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Psychiatric Hospitalization Among Children with Autism Spectrum Disorders

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Abstract

This study examined predictors of psychiatric hospitalization among children with autism spectrum disorders (ASD). Data were collected from 760 caregivers of children with ASD. Cox regression was used to determine factors associated with hospitalization. Almost 11% were hospitalized. Youth in single parent homes were more likely to be hospitalized (OR = 2.54), as were youth diagnosed at a later age (OR = 1.10). Engaging in self-injurious behavior (OR = 2.14), aggressive behavior (OR = 4.83), and being diagnosed with depression (OR = 2.48) or obsessive compulsive disorder (OR = 2.35) increased the odds of hospitalization. Risk for hospitalization increased with age and over time. The results suggest early diagnosis and community-based interventions for aggressive and self-injurious behaviors may reduce hospitalizations.

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References

  • Birenbaum, A., Guyot, D., & Cohen, H. (1990). Health care financing for severe developmental disabilities. Monographs of the American Association on Mental Retardation, 14, 1–150.

    PubMed  Google Scholar 

  • Bodfish, J. (2004). Treating the core features of autism: Are we there yet? Mental Retardation and Developmental Disabilities Research Reviews, 10(4), 318–324.

    Article  PubMed  Google Scholar 

  • Botuck, S., & Winsberg, B. (1991). Effects of respite on mothers of school-age and adult children with severe disabilities. Mental Retardation, 29(1), 43–47.

    PubMed  Google Scholar 

  • CMHS. (1999). Annual report to congress on the evaluation of the comprehensive community mental health services for children and their families program. Atlanta: ORC Macro.

    Google Scholar 

  • Cowen, P., & Reed, D. (2002). Effects of respite care for children with developmental disabilities: Evaluation of an intervention for at risk families. Public Health Nursing, 19(4), 272–283.

    Article  PubMed  Google Scholar 

  • Cox, D., & Oakes, D. (1984). Analysis of survival data. London: Chapman & Hall.

    Google Scholar 

  • Croen, L., Najjar, D., Ray, 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.

    Article  PubMed  Google Scholar 

  • Dossetor, D., Nicol, A., & Stretch, D. (1993). Hostel-based respite care for adolescents with developmental retardation: The need for “normalized” respite resources. Journal of Child Psychology & Psychiatry & Allied Disciplines, 34(3), 391–412.

    Article  Google Scholar 

  • Fombonne, E., Heavey, L., Smeeth, L., Rodrigues, L., Cook, C., Smith, P., et al. (2004). Validation of the diagnosis of autism in general practitioner records. BMC Public Health, 4(Article 5).

  • Gallaher, M., Christakis, D., & Connell, F. (2002). Health care use by children diagnosed as having developmental delay. Archives of Pediatrics & Adolescent Medicine, 156(3), 246–251.

    Google Scholar 

  • Green, J., Kroll, L., Imrie, D., Frances, F., Begum, K., Harrison, L., et al. (2001). Health gain and outcome predictors during inpatient and related day treatment in child and adolescent psychiatry. Journal of the American Academy of Child & Adolescent Psychiatry, 40(3), 325–332.

    Article  Google Scholar 

  • Harpaz-Rotem, I., Leslie, D., Martin, A., & Rosenheck, R. (2005). Changes in child and adolescent inpatient psychiatric admission diagnoses between 1995 and 2000. Social Psychiatry & Psychiatric Epidemiology, 40(8), 642–647.

    Article  Google Scholar 

  • Heidgerken, A., Geffken, G., Modi, A., & Frakey, L. (2005). A survey of autism knowledge in a health care setting. Journal of Autism & Developmental Disorders, 3, 323–330.

    Article  Google Scholar 

  • Henggeler, S., Rowland, M., Halliday-Boykins, C., Sheidow, A., Ward, D., Randall, J., et al. (2003). One-year follow-up of multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis. Journal of the American Academy of Child & Adolescent Psychiatry, 42(5), 543–551.

    Article  Google Scholar 

  • Hill, A., Bolte, S., Petrova, G., Beltcheva, D., Tacheva, S., & Poustka, F. (2001). Stability and interpersonal agreement of the interview-based diagnosis of autism. Psychopathology, 34(4), 187–191.

    Article  PubMed  Google Scholar 

  • Holden, B., & Gitlesen, J. (2006). A total population study of challenging behaviour in the county of Hedmark, Norway: Prevalence, and risk markers. Research in Developmental Disabilities, 27(4), 456–465.

    Article  PubMed  Google Scholar 

  • Hollander, E., Phillips, A., & Yeh, C. (2003). Targeted treatments for symptom domains in child and adolescent autism. Lancet, 362(9385), 732–734.

    Article  PubMed  Google Scholar 

  • Hosmer, D., & Lemeshow, S. (2001). Applied logistic regression, textbook and solutions manual (2nd ed.). Hoboken: Wiley-Interscience.

    Google Scholar 

  • Jacobson, J., & Mulick, J. (2000). System and cost research issues in treatments for people with autistic disorders. Journal of Autism & Developmental Disorders, 30(6), 585–593.

    Article  Google Scholar 

  • Jacobson, J., Mulick, J., & Green, G. (1998). Cost-benefit estimates for early intensive behavioral intervention for young children with autism-general model and single state case. Behavioral Interventions, 13, 201–226.

    Article  Google Scholar 

  • Jarbrink, K., & Knapp, M. (2001). The economic impact of autism in Britain. Autism, 5(1), 7–22.

    Article  PubMed  Google Scholar 

  • Knitzer, J., & Olson, L. (1982). Unclaimed children: The failure of public responsibility to children and adolescents in need of mental health services. Washington: Children’s Defense Fund.

    Google Scholar 

  • Krauss, M., Gulley, S., Sciegaj, M., & Wells, N. (2003). Access to specialty medical care for children with mental retardation, autism and other special health care needs. Mental Retardation, 41(5), 329–339.

    Article  PubMed  Google Scholar 

  • Leichtman, M., Leichtman, M., Barber, C., & Neese, D. (2001). Effectiveness of intensive short-term residential treatment with severely disturbed adolescents. American Journal of Orthopsychiatry, 71(2), 227–235.

    Article  PubMed  Google Scholar 

  • Levy, S. E., Mandell, D. S., Merhar, S., Ittenbach, R. F., & Pinto-Martin, J. A. (2003). Use of complementary and alternative medicine among children recently diagnosed with autistic spectrum disorder. Journal of Developmental and Behavioral Pediatrics, 24(6), 418–423.

    Article  PubMed  Google Scholar 

  • Lord C., & McGee J. (Eds.). (2001). Educating children with autism. Washington: National Academy Press.

    Google Scholar 

  • Lord, C., Wagner, A., Rogers, S., Szatmari, P., Aman, M., Charman, T., et al. (2005). Challenges in evaluating psychosocial interventions for Autistic Spectrum Disorders. Journal of Autism & Developmental Disorders, 35(6), 695–708.

    Article  Google Scholar 

  • Mahoney, W., Szatmari, P., MacLean, J., Bryson, S., Bartolucci, G., Walter, S., et al. (1998). Reliability and accuracy of differentiating pervasive developmental disorder subtypes. Journal of the American Academy of Child & Adolescent Psychiatry, 37(3), 278–285.

    Article  Google Scholar 

  • Mandell, D., Novak, M., & Zubritsky, C. (2005). Factors associated with the age of diagnosis among children with autism spectrum disorders. Pediatrics, 116(6), 1480–1486.

    Article  PubMed  Google Scholar 

  • Mandell, D., & Palmer, R. (2005). Differences among states in the identification of autistic spectrum disorders. Archives of Pediatrics & Adolescent Medicine, 159(3), 266–269.

    Article  Google Scholar 

  • Mandell, D., Walrath, C., Manteuffel, B., Sgro, G., & Pinto-Martin, J. (2005). Characteristics of children with autistic spectrum disorders served in comprehensive community-based mental health settings. Journal of Autism and Developmental Disorders, 35(3), 113–121.

    Article  Google Scholar 

  • Mandell, D. S., Cao, J., Ittenbach, R., & Pinto-Martin, J. (2006). Medicaid expenditures for children with autistic spectrum disorders: 1994 to 1999. Journal Of Autism And Developmental Disorders, 36(4), 475–485.

    Article  PubMed  Google Scholar 

  • McConkey, R., & Adams, L. (2000). Matching short break services for children with learning disabilities to family needs and preferences. Child: Care, Health & Development, 26(5), 429–444.

    Article  Google Scholar 

  • McCracken, J., McGough, J., Shah, B., Cronin, P., Hong, D., Aman, M., et al. (2004). Risperidone in children with autism and serious behavior problems. New England Journal of Medicine, 347(5), 314–321.

    Article  Google Scholar 

  • McGill, P., Papachristoforou, E., & Cooper, V. (2006). Support for family carers of children and young people with developmental disabilities and challenging behaviour. Child: Care, Health & Development, 32(2), 159–165.

    Article  Google Scholar 

  • Romansky, J., Lyons, J., Lehner, R., & West, C. (2003). Factors related to psychiatric hospital readmission among children and adolescents in state custody. Psychiatric Services, 54(3), 356–362.

    Article  PubMed  Google Scholar 

  • Saeed, H., Ouellette-Kuntz, H., Stuart, H., & Burge, P. (2003). Length of stay for psychiatric inpatient services: A comparison of admissions of people with and without developmental disabilities. Journal of Behavioral Health Services & Research, 30(4), 406–417.

    Article  Google Scholar 

  • Sheidow, A., Bradford, W., Henggeler, S., Rowland, M., Halliday-Boykins, C., Schoenwald, S., et al. (2004). Treatment costs for youths receiving multisystemic therapy or hospitalization after a psychiatric crisis. Psychiatric Services, 55(5), 548–554.

    Article  PubMed  Google Scholar 

  • Stahmer, A. (2006). The Basic Structure of Community Early Intervention Programs for Children with Autism: Provider Descriptions. Journal of Autism & Developmental Disorders, epub ahead of print.

  • Stahmer, A., & Ingersoll, B. (2004). Inclusive programming for toddlers autism spectrum disorders: Outcomes from the Children’s Toddler School. Journal of Positive Behavior Interventions, 6(2), 67–82.

    Article  Google Scholar 

  • Stahmer, A., & Mandell, D. (2006). State infant/toddler program policies for eligibility and services provision for young children with autism. Mental Health Services Research, Epub ahead of print.

  • Volkmar, F. (2001). Pharmacological interventions in autism: Theoretical and practical issues. Journal of Clinical Child Psychology, 30(1), 80–87.

    Article  PubMed  Google Scholar 

  • Volkmar, F., Cook, E., Pomeroy, J., Realmuto, G., & Tanguay, P. (1999). Practice parameters for the assessment and treatment of children, adolescents and adults with autism and other pervasive developmental disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 38(12 Suppl), 32S–54S.

    Google Scholar 

  • Volkmar, F., Lord, C., Bailey, A., Schultz, R., & Klin, A. (2004). Autism and pervasive developmental disorders. Journal of Child Psychology & Psychiatry & Allied Disciplines, 45(1), 135–155.

    Article  Google Scholar 

  • Walsh, K., Kastner, T., & Criscione, T. (1997). Characteristics of hospitalizations for people with developmental disabilities: utilization, costs, and impact of care coordination. American Journal of Mental Retardation, 101(5), 505–520.

    PubMed  Google Scholar 

Download references

Acknowledgments

Support for this study was provided by a grant from the Pennsylvania Department of Health (ME02271) and a mentored scientist career development award from the National Institute of Mental Health (MH067628).

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  1. Center for Mental Health Policy and Services Research, University of Pennsylvania School of Medicine, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA

    David S. Mandell

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  1. David S. Mandell
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Correspondence to David S. Mandell.

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Mandell, D.S. Psychiatric Hospitalization Among Children with Autism Spectrum Disorders. J Autism Dev Disord 38, 1059–1065 (2008). https://doi.org/10.1007/s10803-007-0481-2

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  • DOI: https://doi.org/10.1007/s10803-007-0481-2

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