Examining the experiences and quality of life of patients with an autism spectrum disorder detained in high secure psychiatric care

2017 ◽  
Vol 3 (1) ◽  
pp. 3-14 ◽  
Author(s):  
David Murphy ◽  
Hannah Mullens
Keyword(s):  
Quality Of Life ◽  
Autism Spectrum Disorder ◽  
Psychiatric Care ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Living Situation ◽  
Diverse Range ◽  
Content Type ◽  
Secure Psychiatric Care

Purpose Although individuals with an autism spectrum disorder (ASD) represent a small proportion of forensic psychiatric patients as a group they present with specific difficulties and needs. There is also evidence that if detained individuals with an ASD experience particular difficulties within custodial environments as a result of a mismatch between the difficulties associated with their ASD and the environmental demands. The purpose of this paper is to explore the experience of individuals with an ASD admitted to a high secure psychiatric care (HSPC) hospital. Design/methodology/approach Using both a semi-structured interview and a quality of life self-report measure (the Lancashire Quality of Life Profile) the experiences and views of seven patients with an ASD detained in one HSPC hospital were qualitatively explored. Findings Whilst a diverse range of negative and positive aspects of being within HSPC were identified by patients interviewed, those with prison experience thought HSPC was a less stressful environment with more therapeutic opportunities. As a group, patients with an ASD reported a similar or significantly better quality of life in many domains (global, leisure, financial and living situation) compared to other detained forensic patient groups. Practical implications Although most patients with an ASD interviewed reported positive experiences, there are a number of practical improvements that could be made within the hospital to reduce experienced stress levels and perhaps improve therapeutic outcomes. Originality/value Within the context of the Department of Health's autism strategy (2010) and subsequent update think autism (2014), the survey highlights continued ASD awareness training for staff as important. In responding to the risks and needs of individuals with an ASD in HSPC there is further support for the development of an ASD specialist service.

scholarly journals A systematic PRISMA review of individuals with autism spectrum disorder in secure psychiatric care: prevalence, treatment, risk assessment and other clinical considerations

2018 ◽  
Vol 8 (1) ◽  
pp. 58-79 ◽  
Author(s):  
Clare S. Allely
Keyword(s):  
Autism Spectrum Disorder ◽  
Psychiatric Care ◽  
Psychiatric Hospitals ◽  
Autistic Traits ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Bibliographic Databases ◽  
Future Research ◽  
Content Type ◽  
Secure Psychiatric Care

Purpose Patients with autism spectrum disorder (ASD) present with specific assessment, specific difficulties, needs and therapeutic issues and therefore are a challenging group for forensic services. Given the challenge that individuals with ASD present to forensic services, the suggested increase in the number of this group within this setting and the relatively little amount of research which suggests they face a number of difficulties within the prison environment, the purpose of this paper is to identify and review all the studies which have been carried out investigating any aspect of ASD in relation to secure hospital settings. Design/methodology/approach Seven internet-based bibliographic databases were used for the present review. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Findings A total of 12 studies were included in this review; 3 looked at the prevalence of ASD in secure psychiatric hospitals. One study evaluated the clinical utility of the AQ screening tool to assess self-reported autistic traits in secure psychiatric settings. Three explored any type of characteristics of patients with ASD detained in secure psychiatric hospitals. One study investigated the experiences or quality of life of patients with an ASD detained in secure psychiatric care. Two studies investigated awareness, knowledge and/or views regarding patients with ASD held by staff working within secure psychiatric hospitals. Lastly, three studies (one of which was also included in the prevalence category above) looked at the effectiveness of interventions or treatment of patients with ASD in secure psychiatric hospitals. Clinical recommendations and future research directions are discussed. Originality/value To the author’s knowledge, this is the first review to explore what research has been carried out looking specifically at patients with ASD in relation to secure forensic settings.

scholarly journals A phenomenological approach to diagnosing psychosis in autism spectrum disorder and intellectual disability: a case series

2018 ◽  
Vol 4 (2) ◽  
pp. 39-48
Author(s):  
Rahul Rai ◽  
Samuel Tromans ◽  
Chaya Kapugama ◽  
Verity Chester ◽  
Ignatius Gunaratna ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Autism Spectrum Disorder ◽  
Intellectual Disability ◽  
Case Series ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Psychotic Symptoms ◽  
Related Case ◽  
Content Type

Purpose The diagnosis of psychosis in individuals with autism spectrum disorder (ASD) poses a unique clinical challenge. The presence of intellectual disability (ID) further complicates the diagnostic picture. Reliable and timely diagnosis of psychosis in such individuals minimises the duration of untreated psychotic symptoms and the subsequent impact on the quality of life of the patients concerned. The paper aims to discuss this issue. Design/methodology/approach The authors present four patients with psychosis, ASD and ID, who have received care within forensic mental health and ID settings. These examples demonstrate the interaction between these conditions, as well as issues pertaining to diagnosis and management. Findings In all four patients, sustained use of antipsychotic medication was objectively associated with an improvement in psychotic symptoms and quality of life. In instances where autistic phenomena were accentuated upon development of psychosis, such features returned to the baseline levels evident prior to the onset of psychosis. Practical implications The discussion and related case examples could improve the understanding of the possibility of psychosis in individuals with ASD and ID, and increase awareness of this diagnostic possibility among healthcare professionals. Originality/value This is the first published case series illustrating the challenges of diagnosing psychosis in individuals with ASD and ID.

Incompatibilities and seclusion of patients with an autism spectrum disorder detained in high-secure psychiatric care

2017 ◽  
Vol 8 (4) ◽  
pp. 188-200 ◽  
Author(s):  
David Murphy ◽  
Emma-Louise Bush ◽  
Ignazio Puzzo
Keyword(s):  
Autism Spectrum Disorder ◽  
Risk Management ◽  
Psychiatric Care ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Future Research ◽  
Hospital Data ◽  
Content Type ◽  
Management Actions ◽  
Secure Psychiatric Care

Purpose Whilst individuals with an autism spectrum disorder (ASD) represent a relatively small proportion of patients detained in high-secure psychiatric care (HSPC), previous research suggests that such individuals present with difficulties and needs significantly different from non-ASD patient groups. However, to date, there has not been any formal examination of how individuals with an ASD are represented in records of key risk management actions (i.e. seclusions and incompatibilities with other patients). The paper aims to discuss these issues. Design/methodology/approach An observation of hospital data examining two key risk management actions for a group of individuals with an ASD is detained in one HSPC hospital. These include the number of formal incompatibilities with other patients and the number of, and hours in, seclusion. Both actions require extra staff and security provisions and can decelerate the rehabilitation and recovery process. Findings In addition to suggesting an overall increase in the general prevalence of ASD within the hospital compared to previous estimates, individuals with an ASD appear to have a disproportionately higher number of incompatibilities with other patients compared to those patients without an ASD and experience more and longer periods of seclusions. Originality/value Although the methodological limitations of the study are acknowledged, explanations for the findings are discussed along with future research and recommendations as to how ASD patients might be best managed in the hospital. It is argued that the findings add further support for a specialist ASD service within HSPC.

Development and Validation of a Questionnaire to Assess Parent Reported Quality of Life Pre and Post Vision Therapy in a Population with Autism Spectrum Disorder

2019 ◽  
pp. 195-207
Keyword(s):  
Quality Of Life ◽  
Autism Spectrum Disorder ◽  
Social Behavior ◽  
Psychometric Properties ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Visual Behavior ◽  
The Mean ◽  
Vision Therapy

Background: Autism spectrum disorder is characterized in part by atypical behavior in the communication, social, and visual domains. Success in vision therapy is judged not only by changes in optometric findings, but through improvement in quality of life involving communication, social behavior and visual behavior. It would therefore be beneficial to have a validated questionnaire to assess parent reported quality of life pre and post vision therapy specific to patients with autism spectrum disorder. To our knowledge, a questionnaire of this nature has not been previously published in the literature. Methods: Questionnaire items were generated through surveying medical literature based on symptoms in three different categories: visual behavior, social behavior and communication. A pool of 34 questions was developed initially and then with thorough discussion with other experts, a 20-point questionnaire was developed with each item reflected in the construct concept. A draft of 20 questions was then sent to 10 subject experts with clinical experience in the field for more than 20 years, to review the pooled items. Validity and reliability was established prior to assessing the psychometric properties of the ASD/QOL-VT. Prospective observational study was conducted for a duration of 18 months. The study included individuals undergoing vision therapy in the age range of 3 to 15 years who had been diagnosed with ASD. The questionnaire was administered to parents of these children prior to the start of vision therapy. All subjects completed a minimum of 60 vision therapy sessions. The questionnaire was readministered after completing 60 sessions of vision therapy. Results: Cronbach’s alpha value for this questionnaire was 0.93, which reflected very good internal consistency. Factorial analysis yielded four factors with an Eigen value exceeding 1.0 which accounted for 68% variation in the model. The Cronbach alpha value for subscales identified by factorial analysis is 0.97 indicating excellent internal reliability. The mean pre vision therapy social behavior, communication and visual behavior score was 12.0±3.21, 17.07±4.57 and 26.97±6.41 respectively. The mean post vision therapy scores for social behavior, communication and visual behavior was 8.27±4.16, 11.33±5.27 and 17.93±6.52 respectively. On paired t test, the mean difference in score was statistically significant with P<0.001 in all three subcategories. Conclusions: Our study presents the development of a valid and reliable parent questionnaire, the ASD/QOL-VT, that judges communication, social behavior, and visual behavior in autism. Results of the study conducted indicate that vision therapy can result in significant improvements in the quality of life of patients with ASD as judged by their parents. This is evidenced by statistically significant changes in psychometric properties of the ASD/QOL-VT in social behavior, communication and visual behavior.

scholarly journals Exploring possible predictors and moderators of an executive function training for children with an autism spectrum disorder

Autism ◽  
2017 ◽  
Vol 22 (4) ◽  
pp. 440-449 ◽  
Author(s):  
Marieke de Vries ◽  
Mathilde GE Verdam ◽  
Pier JM Prins ◽  
Ben A Schmand ◽  
Hilde M Geurts
Keyword(s):  
Quality Of Life ◽  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Reward Sensitivity ◽  
Spectrum Disorder ◽  
Autism Traits ◽  
Moderating Factors ◽  
Flexibility Training ◽  
Executive Function Training

Previously, a total of 121 children with an autism spectrum disorder (ASD) performed an adaptive working memory (WM)-training, an adaptive flexibility-training, or a non-adaptive control (mock)-training. Despite overall improvement, there were minor differences between the adaptive and mock-training conditions. Moreover, dropout was relatively high (26%). In the current study we explored potential predicting and moderating factors to clarify these findings. The effects of intelligence, autism traits, WM, flexibility, reward sensitivity and Theory of Mind on dropout, improvement during training, and improvement in everyday executive functioning (EF), ASD-like behavior, and Quality of Life (QoL) were studied. None of the predictors influenced dropout or training improvement. However, 1) more pre-training autism traits related to less improvement in EF and QoL, and 2) higher reward sensitivity was related to more improvement in QoL and ASD-like behavior. These findings suggest that these EF-training procedures may be beneficial for children with fewer autism traits and higher reward sensitivity. However, the exploratory nature of the analyses warrant further research before applying the findings clinically.

Dance, functioning and quality of life in children with Down syndrome and autism spectrum disorder dance, functioning and quality of life in Down syndrome and autism spectrum disorder

2021 ◽  
pp. 135910452110617
Author(s):  
Evanilza T. Adorno ◽  
Daiany C de J. Dos Santos ◽  
Beatriz M. DeJesus ◽  
Adrielle A. Passos ◽  
Lavínia Teixeira-Machado
Keyword(s):  
Quality Of Life ◽  
Autism Spectrum Disorder ◽  
Down Syndrome ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Children With Down Syndrome

This study investigated dance practice in psychosocial and functional aspects, and quality of life in children with Down syndrome and autism spectrum disorder. Children with DS and ASD, between 3 and 12 years old, attended a dance program during 16 sessions/lessons, lasting 60 min, twice a week, in suitable place. Functional Independence Measure (FIM), Childhood Autism Rating Scale SF-36 quality of life survey, and Knowledge, Attitude and Practice Inquiry (KAP Inquiry) were applied before and after dance classes. Eleven participants concluded the study. Functional independence changes were observed in relation to self-care, sphincter control, locomotion, and communication domains. Children’ “quality of life” reported by parents showed changes in functional capacity, vitality, mental health, physical and social aspects, and general state of health domains. These findings suggest that regular dance practice can underlie psychosocial adjustments in children with DS and ASD.

Quality of life of French Canadian parents raising a child with autism spectrum disorder and effects of psychosocial factors

2017 ◽  
Vol 27 (4) ◽  
pp. 955-967 ◽  
Author(s):  
Émilie Cappe ◽  
Nathalie Poirier ◽  
Carol Sankey ◽  
Andréa Belzil ◽  
Carmen Dionne
Keyword(s):  
Quality Of Life ◽  
Autism Spectrum Disorder ◽  
Psychosocial Factors ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
French Canadian
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