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Barriers and Benefits Experienced by Caregivers Seeking Medical Care for Their Children with Autism Spectrum Disorders: a Qualitative Meta-synthesis. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00306-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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McCormack G, Dillon AC, Healy O, Walsh C, Lydon S. Primary Care Physicians’ Knowledge of Autism and Evidence-Based Interventions for Autism: A Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-019-00189-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Solomon D, Pantalone DW, Faja S. Autism and Adult Sex Education: A Literature Review using the Information-Motivation-Behavioral Skills Framework. SEXUALITY AND DISABILITY 2019; 37:339-351. [PMID: 33311815 DOI: 10.1007/s11195-019-09591-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Adults on the autism spectrum report comparable levels of desire for sex and sexual satisfaction as adults who are not on the spectrum. However, there has been little empirical focus on the need for sexual and relationship-oriented education for youth on the spectrum as they transition to adulthood. In this review, we use the Information-Motivation-Behavioral Skills Model of sexual health behavior change as a lens through which to understand the experiences of adults on the autism spectrum. We present those insights infused with emerging data and best practices in the field. Overall, it appears clear from the extant literature that providers need to recognize the specific characteristics of autism when developing sexual education curricula. Specifically, the social communication and sensory profile of people on the autism spectrum appears to interact with access to information, motivation to engage in healthy sexual activities, and the development of skills needed to engage in healthy sexual behavior. Finally, the voice of adults on the spectrum is essential to guide the emerging understanding of healthy sexuality.
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Affiliation(s)
- Dasha Solomon
- Division of Developmental Medicine, Boston Children's Hospital, 02215.,Department of Pediatrics, Harvard Medical School, 02215
| | - David W Pantalone
- Department of Psychology, University of Massachusetts Boston, 02125.,The Fenway Institute, Fenway Health, 02215
| | - Susan Faja
- Division of Developmental Medicine, Boston Children's Hospital, 02215.,Department of Pediatrics, Harvard Medical School, 02215
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Kennedy R, Binns F, Brammer A, Grant J, Bowen J, Morgan R. Continuous Service Quality Improvement and Change Management for Children and Young People with Autism and Their Families: A Model for Change. Compr Child Adolesc Nurs 2016. [DOI: 10.1080/24694193.2016.1178357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Garg P, Lillystone D, Dossetor D, Wilkinson H, Kefford C, Eastwood J, Liaw ST. A Framework for Developing a Curriculum Regarding Autism Spectrum Disorders for Primary Care Providers. J Clin Diagn Res 2015; 9:SC01-6. [PMID: 26557583 DOI: 10.7860/jcdr/2015/13248.6651] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 05/21/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The prevalence of Autism Spectrum Disorders (ASDs) has increased and varies across age groups. Thus there is an increasing need for educational opportunities for General Practitioners (GPs) and other Primary Care providers to help in early identification and referral to specialist services. An earlier survey of GPs in New South Wales (Australia) demonstrated two broad domains for educational activities: (1) a general knowledge (important for early identification and referral) and (2) surveillance (important for ongoing management). AIM To seek further evidence to these domains and synthesize the important contents for educational programs for GPs. MATERIALS AND METHODS We conducted a (1) Confirmatory Factor Analysis (CFA) on our original survey data and (2) systematic review of the literature to identify important educational topics, using a life cycle approach. RESULTS CFA and literature review support theoretical framework of two domains. Alerts and red flags for ASDs, knowledge of simple surveillance tools, communication of diagnosis with parents, referral pathways particularly to speech pathologists before a formal diagnosis is confirmed, and appreciation of vulnerabilities for identifying supports were important in the general knowledge domain, while supporting the families through transition points such as from pre-school to school entry, secondary school and adolescence, role of psychopharmacology such as medications for sleep issues, and for common co-morbidities of anxiety were important in the surveillance dimension. CONCLUSION GP supervisors and medical and nursing educators can use findings from this paper for developing structured learning activities for training primary health care workforce regarding ASD's.
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Affiliation(s)
- Pankaj Garg
- School of Women's and Children's Health, UNSW, Discipline of Paediatrics, Central Clinical School, University of Sydney, Ingham Health Research Institute , Liverpool, NSW
| | - David Lillystone
- Senior Community Paediatrician, Hornsby Ku-Ring Hospital and Hornsby Community Child Health Centre, Hornsby, Northern Clinical School, University of Sydney
| | - David Dossetor
- Senior Child Psychiatrist with an interest in Autism and Intellectual Disability, Department of Psychological Medicine, Sydney Children's Hospital Network (Westmead), Clinical Associate Professor, University of Sydney
| | - Helen Wilkinson
- Senior Career Medical Officer in Community Paediatrics, Hornsby Child health , 59, Florence street, Hornsby, NSW 2077
| | - Carolyn Kefford
- Senior Academic General Practitioner, Northern Clinical School, University of Sydney
| | - John Eastwood
- Conjoint Associate Professor School of Women's and Children's Health and School of Public Health and Community Medicine, UNSW and Sydney School of Public Health, University of Sydney, Ingham Health Research Institute , Liverpool, NSW, Community Paediatrics, Sydney Local Health District
| | - Siaw Teng Liaw
- Professor of General Practice, School of Public Health and Community Medicine, UNSW, Centre for Primary Health Care and Equity, UNSW and Academic General practice Unit, Fairfield Hospital , Fairfield
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Ethnicity Reporting Practices for Empirical Research in Three Autism-Related Journals. J Autism Dev Disord 2014; 44:1507-19. [DOI: 10.1007/s10803-014-2041-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Is Medication Information for Children with Autism Spectrum Disorder Monitored and Coordinated Across Professionals? Findings from a Teacher Survey. SCHOOL MENTAL HEALTH 2013; 5:48-57. [PMID: 23526921 DOI: 10.1007/s12310-012-9098-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Prescription medications are commonly used for children with autism spectrum disorder (ASD), however, there is little research regarding how the effect of medication is monitored across settings once prescribed. The present study addressed this issue for children with ASD in school by administering a questionnaire to teachers of students with ASD who were and were not being given medication. Specifically, the questionnaire assessed the teachers' knowledge about whether the child was being given medication, and whether behavior changes or side effects were being communicated in any way to the child's family and prescribing physician. The results showed that for children who were being given medication, fewer than half of the teachers reported knowing the child was being given medication. For those children who were not being given medication, only 53% of the teachers reported correct information for their students. Of the teachers who knew their students were being given medication, all reported that they were not conferring with the child's prescribing physician regarding behavioral observations or side effects. Whether teachers are blind to the medication types and dosage the students are being given or not, some type of communication to physicians about the children's behavior at school is important. Given the importance of monitoring medication for children with ASD, implications for system change, for professionals and for funding agencies are discussed.
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Bultas MW. The health care experiences of the preschool child with autism. J Pediatr Nurs 2012; 27:460-70. [PMID: 22920657 DOI: 10.1016/j.pedn.2011.05.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 05/11/2011] [Accepted: 05/15/2011] [Indexed: 11/30/2022]
Abstract
It is known that children with autism spectrum disorder (ASD) visit health care providers (HCPs) more frequently than typically developing peers, and mothers experience barriers in this process. The purpose of this interpretive phenomenological study was to gain a better understanding of a mother's experiences of taking her child with ASD to the HCP. Two themes related to the health care experience of the child surfaced from the study. These themes included feelings that HCPs do not "get" the complexity of caring for the child and marginalization of mothers by the HCP. The need for creation of child-specific profiles emerged from this study.
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Balfe M, Tantam D. A descriptive social and health profile of a community sample of adults and adolescents with Asperger syndrome. BMC Res Notes 2010; 3:300. [PMID: 21070680 PMCID: PMC2992545 DOI: 10.1186/1756-0500-3-300] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Accepted: 11/12/2010] [Indexed: 11/24/2022] Open
Abstract
Background Little is known about the health and social profile of adolescents and adults with Asperger syndrome (AS) living in the community. We conducted a study to describe the living, employment and psycho-social situation of a community sample of forty two adults and adolescents with AS, and to describe these indivdiuals' experiences of accessing health services and taking medication. Findings Most respondents (including those over eighteen years of age) lived at home with their parents. Most had trouble reading and responding to other people's feelings, and coping with unexpected changes. Difficulties with life skills, such as cleaning, washing and hygiene were prevalent. The majority of respondents were socially isolated and a large minority had been sexually or financially exploited. Almost all respondents had been bullied. Mental health problems such as anxiety or depression were common. 30% of respondents said that they regularly became violent and hit other people and 15% had attempted suicide. More positively, the majority of respondents felt that they could access health services if they had a health problem. Conclusions The results of this study suggest a relatively poor social and health profile for many people with Asperger syndrome living in the community, with high levels of social problems and social exclusion, and difficulties managing day to day tasks such as washing and cleaning; these findings support the results of other studies that have examined psycho-social functioning in this group.
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Affiliation(s)
- Myles Balfe
- Centre for the Study of Conflict and Reconciliation, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
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Chuthapisith J, diMambro B, Doody G. Effectiveness of a computer assisted learning (CAL) package to raise awareness of autism. BMC MEDICAL EDUCATION 2009; 9:12. [PMID: 19245703 PMCID: PMC2652457 DOI: 10.1186/1472-6920-9-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Accepted: 02/26/2009] [Indexed: 05/27/2023]
Abstract
BACKGROUND Promoting awareness of autism in populations who work with children may result in an earlier diagnosis of the condition. In this study, a computer assisted learning (CAL) package, containing educationally appropriate knowledge about autism was developed; and the effectiveness of this CAL package was evaluated. METHODS The CAL package was developed using computer software, "Xerte" and "Flash Macromedia". The effectiveness of the CAL package was evaluated in 32 childcare students in the UK, who were randomised to watch the CAL package or to read the information leaflet containing the same information (n = 16 in each group). Retention performance, level of enjoyment, and level of confidence to identify a child with autism, after the interventions, were evaluated. The data obtained from two studied groups was analysed using unpaired Student's t-test, 95% confidence interval, and effect size. RESULTS Students who watched the CAL package had superior retention performance percentage scores (p = 0.02, 95% CI = 0.83-12.19, effect size = 0.8) and level of enjoyment (p = 0.04, 95% CI = 0.03-2.75, effect size = 0.7) compared with students who read the information leaflet. However, there was no significant difference in level of confidence to identify a child with autism (p = 0.39, 95% CI = -1.80-0.72, effect size = -0.3). CONCLUSION The CAL package developed was an effective method of educating people who work with children about autism.
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Affiliation(s)
- Jariya Chuthapisith
- Department of Paediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Division of Psychiatry, University of Nottingham, Nottingham, UK
| | | | - Gillian Doody
- Division of Psychiatry, University of Nottingham, Nottingham, UK
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Inglese MD. Caring for children with autism spectrum disorder. Part II: screening, diagnosis, and management. J Pediatr Nurs 2009; 24:49-59. [PMID: 19159835 DOI: 10.1016/j.pedn.2008.06.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Accepted: 06/12/2008] [Indexed: 11/29/2022]
Abstract
Recent emphasis on the importance of early identification and intervention for children with autism spectrum disorder (ASD) highlights the need for nurses in the community and primary care settings to learn to screen for ASD in children. In addition, given that ASD now affects 1 in 150 children, it is probable that nurses in a variety of settings, at all practice levels, will encounter children with ASD. Nurses need to be able to support families, educate parents, manage basic issues relevant to ASD, and advocate for these children and their families.
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Affiliation(s)
- Melissa Dodd Inglese
- University of Florida, College of Nursing, Psychiatry, Gainesville, FL 32610, USA.
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Roohi J, Montagna C, Tegay DH, Palmer LE, DeVincent C, Pomeroy JC, Christian SL, Nowak N, Hatchwell E. Disruption of contactin 4 in three subjects with autism spectrum disorder. J Med Genet 2008; 46:176-82. [PMID: 18349135 PMCID: PMC2643049 DOI: 10.1136/jmg.2008.057505] [Citation(s) in RCA: 123] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Autism spectrum disorder (ASD) is a developmental disorder of the central nervous system of largely unknown aetiology. The prevalence of the syndrome underscores the need for biological markers and a clearer understanding of pathogenesis. For these reasons, a genetic study of idiopathic ASD was undertaken. Methods and results: Array based comparative genomic hybridisation identified a paternally inherited chromosome 3 copy number variation (CNV) in three subjects: a deletion in two siblings and a duplication in a third, unrelated individual. These variations were fluorescence in situ hybridisation (FISH) validated and the end points further delineated using a custom fine tiling oligonucleotide array. Polymerase chain reaction (PCR) products unique to the rearrangements were amplified and sequence analysis revealed the variations to have resulted from Alu Y mediated unequal recombinations interrupting contactin 4 (CNTN4). Conclusion: CNTN4 plays an essential role in the formation, maintenance, and plasticity of neuronal networks. Disruption of this gene is known to cause developmental delay and mental retardation. This report suggests that mutations affecting CNTN4 function may be relevant to ASD pathogenesis.
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Affiliation(s)
- J Roohi
- Department of Genetics, Stony Brook University, Stony Brook, New York, USA
| | - C Montagna
- Department of Pathology and Molecular Genetics, Albert Einstein College of Medicine, Bronx, New York, USA
| | - D H Tegay
- Department of Pediatrics, Stony Brook University Medical Center, Stony Brook, New York, USA
- Department of Medicine & Medical Genetics, New York College of Osteopathic Medicine, Old Westbury, New York, USA
| | - L E Palmer
- Department of Microbiology, Stony Brook University, Stony Brook, New York, USA
| | - C DeVincent
- Department of Pediatrics, Stony Brook University Medical Center, Stony Brook, New York, USA
| | - J C Pomeroy
- Department of Pediatrics, Stony Brook University Medical Center, Stony Brook, New York, USA
| | - S L Christian
- Department of Human Genetics, The University of Chicago, Chicago, Illinois, USA
| | - N Nowak
- Department of Cancer Prevention and Population Sciences, RPCI and New York State Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo, New York, USA
| | - E Hatchwell
- Department of Genetics, Stony Brook University, Stony Brook, New York, USA
- Department of Pathology, Stony Brook University, Stony Brook, New York, USA
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Abstract
Pediatricians have an important role not only in early recognition and evaluation of autism spectrum disorders but also in chronic management of these disorders. The primary goals of treatment are to maximize the child's ultimate functional independence and quality of life by minimizing the core autism spectrum disorder features, facilitating development and learning, promoting socialization, reducing maladaptive behaviors, and educating and supporting families. To assist pediatricians in educating families and guiding them toward empirically supported interventions for their children, this report reviews the educational strategies and associated therapies that are the primary treatments for children with autism spectrum disorders. Optimization of health care is likely to have a positive effect on habilitative progress, functional outcome, and quality of life; therefore, important issues, such as management of associated medical problems, pharmacologic and nonpharmacologic intervention for challenging behaviors or coexisting mental health conditions, and use of complementary and alternative medical treatments, are also addressed.
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McGrew S, Malow BA, Henderson L, Wang L, Song Y, Stone WL. Developmental and behavioral questionnaire for autism spectrum disorders. Pediatr Neurol 2007; 37:108-16. [PMID: 17675025 DOI: 10.1016/j.pediatrneurol.2007.04.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Revised: 03/23/2007] [Accepted: 04/30/2007] [Indexed: 11/16/2022]
Abstract
The validity of the Parental Concerns Questionnaire, a brief screening checklist assessing the presence and severity of 13 developmental and behavioral concerns expressed by parents of children with autism spectrum disorders, was determined in 53 children ages 4 to 10 years with a clinical diagnosis of autism spectrum disorder and 48 age-matched typically developing controls. Parents completed the Parental Concerns Questionnaire, the Child Behavior Checklist, the Child Sleep Habits Questionnaire, and either the Repetitive Behavior Scale or the Compulsive Behavior Checklist. A clinical examiner administered the Peabody Picture Vocabulary Test and the Autism Diagnostic Observation Scale. The Parental Concerns Questionnaire demonstrated high internal consistency in the autism spectrum disorder subgroup. Reliability and stability over time were demonstrated. Analyses showed variability in item responses for each child indicating that parents were not globally answering all items as concerns. Comparison of Parental Concerns Questionnaire item scores to scores for similar multiquestion domains on standardized parent-rated and clinician-administered assessment tools demonstrated external validity with other parent-rated and clinician-rated instruments. The Parental Concerns Questionnaire is a reliable screening instrument to assess parentally reported developmental and behavioral symptoms in children with autism spectrum disorders.
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Affiliation(s)
- Susan McGrew
- Department of Pediatrics and Kennedy Center, Vanderbilt University School of Medicine, Nashville, Tennessee 37203, USA.
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Chen CY, Liu CY, Su WC, Huang SL, Lin KM. Urbanicity-related Variation in Help-seeking and Services Utilization among Preschool-age Children with Autism in Taiwan. J Autism Dev Disord 2007; 38:489-97. [PMID: 17665297 DOI: 10.1007/s10803-007-0416-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Accepted: 06/19/2007] [Indexed: 10/23/2022]
Abstract
The present study examines urbanicity-related differences in help-seeking process among preschool children with autism and investigates the factors associated with utilization of autism-related services within the year of diagnosis. Using the 1997-2004 National Health Insurance Research Database (NHIRD) in Taiwan, we identified a total of 3495 autistic children born in 1997-1999 and 13964 matched controls. Results indicate that suburban and rural autism tended to receive the diagnosis at an older age and to have a longer diagnosis process as compared with urban counterparts. Male gender, a younger age of diagnosis, and being diagnosed by psychiatric specialty strongly predict subsequent greater utilization of autism-specific services (all p < 0.05). Health policy makers and other service providers should address the needs of children with early-onset neurodevelopmental disorders in rural areas, particularly those from disadvantaged families.
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Affiliation(s)
- Chuan-Yu Chen
- Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Fl. 5, Campus 2, No. 309, Sung-Te Rd, Taipei 110, Taiwan.
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