scholarly journals COVID-19-related prescribing challenge in intellectual disability

BJPsych Open ◽  
2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Bushra Rauf ◽  
Hafsa Sheikh ◽  
Hassan Majid ◽  
Ashok Roy ◽  
Rani Pathania
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Intellectual Disability ◽  
Multidisciplinary Team ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Multidisciplinary Teams ◽  
Prospective Data ◽  
Disability Service ◽  
Manage Mental

Background The COVID-19 pandemic and associated restrictions are expected to affect the mental health of the population, especially people with intellectual disability and/or autism spectrum disorder, because of a variety of biological and psychosocial reasons. Aims This study aimed to estimate if COVID-19 restrictions are associated with a change in number of total consultations carried out by psychiatrists and prescription of psychotropic medication in people with intellectual disability and/or autism spectrum disorder, within a community intellectual disability service. Method A quantitative observational study was conducted, involving retrospective and prospective data collection before and during lockdown. Data was collected on a spreadsheet and emailed to all psychiatrists working within the Coventry and Warwickshire Partnership NHS Trust-wide community intellectual disability service. Variables included total consultations, medication interventions, types of medications used, multidisciplinary team input and clinical reasons for medication interventions. Data was analysed separately for child and adolescent mental health services (CAMHS) and adult intellectual disability teams, and for the whole service. Results During the lockdown period, total consultations in the community intellectual disability service increased by 19 per week and medication interventions increased by two per week. Multidisciplinary team input increased in CAMHS from 0.17 to 0.71 per week and in adult intellectual disability from 5.7 to 6.5 per week. Hypnotics and benzodiazepines were the most commonly prescribed psychotropic medications during the lockdown period. Conclusions COVID-19-related lockdown resulted in an increase in medication interventions, total consultations and involvement of multidisciplinary teams to manage mental health and behavioural issues in people with intellectual disability and/or autism spectrum disorder.

Improving Emotional Competence in Children With Autism Spectrum Disorder and Mild Intellectual Disability in Schools: A Preliminary Treatment Versus Waitlist Study

2019 ◽  
Vol 36 (4) ◽  
pp. 216-232 ◽  
Author(s):  
Belinda Ratcliffe ◽  
Michelle Wong ◽  
David Dossetor ◽  
Susan Hayes
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Intellectual Disability ◽  
Social Skills ◽  
Emotional Competence ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Medium Effect ◽  
Mild Intellectual Disability

AbstractThis pilot study evaluated the effectiveness of delivering a new cognitive behavioural intervention package ‘Emotion-Based Social Skills Training (EBSST) for Children with Autism Spectrum Disorder (ASD) and Mild Intellectual Disability (ASD + MID)’ in schools. Fourteen school counsellors nominated 75 children (aged 7–13 years) with ASD + MID to receive 16 sessions of EBSST in groups of 3–8 children in their schools. Parent and teacher pre-post ratings of emotional competence (Emotions Development Questionnaire), social skills (Social Skills Improvement System Rating Scales) and mental health (Developmental Behaviour Checklist) were collected. Forty-three children received 16 sessions of EBSST and 32 children were allocated to the 9-month waitlist control group. Teachers and parents also received six EBSST training sessions in separate groups at school. Significant improvements in parent and teacher ratings of emotional competence were found at posttreatment among children in the EBSST group relative to controls; however, the results were not significant after the Bonferroni adjustment. Small to medium effect sizes were found. No difference in untrained social skills or mental health was observed. This study provides preliminary support for the utility of EBSST in teaching emotional competence skills for children with ASD + MID in schools and provides valuable pilot data for future research.

scholarly journals Mental Health of Parents of Special Needs Children in China during the COVID-19 Pandemic

2020 ◽  
Vol 17 (24) ◽  
pp. 9519
Author(s):  
Sui-Qing Chen ◽  
Shu-Dan Chen ◽  
Xing-Kai Li ◽  
Jie Ren
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Intellectual Disability ◽  
Family Support ◽  
Behavioral Problems ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Special Needs Children ◽  
Parenting Distress

We assessed the mental health of parents (N = 1450, Mage = 40.76) of special needs children during the COVID-19 pandemic. We conducted an online survey comprising items on demographic data; two self-designed questionnaires (children’s behavioral problems/psychological demand of parents during COVID-19); and four standardized questionnaires, including the General Health Questionnaire, Perceived Social Support, Parenting Stress Index, and Neuroticism Extraversion Openness Five Factor Inventory. The results showed that there were significant differences among parents of children with different challenges. Parents of children with autism spectrum disorder were more likely to have mental health problems compared to parents whose children had an intellectual disability or a visual or hearing impairment. Behavioral problems of children and psychological demands of parents were common factors predicting the mental health of all parents. Parent–child dysfunctional interactions and parenting distress were associated with parents of children with autism spectrum disorder. Family support, having a difficult child, and parenting distress were associated with having children with an intellectual disability. It is necessary to pay attention to the parents’ mental health, provide more social and family support, and reduce parenting pressures.

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.

scholarly journals Using electronic clinical records to investigate service use and in-patient care of adults with intellectual disability and/or autism spectrum disorder

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S275-S275
Author(s):  
Jennifer Mutch ◽  
Rory Sheehan ◽  
Louise Marston ◽  
Nomi Werbeloff ◽  
David Osborn ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Intellectual Disability ◽  
Personality Disorder ◽  
Affective Disorder ◽  
Service Use ◽  
Autism Spectrum ◽  
Patient Admission ◽  
Spectrum Disorder ◽  
Factors Associated

AimsTo describe characteristics of adults with intellectual disability (ID) and/or autism spectrum disorder (ASD) accessing care in one mental health Trust.To explore factors associated with in-patient admission/risk of re-admission within 12 months of discharge.BackgroundThere is concern that adults with intellectual disability and those with autism spectrum disorder are frequently admitted to mental health hospitals. The evidence from NHS datasets suggests that this remains a significant issue and is associated with personal, social and economic costs.MethodAdults (≥ 18 years) with ICD-10 diagnosis of “mental retardation” and/or autism who had accessed care in the Camden and Islington Foundation Trust were identified using the Clinical Record Interactive Search (CRIS). The identification process was validated through cross checking of free text in the electronic clinical notes. We compared demographic and clinical characteristics and service use, including length of admission, of 315 individuals with ASD and 339 with ID (with or without ASD). Logistic regression was used to explore factors associated with in-patient admission and re-admission within 12 months of discharge.ResultA greater proportion of adults with ID (with or without ASD) had a diagnosis of psychosis, substance misuse, or dementia whereas diagnosis of anxiety disorder was greater in those with ASD. Antipsychotics and other psychotropics were twice as likely to be prescribed for the ID ± group. Admission to psychiatric in-patient care was greater in those with ID ± ASD (adjusted OR 4.00, 95% confidence interval (CI) 2.41-6.63), men (aOR 2.28, 95%CI 1.39-3.75), younger adults (aOR 0.98, 95%CI 0.97-1.00), and in those with a diagnosis of schizophrenia spectrum disorder (aOR 5.08, 95%CI 3.00-8.61), affective disorder (aOR 2.23, 95%CI 1.29-3.83), personality disorder (aOR 1.94, 95%CI 1.02-3.68), and record of previous inpatient admission (aOR 2.18, 95%CI 1.17-4.05). Having ASD alone was associated with a greater risk of re-admission within one year of discharge, although this difference was not statistically significant (aOR 0.70, 95% CI 0.32-1.52). Comorbid diagnoses of affective disorder or personality disorder were the only significant associations with re-admission (aOR 3.11, 95%CI 1.34-7.23 and aOR 8.28, 95%CI 2.85-24.04, respectively).ConclusionThese findings provide the first longitudinal investigation into the acute care pathway for adults with ID and/or ASD in the NHS. Replication in other trusts is now needed to inform “at risk of admission” registers and guide targeted interventions to prevent admission.

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