Service use by youth with autism within a system-driven implementation of evidence-based practices in children’s mental health services

Stadnick, Nicole A.; Lau, Anna S.; Dickson, Kelsey S.; Pesanti, Keri; Innes-Gomberg, Debbie; Brookman‐Frazee, Lauren

doi:10.1177/1362361320934230

Cited by 11 publications

(8 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Screening results indicated that children in our sample had elevated scores on the Attention and Externalizing but not Internalizing subscales of the PSC-17. The high positive screen rate and the pattern of mental health need types are consistent with research reporting high rates of co-occurring mental health conditions for children with autism and the common co-occurrence of challenging behaviors, which includes both attention and externalizing symptoms, for these youth (Brookman-Frazee et al, 2018; Stadnick, Lau, et al, 2020).…”

Section: Discussionsupporting

confidence: 83%

“…For example, our findings indicated that children in our sample did not evidence elevations on the Internalizing subscale of the PSC-17. While challenging behaviors are the most common mental health need in school-age children with ASD (Brookman-Frazee et al, 2018; Stadnick, Lau, et al, 2020), there is potential that caregivers under-reported internalizing symptoms because they can be difficult to recognize.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Mental health screening in pediatric primary care for children with autism

Stadnick

Martinez

Coleman

et al. 2022

Autism

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Mental health screening in pediatric primary care for children with autism

Stadnick

Martinez

Coleman

et al. 2022

Autism

Self Cite

View full text Add to dashboard Cite

show abstract

“…Some highlighted the significant ramifications diagnostic overshadowing had in terms of the resources and legal recourse made available to them, while others reflected that not recognizing signs of coping caused themselves, educators, and healthcare workers to miss opportunities to intervene at the peak of their child's distress. These observations are consistent with studies documenting the reduced provision of trauma-focused treatments to autistic versus non-autistic youth, as well as a desire for training in trauma identification and treatment amongst autism-focused providers ( 29 , 84 ). Similarly, autistic adults reflected on how their attempts to cope could be dismissed as part of their autism diagnosis.…”

Section: Discussionsupporting

confidence: 88%

A Qualitative Study of Self and Caregiver Perspectives on How Autistic Individuals Cope With Trauma

et al. 2022

View full text Add to dashboard Cite

BackgroundCoping can moderate the relationship between trauma exposure and trauma symptoms. There are many conceptualisations of coping in the general population, but limited research has considered how autistic individuals cope, despite their above-average rates of traumatic exposure.ObjectivesTo describe the range of coping strategies autistic individuals use following traumatic events.MethodsFourteen autistic adults and 15 caregivers of autistic individuals, recruited via stratified purposive sampling, completed semi-structured interviews. Participants were asked to describe how they/their child attempted to cope with events they perceived as traumatic. Using an existing theoretical framework and reflexive thematic analysis, coping strategies were identified, described, and organized into themes.ResultsCoping strategies used by autistic individuals could be organized into 3 main themes: (1) Engaging with Trauma, (2) Disengaging from Trauma, and (3) Self-Regulatory Coping. After the three main themes were developed, a fourth integrative theme, Diagnostic Overshadowing, was created to capture participants' reports of the overlap or confusion between coping and autism-related behaviors.ConclusionsAutistic individuals use many strategies to cope with trauma, many of which are traditionally recognized as coping, but some of which may be less easily recognized given their overlap with autism-related behaviors. Findings highlight considerations for conceptualizing coping in autism, including factors influencing how individuals cope with trauma, and how aspects of autism may shape or overlap with coping behavior. Research building on these findings may inform a more nuanced understanding of how autistic people respond to adversity, and how to support coping strategies that promote recovery from trauma.

show abstract

“…Yet, in a recent study of community ASD providers in the US (Kerns, Berkowitz, et al, 2020), >75% agreed that trauma assessments are warranted for autistic youth and over half reported screening and treating trauma symptoms in their autistic clients despite a professed need for further training. Stadnick et al (2020) found that autistic children were significantly less likely than those not on the spectrum to receive trauma services in a US public mental health system-a disparity, which may also reflect the limited evidence available to guide trauma services in this group. As such, experts in this study represent a rare and specialized cohort, whose insights may help address the high demand for clinical knowledge in this area and guide future research.…”

Section: Discussionmentioning

confidence: 98%

“…Stadnick et al. (2020) found that autistic children were significantly less likely than those not on the spectrum to receive trauma services in a US public mental health system–a disparity, which may also reflect the limited evidence available to guide trauma services in this group. As such, experts in this study represent a rare and specialized cohort, whose insights may help address the high demand for clinical knowledge in this area and guide future research.…”

Section: Discussionmentioning

confidence: 99%

Expert consensus regarding indicators of a traumatic reaction in autistic youth: a Delphi survey

Kerns

Robins

Shattuck

et al. 2022

Child Psychology Psychiatry

View full text Add to dashboard Cite

Objective: It has been suggested that the sequelae of trauma are under-recognized in youth on the autism spectrum. We aimed to generate expert consensus regarding important trauma indicators, including but not limited to traumatic stress symptoms, in autistic youth. Methods: We recruited 72 experts in autism and/or childhood trauma. Via a 2-round Delphi survey, experts commented on and rated the importance of 48 potential indicators, drawn from PTSD criteria and a broader literature on traumatic sequelae in autism. A revised list of 51 indicators, 18 clinical guidelines developed from expert comments, and summaries of expert qualifications and ratings from Round 1 were submitted to a second round (n = 66; 92% retention) of expert review and rating. Results: Twenty-two indicators reached consensus (>75% round 2 endorsement). Many, but not all, reflected PTSD criteria, including intrusions (e.g., trauma re-enactments in perseverative play/speech), avoidance of trauma-reminders, and negative alterations in mood/cognition (e.g., diminished interest in activities) and in arousal/reactivity (e.g., exaggerated startle). Experts also identified increased reliance on others, adaptive and language regressions, self-injurious behavior, and non-suicidal self-injury as important indicators. Consensus guidelines emphasized the need for tailored measures, developmentally informed criteria, and multiple informants to increase diagnostic accuracy. Conclusions: Expert consensus emphasizes and informs a need for tailored diagnostic guidelines and measures to more sensitively assess traumatic reactions in autistic youth.

show abstract

Service use by youth with autism within a system-driven implementation of evidence-based practices in children’s mental health services

Cited by 11 publications

References 32 publications

Mental health screening in pediatric primary care for children with autism

Mental health screening in pediatric primary care for children with autism

A Qualitative Study of Self and Caregiver Perspectives on How Autistic Individuals Cope With Trauma

Expert consensus regarding indicators of a traumatic reaction in autistic youth: a Delphi survey

Contact Info

Product

Resources

About