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.

Oppositional Defiant Disorder and Related Disruptive Behaviors in Autism Spectrum Disorder

2020 ◽  
pp. 136-158
Author(s):  
Connor M. Kerns ◽  
Chandler Puhy ◽  
Chelsea M. Day ◽  
Steven J. Berkowitz
Keyword(s):  
Autism Spectrum Disorder ◽  
Oppositional Defiant Disorder ◽  
Challenging Behaviors ◽  
Disruptive Behaviors ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Future Research ◽  
Oppositional Defiant ◽  
Assessment And Treatment ◽  
Defiant Behavior

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition characterizes oppositional defiant disorder (ODD) as reflecting pervasive patterns of irritable mood, defiant behavior, and/or vindictiveness. Youth with autism spectrum disorder (ASD) exhibit high rates of disruptive behaviors commonly associated with ODD, such as noncompliance, irritability, temper tantrums, and mood dysregulation. This chapter reviews the presentation of ODD in individuals with ASD, including current prevalence estimates, proposed etiology, validated assessment methods, and emerging best practices designed to treat challenging behaviors. Although there is a robust literature describing assessment and treatment procedures for disruptive behaviors in individuals with ASD, conceptualizing these hallmark behaviors within the framework of ODD is relatively novel and not without controversy. Discussion thus includes challenges around the applicability of the diagnostic criteria in this population and future research directions that may provide clarity on this issue.

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.

scholarly journals Lagging skills contribute to challenging behaviors in children with autism spectrum disorder without intellectual disability

Autism ◽  
2017 ◽  
Vol 22 (8) ◽  
pp. 898-906 ◽  
Author(s):  
Brenna B Maddox ◽  
Patrick Cleary ◽  
Emily S Kuschner ◽  
Judith S Miller ◽  
Anna Chelsea Armour ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Emotion Regulation ◽  
Executive Function ◽  
Intellectual Disability ◽  
Social Skills ◽  
Challenging Behaviors ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Environmental Demands

Many children with autism spectrum disorder display challenging behaviors. These behaviors are not limited to those with cognitive and/or language impairments. The Collaborative and Proactive Solutions framework proposes that challenging behaviors result from an incompatibility between environmental demands and a child’s “lagging skills.” The primary Collaborative and Proactive Solutions lagging skills—executive function, emotion regulation, language, and social skills—are often areas of weakness for individuals with autism spectrum disorder. The purpose of this study was to evaluate whether these lagging skills are associated with challenging behaviors in youth with autism spectrum disorder without intellectual disability. Parents of 182 youth with autism spectrum disorder (6–15 years) completed measures of their children’s challenging behaviors, executive function, language, emotion regulation, and social skills. We tested whether the Collaborative and Proactive Solutions lagging skills predicted challenging behaviors using multiple linear regression. The Collaborative and Proactive Solutions lagging skills explained significant variance in participants’ challenging behaviors. The Depression (emotion regulation), Inhibit (executive function), and Sameness (executive function) scales emerged as significant predictors. Impairments in emotion regulation and executive function may contribute substantially to aggressive and oppositional behaviors in school-age youth with autism spectrum disorder without intellectual disability. Treatment for challenging behaviors in this group may consider targeting the incompatibility between environmental demands and a child’s lagging skills.

Sensory processing in children with autism spectrum disorder and the mental health of primary caregivers

2019 ◽  
Vol 41 (4) ◽  
pp. 341-351 ◽  
Author(s):  
Kanae Suzuki ◽  
Shu Takagai ◽  
Masatsugu Tsujii ◽  
Hiroyuki Ito ◽  
Tomoko Nishimura ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Sensory Processing ◽  
Primary Caregivers ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder

scholarly journals Caregiver-mediated approaches to managing challenging behaviors in children with autism spectrum disorder

2013 ◽  
Vol 15 (2) ◽  
pp. 225-233
Keyword(s):  
Autism Spectrum Disorder ◽  
Children And Adolescents ◽  
Behavioral Interventions ◽  
Challenging Behaviors ◽  
Significant Proportion ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Children With Asd ◽  
Adolescents With Asd

A significant proportion of children with autism spectrum disorder (ASD) are referred to mental health centers due to the presence of challenging behaviors. Because challenging behaviors in children and adolescents with ASD often result from underlying social and communication difficulties and comorbid anxiety, traditional caregiver-mediated behavior intervention techniques developed for children with disruptive behavior disorders may need to be adapted for this population. Behavioral interventions that target communication skills, social skills, anxiety, and sensory responsiveness in children with ASD may be needed. Notably, while best practice necessitates the involvement of caregivers in treating children and adolescents with ASD, few randomized control studies have examined the effectiveness of caregiver-implemented interventions in reducing challenging behaviors. This review summarizes the current literature with regard to caregiver-mediated behavioral interventions for children with ASD, and suggests areas for intervention development and research.

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