Journal of Autism and Developmental Disorders

, Volume 48, Issue 5, pp 1854–1860 | Cite as

Brief Report: Factors Associated with Emergency Department Visits for Epilepsy Among Children with Autism Spectrum Disorder

Brief Report

Abstract

We examined how demographic and clinical characteristics differ between emergency department (ED) visits for epilepsy (EP cohort) and ED visits for other reasons (non-EP cohort) in children with ASD. The data were drawn from the 2009 and 2010 Nationwide Emergency Department Sample. We performed both univariate and multivariate analyses to compare and contrast similarities and differences between EP cohort and non-EP cohort among children with ASD. The results showed ED visits in EP cohort were more likely to occur among adolescents aged 13–17 years, less likely to occur among children with co-occurring psychiatric conditions, and were more likely to co-occur with injury. We discussed some unique challenges for managing children with both ASD and epilepsy.

Keywords

Autism Epilepsy Emergency department (ED) Children with ASD 

Notes

Acknowledgments

This study was partially supported by Grant # R40MC27475-01-05, MCH Research Program, from the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. For further information, contact: Wanqing Zhang, PhD, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, 321S. Columbia Street, Chapel Hill, NC 27599-7122; E-mail: wanqing_zhang@med.unc.edu; Tel: 919-962-4019. The authors would like to acknowledge the Healthcare Cost and Utilization Project (HCUP) for supplying the data for this analysis.

Author Contributions

WZ conceived of the study, participated in its design and coordination, drafted the manuscript, and performed the statistical analysis; GB participated in the design and coordination of the study, interpretation of the data, and critically revised the manuscript; BB participated in the design and interpretation of the data. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest. Dr. Zhang declares that she has no conflict of interest. Dr. Baranek declares that she has no conflict of interest. Dr. Boyd declares that he has no conflict of interest.

Research Involving Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

References

  1. American Academy of Pediatrics, Medical Home Initiatives for Children with Special Needs Project Advisory Committee. 2002. The medical home. Pediatric, 110(1), 184–186.CrossRefGoogle Scholar
  2. Amiet, C., Gourfinkel-An, I., Bouzamondo, A., Tordjman, S., Baulac, M., Lechat, P., et al. (2008). Epilepsy in autism is associated with intellectual disability and gender: Evidence from a meta-analysis. Biological Psychiatry, 64(7), 577–582.CrossRefPubMedGoogle Scholar
  3. Besag, F. M. C. (2009). The relationship between epilepsy and autism: A continuing debate. Acta Paediatrica, 98(4), 618–620.CrossRefPubMedGoogle Scholar
  4. Bolton, P. F., Carcani-Rathwell, I., Hutton, J., Goode, S., Howlin, P., & Rutter, M. (2011). Epilepsy in autism: Features and correlates. The British Journal of Psychiatry, 198(4), 289–294.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Canitano, R. (2007). Epilepsy in autism spectrum disorders. European Child & Adolescent Psychiatry, 16(1), 61–66.CrossRefGoogle Scholar
  6. Carbone, P. S., Young, P. C., Stoddard, G. J., Wilkes, J., & Trasande, L. (2015). A comparison of ambulatory care sensitive hospitalizations among children with and without autism apectrum disorder. Academic Pediatrics, 15(6), 626–635.CrossRefPubMedGoogle Scholar
  7. Casey, L. B., Williamson, R. L., Miller, S., Smith, J. B., Frame, K. N., Langford, E. C., et al. (2015). Emergency department visits by children with and without autism spectrum disorder: An initial comparison evaluating multiple outcome measures at one urban children’s hospital. Research in Autism Spectrum Disorders, 9, 144–150.CrossRefGoogle Scholar
  8. Centers for Disease Control and Prevention (CDC). 2013. Epilepsy fast facts. Retrieved 16 March 16, 2017 from https://www.cdc.gov/epilepsy/basics/fast-facts.htm.
  9. Centers for Disease Control and Prevention (CDC). 2016. Prevalence of autism spectrum disorder among children aged 8 years: Autism and developmental disabilities monitoring network, 11 sites, United States, 2012. MMWR Surveillance Summary, 65(3), 1–23.CrossRefGoogle Scholar
  10. El Achkar, C. M., & Spence, S. J. (2015). Clinical characteristics of children and young adults with co-occurring autism spectrum disorder and epilepsy. Epilepsy & Behavior, 47, 183–190.CrossRefGoogle Scholar
  11. Gurney, J. G., McPheeters, M. L., & Davis, M. M. (2006). Parental report of health conditions and health care use among children with and without autism. Archives of Pediatrics and Adolescent Medicine, 160(8), 825–830.CrossRefPubMedGoogle Scholar
  12. Hara, H. (2007). Autism and epilepsy: A retrospective follow-up study. Brain & Development, 29(8), 486–490.CrossRefGoogle Scholar
  13. Healthcare Cost and Utilization Project (HCUP). 2011. HCUP nationwide emergency department sample (NEDS). Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
  14. Iannuzzi, D. A., Cheng, E. R., Broder-Fingert, S., & Bauman, M. L. (2015). Brief report: Emergency department utilization by individuals with autism. Journal of Autism and Developmental Disorders, 45(4), 1096–1102.CrossRefPubMedGoogle Scholar
  15. Kalb, L. G., Stuart, E. A., Freedman, B., Zablotsky, B., & Vasa, R. (2012). Psychiatric-related emergency department visits among children with an autism spectrum disorder. Pediatric Emergency Care, 28(12), 1269–1276.CrossRefPubMedGoogle Scholar
  16. Kalb, L. G., Vasa, R. A., Ballard, E. D., Woods, S., Goldstein, M., & Wilcox, H. C. (2016). Epidemiology of injury-related emergency department visits in the US among youth with autism spectrum disorder. Journal of Autism and Developmental Disorders, 46(8), 2756–2763.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Kanner, A. M. (2002). Psychiatric comorbidity in patients with developmental disorders and epilepsy: A practical approach to its diagnosis and treatment. Epilepsy & Behavior, 3(6S1), 7–13.CrossRefGoogle Scholar
  18. Levisohn, P. M. (2007). The autism-epilepsy connection. Epilepsia, 48(s9), 33–35.CrossRefPubMedGoogle Scholar
  19. Liu, G., Pearl, A. M., Kong, L., Leslie, D. L., & Murray, M. J. (2017). A profile on emergency department utilization in adolescents and young adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 47(2), 347–358.CrossRefPubMedGoogle Scholar
  20. McGonigle, J. J., Venkat, A., Beresford, C., Campbell, & Gabriels, R. L. (2014). Management of agitation in individuals with autism spectrum disorders in the emergency department. Child and Adolescent Psychiatric Clinics of North America, 23(1), 83–95.CrossRefPubMedGoogle Scholar
  21. Patel, A. D. (2014). A case series using a care management checklist to decrease emergency department visits and hospitalizations in children with epilepsy. Journal of Child Neurology, 29(2), 243–246.CrossRefPubMedGoogle Scholar
  22. Puka, K., Smith, M. L., Moineddin, R., Snead, O. C., & Widjaja, E. (2016). Health resource utilization varies by comorbidities in children with epilepsy. Epilepsy & Behavior, 57(Pt A), 151–154.CrossRefGoogle Scholar
  23. Schlenz, A. M., Carpenter, L. A., Bradley, C., Charles, J., & Boan, A. (2015). Age differences in emergency department visits and inpatient hospitalizations in preadolescent and adolescent youth with autism spectrum disorders. Journal of Autism and Developmental Disorders, 45(8), 2382–2391.CrossRefPubMedGoogle Scholar
  24. Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child & Adolescent Psychiatry, 47(8), 921–929.CrossRefGoogle Scholar
  25. Viscidi, E. W., Triche, E. W., Pescosolido, M. F., McLean, R. L., Joseph, R. M., Spence, S. J., et al. (2013). Clinical characteristics of children with autism spectrum disorder and co-occurring epilepsy. PLoS ONE, 8, e67797.  https://doi.org/10.1371/journal.pone.0067797.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Zhang, W., Ashley, E. M., Boyd, B., Sikich, L., & Baranek, G. T. (2017). A rural–urban comparison in emergency department visits for U.S. children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(3), 590–598.CrossRefPubMedGoogle Scholar
  27. Zuckerman, K. E., Lindly, O. J., Bethell, C. D., & Kuhlthau, K. (2014). Family impacts among children with autism spectrum disorder: The role of health care quality. Academic Pediatrics, 14(4), 398–407.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Allied Health Sciences, School of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.USC Chan Division of Occupational Science and Occupational TherapyUniversity of Southern CaliforniaLos AngelesUSA

Personalised recommendations