scholarly journals Mothers’ Experiences of Accessing Mental Health Care for their Child with an Autism Spectrum Disorder

2019 ◽  
Vol 29 (2) ◽  
pp. 534-545 ◽  
Author(s):  
Laura Jackson ◽  
Saskia Keville ◽  
Amanda K. Ludlow
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Autism Spectrum Disorder ◽  
Mental Health Care ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Mothers Experiences

Unmet health care needs and health care quality in youth with autism spectrum disorder with and without intellectual disability

Autism ◽  
2021 ◽  
pp. 136236132110147
Author(s):  
Michelle Menezes ◽  
Melissa F Robinson ◽  
Christina Harkins ◽  
Eleonora Sadikova ◽  
Micah O Mazurek
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Autism Spectrum Disorder ◽  
Intellectual Disability ◽  
Mental Health Care ◽  
Autism Spectrum ◽  
Care Quality ◽  
Spectrum Disorder ◽  
Health Care Needs ◽  
Care Needs

Research indicates that youth with autism spectrum disorder often experience unmet health care needs and receive poorer quality of care. Intellectual disability commonly co-occurs with autism spectrum disorder; however, the nature of unmet health care needs and health care quality in youth with autism spectrum disorder and intellectual disability have not been investigated. As such, this study sought to examine associations among co-occurring intellectual disability, unmet physical and mental health care needs, and health care quality in youth with autism spectrum disorder. Data from this study were acquired from the 2016–2018 National Survey of Children’s Health, a nationally distributed caregiver-report questionnaire. Results found that the frequency of unmet mental health care need was significantly higher among children with autism spectrum disorder with co-occurring intellectual disability than those without intellectual disability. Using a structural equation modeling approach, it was found that the total effect of co-occurring intellectual disability on composite health care quality was significant. Investigation of indirect effects indicated that unmet mental health care need mediated the relationship between co-occurring intellectual disability and health care quality. These findings suggest that youth with autism spectrum disorder and co-occurring intellectual disability may be more likely to experience unmet mental health care needs, and that their unmet mental health care needs may negatively impact their health care quality. Lay abstract The increase in the prevalence of autism spectrum disorder has placed greater demands on the health care system. Children and adolescents with autism spectrum disorder often experience challenges accessing high-quality physical and mental health care due to characteristic social-communication deficits and behavioral difficulties, as well as high rates of complex medical and psychiatric comorbidities. Intellectual disability commonly co-occurs with autism spectrum disorder and individuals affected by this co-occurrence may have additional impairments that compound challenges accessing health care. This study investigated the relations among co-occurring intellectual disability, unmet physical and mental health care needs, and health care quality in a large, nationally distributed sample of youth with autism spectrum disorder using structural equation modeling techniques. Co-occurring intellectual disability was significantly associated with unmet mental health care needs in children with autism. In addition, unmet mental health care needs mediated the relationship between co-occurring intellectual disability and health care quality; youth with autism spectrum disorder and co-occurring intellectual disability who had a past-year unmet mental health need had significantly poorer caregiver-reported health care quality. These findings suggest that youth with autism spectrum disorder and co-occurring intellectual disability may be more likely to experience unmet mental health care needs and receive poorer quality of care than the broader autism spectrum disorder population.

Individuals with Developmental Disabilities

2017 ◽  
Author(s):  
Katharine Stratigos ◽  
Nina Tioleco ◽  
Anna Silberman ◽  
Agnes Whitaker
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Autism Spectrum Disorder ◽  
Mental Illness ◽  
Developmental Disabilities ◽  
Social Services ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Federal State ◽  
Care Needs

Persons with developmental disabilities (DD), such as autism spectrum disorder and intellectual disability, are at substantially greater risk of having comorbid mental illness compared to the general population. Their mental health care needs, however, are vastly undertreated. Contributors to this situation include the challenges of evaluating mental illness in individuals with DD; stigma associated with and systematic barriers against people with DD; communication barriers; inadequate training of health care workers; insufficient availability of community mental health services; and the complexity of the available social services and legal systems at the federal, state, and community levels. This chapter uses a case to review the different factors that contribute to irritability and problem behavior in a person who has autism spectrum disorder with intellectual and language impairment. Also reviewed is the complicated system of services and statutes that may be of assistance when working with this population.

Where are US outpatient mental health facilities that serve children with autism spectrum disorder? A national snapshot of geographic disparities

Autism ◽  
2021 ◽  
pp. 136236132110240
Author(s):  
Jonathan Cantor ◽  
Ryan K McBain ◽  
Aaron Kofner ◽  
Bradley D Stein ◽  
Hao Yu
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Autism Spectrum Disorder ◽  
Mental Health Treatment ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Health Treatment ◽  
Outpatient Mental Health ◽  
Treatment Facilities

Despite a rise in the observed prevalence of autism spectrum disorder among children, few estimates exist of the share of US outpatient mental health treatment facilities that provide services for children with autism spectrum disorder. We identified key facility- and county-level characteristics in offering mental health care for children with autism spectrum disorder. This study utilized a secret shopper telephone survey to contact almost all outpatient mental health treatment facilities in the contiguous United States. We estimated multivariable regressions to examine county- and facility-level predictors of offering services for children with autism spectrum disorder. We found that 50.3% of 6156 outpatient facilities reported offering care for children with autism spectrum disorder. Non-metro counties, counties with a lower percentage of non-White residents, counties with a higher percentage of uninsured residents, and counties with a higher poverty rate had fewer outpatient mental health treatment facilities providing care for children with autism spectrum disorder. Facilities accepting Medicaid as a form of payment, offering telehealth, and private for-profit facilities were more likely to provide services for children with autism spectrum disorder. Only half of outpatient mental health treatment facilities offered care for children with autism spectrum disorder, and both rural and lower socioeconomic status counties were less likely to have a facility offering care for children with autism spectrum disorder. Lay abstract There has been a rise in the observed prevalence of autism spectrum disorder among children. Existing studies show the share of counties with a treatment facility that offers care for children with autism spectrum disorder. However, no estimates exist of the share of US outpatient mental health treatment facilities that provide services for children with autism spectrum disorder. We identified key facility-level characteristics in offering mental health care for children with autism spectrum disorder. We used a telephone survey to contact almost all outpatient mental health treatment facilities in the contiguous United States. We asked the facilities if they provided mental health care for children with autism spectrum disorder. We took the results of this survey and estimated multivariable regressions to examine county- and facility-level predictors of offering services. We found that over half (50.3%) of the 6156 outpatient facilities reported offering care for children with autism spectrum disorder. Non-metro counties, counties with a lower percentage of non-White residents, counties with a higher percentage of uninsured residents, and counties with a higher poverty rate had fewer outpatient mental health treatment facilities providing care for children with autism spectrum disorder. Facilities accepting Medicaid as a form of payment, offering telehealth, and private for-profit facilities were more likely to provide services for children with autism spectrum disorder. Because only half of outpatient mental health treatment facilities offer care for children with autism spectrum disorder, public health officials and policymakers should do more to ensure that this vulnerable population has access to mental health services.

Characterizing therapist delivery of evidence-based intervention strategies in publicly funded mental health services for children with autism spectrum disorder: Differentiating practice patterns in usual care and AIM HI delivery

Autism ◽  
2021 ◽  
pp. 136236132110016
Author(s):  
Eliana Hurwich-Reiss ◽  
Colby Chlebowski ◽  
Teresa Lind ◽  
Kassandra Martinez ◽  
Karin M Best ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Usual Care ◽  
Teaching Strategies ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Intervention Strategies ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Active Teaching

This study identified patterns of therapist delivery of evidence-based intervention strategies with children with autism spectrum disorder within publicly funded mental health services and compared patterns for therapists delivering usual care to those trained in AIM HI (“An Individualized Mental Health Intervention for ASD”). Data were drawn from a randomized community effectiveness trial and included a subsample of 159 therapists (86% female) providing outpatient or school-based psychotherapy. Therapist strategies were measured via observational coding of psychotherapy session recordings. Exploratory factor analysis used to examine patterns of strategy delivery showed that among therapists in the usual care condition, strategies loaded onto the single factor, General Strategies, whereas for therapists in the AIM HI training condition, strategies grouped onto two factors, Autism Engagement Strategies and Active Teaching Strategies. Among usual care therapists, General Strategies were associated with an increase in child behavior problems, whereas for AIM HI therapists, Active Teaching Strategies were associated with reductions in child behavior problems over 18 months. Results support the effectiveness of training therapists in evidence-based interventions to increase the specificity of strategies delivered to children with autism spectrum disorder served in publicly funded mental health settings. Findings also support the use of active teaching strategies in reducing challenging behaviors. Lay abstract This study was conducted to identify patterns of therapist delivery of evidence-based intervention strategies with children with autism spectrum disorder receiving publicly funded mental health services and compare strategy use for therapists delivering usual care to those trained to deliver AIM HI (“An Individualized Mental Health Intervention for ASD”), an intervention designed to reduce challenging behaviors in children with autism spectrum disorder. For therapists trained in AIM HI, intervention strategies grouped onto two factors, Autism Engagement Strategies and Active Teaching Strategies, while strategies used by usual care therapists grouped onto a broader single factor, General Strategies. Among usual care therapists, General Strategies were related to an increase in child behavior problems, whereas for AIM HI therapists, Active Teaching Strategies were related with reductions in child behavior problems over 18 months. Findings support the use of active teaching strategies in reducing challenging behaviors in children with autism spectrum disorder and provide support for the effectiveness of training therapists in evidence-based interventions to promote the delivery of targeted, specific intervention strategies to children with autism spectrum disorder in mental health services.

Mental health correlates and potential childhood predictors for the wish to be of the opposite sex in young autistic adults

Autism ◽  
2021 ◽  
pp. 136236132110240
Author(s):  
Jung-Chi Chang ◽  
Meng-Chuan Lai ◽  
Yueh-Ming Tai ◽  
Susan Shur-Fen Gau
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Typically Developing ◽  
Item Endorsement ◽  
Opposite Sex ◽  
Autistic Adults

Cross-sectional research has demonstrated the overrepresentation of gender dysphoria in children and adults with autism spectrum disorder. However, the predictors and underlying mechanisms of this co-occurrence remain unclear. This follow-up study aimed to explore baseline (childhood/adolescence) predictors for the follow-up (adulthood) self-reported wish to be of the opposite sex and to investigate its mental health correlates in a sample of 88 autistic individuals as compared with 42 typically developing controls. An item on the Adult Self-Report Inventory-4, “I wish I was the opposite sex,” was used. We compared mental health symptoms between adults with and without this item endorsement. We used prediction models to explore family and autism-related predictors in childhood/adolescence to endorse this item in adulthood. There were more adults endorsing the item in the autism spectrum disorder group compared with the typically developing group. Autistic adults who endorsed the item experienced more mental health challenges, more bullying victimization, more suicidal ideations, and worse quality of life. Lower parent-reported family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. It is necessary to raise more attention to gender development and related mental health impact in autistic individuals. Lay abstract Autistic people/people with autism spectrum disorder are more likely to experience gender dysphoria. However, the possible longitudinal predictors and underlying mechanisms of this co-occurrence are unclear. To fill this knowledge gap, we assessed 88 people with autism spectrum disorder and 42 typically developing individuals at their average ages of 13.0 (baseline, childhood/adolescence) and 20.2 years old (follow-up, adulthood). At follow-up, their endorsement on the item “I wish I was the opposite sex” was used to evaluate gender dysphoric symptoms. We compared mental health symptoms between adults with and without this item endorsement at the follow-up assessment. We explored parent-reported family and autism characteristics-related predictors in childhood/adolescence to this item endorsement in adulthood. We found that more autistic adults reported the wish to be of the opposite sex than did typically developing individuals. Autistic adults who endorsed this item experienced more mental health challenges, more school bullying and cyberbullying, more suicidal ideation, and worse quality of life. Moreover, parent-reported lower family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. More attention and support should be provided to autistic people regarding gender development and related mental health and quality of life impact, especially during the transition period to young adulthood.

scholarly journals Pharmacological treatments prescribed to people with autism spectrum disorder (ASD) in primary health care

2013 ◽  
Vol 231 (6) ◽  
pp. 1011-1021 ◽  
Author(s):  
Macey L. Murray ◽  
Yingfen Hsia ◽  
Karen Glaser ◽  
Emily Simonoff ◽  
Declan G. M. Murphy ◽  
...  
Keyword(s):  
Health Care ◽  
Autism Spectrum Disorder ◽  
Primary Health Care ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Pharmacological Treatments ◽  
Primary Health

Health Care Quality for Children: The Position of Autism Spectrum Disorder

2014 ◽  
pp. 139-165 ◽  
Author(s):  
Christina D. Bethell ◽  
Olivia Lindly ◽  
Michael Kogan ◽  
Katharine Zuckerman
Keyword(s):  
Health Care ◽  
Autism Spectrum Disorder ◽  
Health Care Quality ◽  
Autism Spectrum ◽  
Care Quality ◽  
Spectrum Disorder

scholarly journals Renaming schizophrenia: 5 × 5

2018 ◽  
Vol 28 (03) ◽  
pp. 254-257 ◽  
Author(s):  
Sinan Guloksuz ◽  
Jim van Os
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Well Being ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Long Run ◽  
The Social ◽  
Technical Features ◽  
In The Beginning

AbstractThere had been a long way to go before we felt comfortable about even discussing the issues revolving around the concept of ‘schizophrenia’, let alone reckoning on mere semantic revision. In this editorial, we aim to extend our discussion on the reasons behind the slow death of the concept of ‘schizophrenia’ and the benefits of changing the name and embracing a spectrum approach with an umbrella psychosis spectrum disorder (PSD) category (similar to autism spectrum disorder) that goes further than a mere semantic revision. We attempted to cover the topic of the renaming by providing five most pertinent points categorised under five domains: reasons, signals, challenges, promises and steps for the change. Admittedly, even a modest revision, such as classifying all psychotic disorder categories under an umbrella category of PSD, and abolishing the term schizophrenia requires careful deliberation and some effort in the beginning, but the revision is well worth the effort considering the benefits in the long run. Renaming a particular form of mental suffering should be accompanied by a broader debate of the entire diagnosis-evidence-based-practice (EBP)-symptom-reduction model as the normative factor driving the content and organisation of mental health services that may be detached from patients’ needs and reality, overlooks the trans-syndromal structure of mental difficulties, appraises the significance of the technical features over the relational and ritual components of care, and underestimates the lack of EBP group-to-individual generalisability. Individuals may make great strides in attaining well-being by accommodating to living with mental vulnerabilities through building resilience in the social and existential domains. Changing the name and the concept of ‘schizophrenia’, which goes beyond a mere semantic revision, may become the first step that allows catalysation of the process of modernising psychiatric science and services worldwide.

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