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.

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.

Preparing Tomorrow's Doctors to Care for Patients With Autism Spectrum Disorder

2016 ◽  
Vol 54 (3) ◽  
pp. 202-216 ◽  
Author(s):  
Susan M. Havercamp ◽  
Karen Ratliff-Schaub ◽  
Patricia Navas Macho ◽  
Cherelle N. Johnson ◽  
Kelsey L. Bush ◽  
...  
Keyword(s):  
Health Care ◽  
Autism Spectrum Disorder ◽  
Health Disparities ◽  
Medical Students ◽  
Developmental Disabilities ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Barriers To Health Care ◽  
Limited Knowledge ◽  
Barriers To Health

Abstract People with autism spectrum disorder (ASD) and other developmental disabilities have poorer health and face unique barriers to health care compared to people without disabilities. These health disparities can be partially attributed to physicians' limited knowledge about caring for patients with developmental disabilities. The purpose of this study was to determine the effectiveness of ASD training for medical students. Our training included a lecture and a panel presentation that featured people with ASD and family members. Students reported improved knowledge, skills, confidence, and comfort in caring for patients with ASD.

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.

scholarly journals Medical Encounters for Youth With Autism Spectrum Disorder: A Comprehensive Review of Environmental Considerations and Interventions

2019 ◽  
Vol 13 ◽  
pp. 117955651984281 ◽  
Author(s):  
Jolie Straus ◽  
Sarah Coburn ◽  
Stephanie Maskell ◽  
Jessica Pappagianopoulos ◽  
Kathryn Cantrell
Keyword(s):  
Health Care ◽  
Autism Spectrum Disorder ◽  
Health Care Professionals ◽  
Neurodevelopmental Disorder ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Hospital Environment ◽  
Future Research ◽  
Care Needs ◽  
Published Evidence

Approximately 1 in 59 youth are currently diagnosed with autism spectrum disorder (ASD), a neurodevelopmental disorder. In comparison to typically developing peers, youth with ASD encounter hospitalization at higher rates due to their heightened health care needs. While visiting the hospital is a stressor for youth with neurotypical needs, the experience contains unique challenges for those with ASD. This systematic literature review highlights research that considers the psychosocial impact of the hospital environment on the coping and adjustment of youth with ASD. Specifically, the review focuses on recommendations and interventions that may be used by health care professionals while supporting this population as they encounter the health care system. Ninety-six articles were identified as meeting inclusion and exclusion criteria. The findings suggest that practicing clinicians should implement a wide variety of interventions for youth with ASD including diversion techniques, comfort positions, and picture schedules. Although there are published evidence-based interventions for supporting youth with ASD in the hospital, most clinicians lack ASD-specific training. This article concludes with recommendations for future research.

scholarly journals Managing the health care needs of adolescents with autism spectrum disorder: The parents’ experience.

2014 ◽  
Vol 32 (3) ◽  
pp. 328-337 ◽  
Author(s):  
Julie A. Strunk ◽  
Rita Pickler ◽  
Nancy L. McCain ◽  
Suzanne Ameringer ◽  
Barbara J. Myers
Keyword(s):  
Health Care ◽  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Health Care Needs ◽  
Care Needs ◽  
Adolescents With Autism

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.

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