Mental health across the lifespan

Gotham, Katherine; Cassidy, Sarah; Weiss, Jonathan A.

doi:10.1177/1362361320912132

Cited by 9 publications

(7 citation statements)

References 21 publications

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“…Co-occurring mental health problems among children with autism spectrum disorder (ASD) are highly prevalent and require lifespan, transdisciplinary, and community participatory care approaches (Gotham et al, 2020). Pediatric primary care is a principal point of contact for children's healthcare and can be instrumental in first identifying and responding to mental health concerns before these needs escalate to significant impairment (Wissow et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Mental health screening in pediatric primary care for children with autism

Stadnick

Martinez

Coleman

et al. 2022

Autism

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To report mental health screening rates in pediatric primary care as part of a larger program piloting Access to Tailored Autism INtegrated Care, a model promoting timely identification of mental health needs and care linkage for children with autism. Data were extracted from the Access to Tailored Autism INtegrated Care pilot in six pediatrics clinics within two organizations. Demographics and Pediatric Symptom Checklist-17 data were collected during well-child visit appointments over 4 months for 166 children with autism ages 4–16 years. 53% ( n = 43) of 81 eligible children were screened in Organization 1 and 55% ( n = 47) of 85 of eligible children were screened in Organization 2. In Organization 1, 47% screened positive, as evidenced by an elevated Pediatric Symptom Checklist-17 Total Score, while 36% screened positive in Organization 2. Children with positive screens had elevations on the Pediatric Symptom Checklist-17 Externalizing and Attention subscales but not on the Internalizing subscale, confirming typical trends in co-occurring challenging behavior presentations in children with autism. Slightly over half of eligible patients were Pediatric Symptom Checklist-17 screened. Positive screening rates were high, reinforcing the co-occurring nature of mental health needs in children with autism. Findings suggest opportunities to improve mental health screening in primary care for children with autism. Lay abstract Children with autism experience high rates of co-occurring mental health conditions like challenging behaviors and anxiety. However, these co-occurring mental health needs are often not identified when they first become problematic. Pediatricians and their care staff are in a good position to identify mental health needs early and support families to connect to needed services. This study describes a project focused on mental health screening for children with autism in pediatric primary care clinics. Over half of eligible patients were screened using the Pediatric Symptom Checklist-17. Many children with autism had clinically elevated scores, suggesting the need for mental health assessment or services. In particular, children with positive screens had clinical elevations on the challenging behavior and attention subscales of the Pediatric Symptom Checklist-17. This finding is consistent with typical trends in co-occurring challenging behavior presentations in children with autism. Mental health screening in primary care is feasible and offers a promising opportunity to identify co-occurring mental health needs for children with autism early. Screening rates varied between clinics, suggesting tailored to improve routine screening in pediatric primary care for children with autism.

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Section: Introductionmentioning

confidence: 99%

Mental health screening in pediatric primary care for children with autism

Stadnick

Martinez

Coleman

et al. 2022

Autism

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“…. Unfortunately, while increased awareness of this problem has led to calls for action (Gotham et al, 2020), few studies have investigated the current depression service landscape among depressed adults on the autism spectrum. This information is critical to identify disparities and improve access to care for this extremely vulnerable population.…”

mentioning

confidence: 99%

Depression in independent young adults on the autism spectrum: Demographic characteristics, service use, and barriers

Zheng

Adams

Taylor

et al. 2021

Autism

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Depression is a common problem for adults on the autism spectrum, but little is known about depression-related service receipt in this group. To understand depression diagnostic and treatment status better, we collected information on current depressive symptoms, depression diagnosis, and treatment status of 315 young adults with a childhood diagnosis of autism from the Simons Foundation Powering Autism Research for Knowledge registry. About two-thirds (65.4%) of the adults had been diagnosed with depression, and 46.7% currently met clinical cut-offs for depression on depressive symptoms measures. Among the currently depressed, the majority (83.0%) had a formal depression diagnosis. Despite being no more likely than males to be currently depressed, females (biological sex) were more likely to have received a depression diagnosis. As for depression treatment, 58.5% of currently depressed adults were currently being treated, and 68% had previously received treatment. Medication was the most common form of treatment, followed by individual therapy. Likelihood of receiving depression treatment was higher among those with a formal depression diagnosis and with higher levels of education. Adults reported several barriers to accessing treatment for depression, including financial and insurance issues, accessibility to appropriate care, and professionals’ lack of understanding about depression in autism. Lay abstract Depression is common among adults on the autism spectrum, but little is known about the extent to which these adults living in the community access diagnostic and treatment services for depression. To address this gap, we surveyed 315 adults on the autism spectrum on depression symptoms, diagnosis, and services. About half of the sample had scores on standard depression measures that suggested they were currently depressed ( n = 147, 46.7%). Among the currently depressed, most of them had received a depression diagnosis from a professional. Depressed females were about 3.5 times more likely than depressed males to have a depression diagnosis. More than half of the currently depressed adults on the autism spectrum reported receiving depression treatment at the time of the study, while about two-thirds had previously received treatment. Those with a depression diagnosis were more likely to have received treatment, and those who had some education beyond high school were more likely to be currently receiving treatment. Financial and insurance issues were the most common barriers that adults reported in accessing treatment for depression.

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“…With the recent focus on mental health needs of adolescents through the COVID-19 pandemic (Samji et al, 2022 ), it seems important to understand the mental health needs of our autistic school-age youth with and without ADHD. Understanding the prevalence of co-occurring autism, ADHD and mental health conditions has the potential to: (1) ensure that the mental health needs of our school-age youth do not go unnoticed or misinterpreted by healthcare providers and educators as other disability label related characteristics (Hossain et al, 2020 ), and (2) inform the proactive provision of holistic mental health supports, such as community-based care, counseling, and trauma-informed instruction (Gotham et al, 2020 ; Gunin et al, 2021 ).…”

Section: Neurodiversitymentioning

confidence: 99%

“…Findings support a need to educate health-care providers, parents and educators about identifying mental health needs and providing holistic supports. Examples of holistic mental health supports recommended for autistic youth with and without ADHD in the research literature include community-based care, trauma-informed instruction (Gotham et al, 2020 ; Gunin et al, 2021 ), exercise (Spratt et al, 2018 ), counseling, cognitive behavior therapy, emotional support animals, mentoring programs, online resources, and support groups provided with consideration of service delivery modalities preferred by the individual (Kuder et al, 2021 ).…”

Section: Implications For Practicementioning

confidence: 99%

Heightened Anxiety and Depression Among Autistic Adolescents with ADHD: Findings From the National Survey of Children’s Health 2016–2019

Accardo

Pontes

2022

J Autism Dev Disord

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Data from the National Survey of Children’s Health 2016–2019 was used to examine the co-occurrence of autism and ADHD and the impact on anxiety and depression among adolescents age 12–17. Rates of anxiety and depression were up to ten-fold the prevalence of adolescents not diagnosed with autism or ADHD. Over half of autistic females (57%) and nearly half of autistic males (49%) are also diagnosed with ADHD. Autistic females with ADHD had the highest co-occurrence of anxiety at 72% followed by autistic males with ADHD at 69%. The prevalence of depression was highest among autistic adolescents with ADHD yet was consistent across genders (male/female) at 38–39%. Adolescents diagnosed with autism and/or ADHD are at heightened risk for anxiety and depression.

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Mental health across the lifespan

Cited by 9 publications

References 21 publications

Mental health screening in pediatric primary care for children with autism

Mental health screening in pediatric primary care for children with autism

Depression in independent young adults on the autism spectrum: Demographic characteristics, service use, and barriers

Heightened Anxiety and Depression Among Autistic Adolescents with ADHD: Findings From the National Survey of Children’s Health 2016–2019

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