Inpatient Psychiatric Treatment of Serious Behavioral Problems in Children with Autism Spectrum Disorder (ASD): Specialized Versus General Inpatient Units
Psychiatric hospitalization of children with autism spectrum disorder (ASD) is common, but there is little comparative information available on different psychiatric hospital treatment models. Children with ASD ages 4–20 were enrolled upon admission to either a specialized (N = 53) or a general child psychiatric unit (N = 27). Caregivers completed the Aberrant Behavioral Checklist-Irritability Sub-scale (ABC-I) at admission, discharge, and 2 months post-discharge and reported information on crisis service utilization 2 months post-discharge. Children treated in the specialized unit had lower ABC-I scores at discharge and 2 months post-discharge (F = 8.98, p = 0.003) and were significantly less likely to experience an ER visit within 2 months post-discharge (X2 = 5.51, p = 0.019). Specialized inpatient units may be more effective for children with ASD in need of psychiatric hospitalization.
KeywordsAutism Inpatient Psychiatric hospitalization Specialized unit
We gratefully acknowledge the families and children who participated in this research.
MS and JV for conceptualization and significant writing of the manuscript, BJT and KAP for statistical analyses, BJT, KBS, and MK for significant writing and revisions of the manuscript.
Compliance with Ethical Standards
Conflict of interest
The authors have no conflicts of interest to disclose.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent was obtained from all individual participants in the study.
- Biau, D. J., Kerneis, S., & Porcher, R. (2008). Statistics in brief: The importance of sample size in the planning and interpretation of medical research. Clinical Orthopaedics and Related Research, 466(9), 2282–2288. https://doi.org/10.1007/s11999-008-0346-9.CrossRefPubMedPubMedCentralGoogle Scholar
- Croen, L. A., Najjar, D. V., Ray, G. T., Lotspeich, L., & Bernal, P. (2006). A comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health plan. Pediatrics, 118(4), e1203–e1211. https://doi.org/10.1542/peds.2006-0127.CrossRefPubMedGoogle Scholar
- Deavenport-Saman, A., Lu, Y., Smith, K., & Yin, L. (2016). Do children with autism overutilize the emergency department? Examining visit urgency and subsequent hospital admissions. Maternal and Child Health Journal, 20(2), 306–314. https://doi.org/10.1007/s10995-015-1830-y.CrossRefPubMedGoogle Scholar
- Gabriels, R. L., Agnew, J. A., Beresford, C., Morrow, M. A., Mesibov, G., & Wamboldt, M. (2012). Improving psychiatric hospital care for pediatric patients with autism spectrum disorders and intellectual disabilities. Autism Research and Treatment. https://doi.org/10.1155/2012/685053.PubMedPubMedCentralGoogle Scholar
- Madrigal, S., Winner, M. G., & Knopp, K. (2008). SuperFlex: A superhero social thinking curriculum. San Jose: Think Social Publishing.Google Scholar
- Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), e441–e448. https://doi.org/10.1542/peds.2007-0984.CrossRefPubMedPubMedCentralGoogle Scholar
- McGuire, K., Erickson, C., Gabriels, R. L., Kaplan, D., Mazefsky, C., McGonigle, J., & Siegel, M. (2015). Psychiatric hospitalization of children with autism or intellectual disability: consensus statements on best practices. Journal of American Academy of Child & Adolescent Psychiatry, 54(12), 969–971. https://doi.org/10.1016/j.jaac.2015.08.017.CrossRefGoogle Scholar
- Pedersen, K. A., Santangelo, S. L., Gabriels, R. L., Righi, G., Erard, M., & Siegel, M. (2017). Behavioral outcomes of specialized psychiatric hospitalization in the autism inpatient collection (AIC): A multisite comparison. Journal of Autism Developmental Disorders. https://doi.org/10.1007/s10803-017-3366-z.Google Scholar
- Siegel, M., Doyle, K., Chemelski, B., Payne, D., Ellsworth, B., Harmon, J., & Lubetsky, M. (2012). Specialized inpatient psychiatry units for children with autism and developmental disorders: A United States survey. Journal of Autism Developmental Disorders, 42(9), 1863–1869. https://doi.org/10.1007/s10803-011-1426-3.CrossRefPubMedGoogle Scholar
- Siegel, M., Milligan, B., Chemelski, B., Payne, D., Ellsworth, B., Harmon, J., & Smith, K. A. (2014). Specialized inpatient psychiatry for serious behavioral disturbance in autism and intellectual disability. Journal of Autism Developmental Disorders, 44(12), 3026–3032. https://doi.org/10.1007/s10803-014-2157-z.CrossRefPubMedGoogle Scholar
- Siegel, M., Milligan, B., Stein, H., Teer, O., & Smith, K. A. (2013). Telephone administration of the aberrant behavior checklist: A pilot study of feasibility in children with intellectual disability and autism. Journal of Intellectual Disabilities, 17(3), 265–271. https://doi.org/10.1177/1744629513500007.CrossRefPubMedGoogle Scholar
- 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. https://doi.org/10.1097/CHI.0b013e318179964f.CrossRefGoogle Scholar