Physician Perspectives on Severe Behavior and Restraint Use in a Hospital Setting for Patients with Autism Spectrum Disorder

Salvatore, Giovanna L.; Simmons, Christina; Tremoulet, Patrice D.

doi:10.1007/s10803-021-05327-8

Cited by 18 publications

(6 citation statements)

References 63 publications

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“…Weil et al [ 24 ] have previously reported that behavior management strategies chosen by dental care providers might not be the most beneficial strategies when managing patients with ASD. Furthermore, unfamiliarity with comprehensive protective stabilization by physicians and the inability to manage children with difficult behavior has been previously reported [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Dental Treatment Characteristics of Autistic Children and Differences in Dental Procedures under General Anesthesia Relative to Healthy Counterparts

et al. 2023

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Here, we assess the dental treatment characteristics among children with autism spectrum disorder (ASD) and compare the dental procedures delivered under general anesthesia (GA) with those of healthy-matched counterparts. In this retrospective cohort study, we collected data from medical records of ASD children (n = 82) which included demographic profile, medical status (including the severity of the ASD and associated comorbidities), and dental history (including dental visits, behavior, care approach, and dental procedures provided). For those children who received dental GA (DGA) (n = 64), we compared all procedures delivered and the number of repeat sessions with healthy children (n = 64). Our results reveal that most ASD children (78%) received DGA, mainly with one repeat session (63.4%). The dental procedures provided to the children differed significantly according to the severity of the ASD and the behavior of the children. Furthermore, increasing severity led to significantly worse behavior of the children, increased need for DGA and repeat sessions. Comparison of the dental procedures under GA with healthy children revealed a significantly lower mean of almost all dental procedures in ASD children, except fissure-sealed teeth (p < 0.05). Considering these findings, DGA is unavoidable for ASD children with moderate-to-severe conditions or negative behavior in the dental office, even when their dental needs are lower than healthy children. The severity of ASD was the most important factor affecting the behavior of the children and the care approach they received. Along with children’s behavior, they most influenced the dental procedures delivered and the need for repeat DGA.

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Section: Discussionmentioning

confidence: 99%

Dental Treatment Characteristics of Autistic Children and Differences in Dental Procedures under General Anesthesia Relative to Healthy Counterparts

et al. 2023

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“…To rank the salience of themes as one piece of information when considering DSPs needs, the total count of each theme was summed across participants in each focus group and across all 3 focus groups [ 38 , 39 ]. Each example or explanation provided by the participants was counted as an occurrence.…”

Section: Methodsmentioning

confidence: 99%

“…Revisiting a previous example or explanation was counted as a separate occurrence. Although the key information gleaned through qualitative data analysis is the distinct themes that emerge from the data, recent research using the constant comparative method of qualitative data analysis has presented the salience of themes using this methodology as an accompanying piece of information [ 38 ].…”

Section: Methodsmentioning

confidence: 99%

Direct Support Professionals’ Perspectives on Using Technology to Help Support Adults With Autism Spectrum Disorder: Mixed Methods Study

Simmons¹,

Moretti²,

Lobo³

et al. 2023

JMIR Form Res

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Background Documentation is a critical responsibility for direct support professionals (DSPs) who work with adults with autism spectrum disorder (ASD); however, it contributes significantly to their workload. Targeted efforts must be made to mitigate the burden of necessary data collection and documentation, which contributes to high DSP turnover rates and poor job satisfaction. Objective This mixed methods study aimed to explore how technology could assist DSPs who work with adults with ASD and prioritize aspects of technology that would be most useful for future development efforts. Methods In the first study, 15 DSPs who worked with adults with ASD participated in 1 of the 3 online focus groups. The topics included daily tasks, factors that would influence the adoption of technology, and how DSPs would like to interact with technologies to provide information about their clients. Responses were thematically analyzed across focus groups and ranked by salience. In the second study, 153 DSPs across the United States rated the usefulness of technology features and data entry methods and provided qualitative responses on their concerns regarding the use of technology for data collection and documentation. Quantitative responses were ranked based on their usefulness across participants, and rank-order correlations were calculated between different work settings and age groups. The qualitative responses were thematically analyzed. Results In study 1, participants described difficulties with paper-and-pencil data collection, noted benefits and concerns about using technology instead, identified benefits and concerns about particular technology features, and specified work-environment factors that impact data collection. In study 2, participants rated multiple features of technology as useful, with the highest usefulness percentages endorsed for task views (ie, by shift, client, and DSP), logging completed tasks, and setting reminders for specific tasks. Participants also rated most data entry methods (eg, typing on a phone or tablet, typing on a keyboard, and choosing from options on a touch screen) as useful. Rank-order correlations indicated that the usefulness of technology features and data entry methods differed across work settings and age groups. Across both studies, DSPs cited some concerns with technology, such as confidentiality, reliability and accuracy, complexity and efficiency, and data loss from technology failure. Conclusions Understanding the challenges faced by DSPs who work with adults with ASD, and their thoughts about using technology to meet those challenges, represents an essential first step toward developing technology solutions that can increase DSPs’ effectiveness and job satisfaction. The survey results indicate that technology innovations should incorporate multiple features to account for different needs across DSPs, settings, and age groups. Future research should explore barriers to adopting data collection and documentation tools and elicit input from agency directors, families, and others interested in reviewing data about adults with ASD.

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“…Every effort should be made to avoid using restraints, which are associated with increased risk of depression, anxiety, and posttraumatic stress disorder. 9 T A B L E 2 Hospitalists improving the care of hospitalized Autistic adults.…”

Section: Recognizing and Addressing Autistic Traits In The Hospitalmentioning

confidence: 99%

Clinical progress note: Caring for hospitalized Autistic adults

Pineo

2024

Journal of Hospital Medicine

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Physician Perspectives on Severe Behavior and Restraint Use in a Hospital Setting for Patients with Autism Spectrum Disorder

Cited by 18 publications

References 63 publications

Dental Treatment Characteristics of Autistic Children and Differences in Dental Procedures under General Anesthesia Relative to Healthy Counterparts

Dental Treatment Characteristics of Autistic Children and Differences in Dental Procedures under General Anesthesia Relative to Healthy Counterparts

Direct Support Professionals’ Perspectives on Using Technology to Help Support Adults With Autism Spectrum Disorder: Mixed Methods Study

Clinical progress note: Caring for hospitalized Autistic adults

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