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Journal of Autism and Developmental Disorders

, Volume 49, Issue 3, pp 1242–1249 | Cite as

Inpatient Psychiatric Treatment of Serious Behavioral Problems in Children with Autism Spectrum Disorder (ASD): Specialized Versus General Inpatient Units

  • Briana J. TaylorEmail author
  • Kevin B. Sanders
  • Marie Kyle
  • Kahsi A. Pedersen
  • Jeremy Veenstra-Vanderweele
  • Matthew Siegel
Original Paper

Abstract

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.

Keywords

Autism Inpatient Psychiatric hospitalization Specialized unit 

Notes

Acknowledgments

We gratefully acknowledge the families and children who participated in this research.

Author Contributions

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.

Ethical Approval

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

Informed Consent was obtained from all individual participants in the study.

References

  1. Aman, M. G., Singh, N. N., Stewart, A. W., & Field, C. J. (1985). The aberrant behavior checklist: A behavior rating scale for the assessment of treatment effects. American Journal of Mental Deficiency, 89(5), 485–491.PubMedGoogle Scholar
  2. 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
  3. Bondy, A. S., & Frost, L. A. (1998). The picture exchange communication system. Seminars in Speech and Language, 19(4), 373–388.  https://doi.org/10.1055/s-2008-1064055. quiz 389; 424.CrossRefPubMedGoogle Scholar
  4. 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
  5. 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
  6. Elsabbagh, M., Divan, G., Koh, Y. J., Kim, Y. S., Kauchali, S., Marcin, C., & Fombonne, E. (2012). Global prevalence of autism and other pervasive developmental disorders. Autism Research, 5(3), 160–179.  https://doi.org/10.1002/aur.239.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 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
  8. Hamlett, N. M., Carr, E. R., & Hillbrand, M. (2016). Positive behavioral support planning in the inpatient treatment of severe disruptive behaviors: A description of service features. Psychological Services, 13(2), 178–182.  https://doi.org/10.1037/ser0000070.CrossRefPubMedGoogle Scholar
  9. Madrigal, S., Winner, M. G., & Knopp, K. (2008). SuperFlex: A superhero social thinking curriculum. San Jose: Think Social Publishing.Google Scholar
  10. Mandell, D. S. (2008). Psychiatric hospitalization among children with autism spectrum disorders. Journal of Autism Developmental Disorders, 38(6), 1059–1065.  https://doi.org/10.1007/s10803-007-0481-2.CrossRefPubMedGoogle Scholar
  11. 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
  12. 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
  13. 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
  14. 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
  15. Siegel, M., & Gabriels, R. L. (2014). Psychiatric hospital treatment of children with autism and serious behavioral disturbance. Child and Adolescent Psychiatric Clinics, 23(1), 125–142.  https://doi.org/10.1016/j.chc.2013.07.004.CrossRefGoogle Scholar
  16. 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
  17. 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
  18. 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
  19. Tiger, J. H., Hanley, G. P., & Bruzek, J. (2008). Functional communication training: A review and practical guide. Behavior Analysis in Practice, 1(1), 16–23.  https://doi.org/10.1007/bf03391716.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Briana J. Taylor
    • 1
    Email author
  • Kevin B. Sanders
    • 2
  • Marie Kyle
    • 3
  • Kahsi A. Pedersen
    • 1
    • 4
  • Jeremy Veenstra-Vanderweele
    • 2
    • 5
  • Matthew Siegel
    • 1
    • 4
  1. 1.Center for Psychiatric ResearchMaine Medical Center Research InstitutePortlandUSA
  2. 2.Department of Psychiatry and PediatricsVanderbilt University School of MedicineNashvilleUSA
  3. 3.Department of PsychiatryVanderbilt University School of MedicineNashvilleUSA
  4. 4.Department of PsychiatryTufts University School of MedicineBostonUSA
  5. 5.Department of PsychiatryColumbia University Medical CenterNew YorkUSA

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