to be associated with positive outcomes and ongoing problems, including family factors, education transitions and levels of engagement with services. Conclusions The findings show the importance of monitoring and identifying those young people that might be particularly at risk of negative outcomes and crisis presentations. Although some young people were able to successfully manage their mental health following discharge from CAMHS, others reported levels of unmet need and negative experiences of transition.

scholarly journals Mental Health Services for Individuals with High Functioning Autism Spectrum Disorder

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Johanna K. Lake ◽  
Andrea Perry ◽  
Yona Lunsky
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
High Functioning Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Service Needs ◽  
High Functioning ◽  
Adolescents And Adults

Adolescents and adults with an autism spectrum disorder (ASD) who do not have an intellectual impairment or disability (ID), described here as individuals with high-functioning autism spectrum disorder (HFASD), represent a complex and underserved psychiatric population. While there is an emerging literature on the mental health needs of children with ASD with normal intelligence, we know less about these issues in adults. Of the few studies of adolescents and adults with HFASD completed to date, findings suggest that they face a multitude of cooccurring psychiatric (e.g., anxiety, depression), psychosocial, and functional issues, all of which occur in addition to their ASD symptomatology. Despite this, traditional mental health services and supports are falling short of meeting the needs of these adults. This review highlights the service needs and the corresponding gaps in care for this population. It also provides an overview of the literature on psychiatric risk factors, identifies areas requiring further study, and makes recommendations for how existing mental health services could include adults with HFASD.

A case of mistaken diagnoses: diagnostic and management challenges in a case of adult autism spectrum disorder

2019 ◽  
pp. 1-4 ◽  
Author(s):  
L. Alexander ◽  
N. Farrelly
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Treatment Plan ◽  
Supportive Therapy ◽  
Community Mental Health Services ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Successful Outcome

Autism spectrum disorder (ASD) is frequently identified in children but is often unrecognised in adults. ASD is characterised by difficulties in social interaction, communication and restricted interests, but other presentations are common, especially in adults. This report describes a 34-year-old man with a history of multiple psychiatric diagnoses including generalised anxiety disorder, major depressive disorder and panic disorder. He was diagnosed with ASD in his early 30s and engaged in a targeted treatment plan, including rationalisation of medications, supportive therapy and occupational therapy, which successfully facilitated discharge from mental health services. This case illustrates the atypical presentation of ASD in adults, which is diagnostically challenging. Such cases often present to community mental health services and may be misdiagnosed as treatment resistant cases of depressive, anxiety or personality disorders. Accurate diagnosis and targeted management is more likely to yield a successful outcome.

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