A Case-Mix System for Children and Youth With Developmental Disabilities

Stewart, Shannon L.; Celebre, Angela; Head, Michael; James, Mary L.; Martin, Lynn; Fries, Brant E.

doi:10.1177/1178632920977899

Cited by 12 publications

(5 citation statements)

References 22 publications

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“…The ChYMH-DD obtains information regarding care planning in domains that may be relevant to this demographic (e.g., accessibility and mobility, modified nutrition intake). Further, both the ChYMH and ChYMH-DD contain scales and algorithms that have demonstrated strong reliability and validity across multiple contexts ( Stewart et al, 2015 , 2019 , 2020a , b , c , 2021b , 2022a ; Stewart and Hamza, 2017 ; Lau et al, 2018 , 2019 , 2021 ; Hirdes et al, 2020 ; Redquest et al, 2020 ; Stewart and Babcock, 2020 ; Barbaree et al, 2021 ; Li et al, 2021 ).…”

Section: Methodsmentioning

confidence: 99%

A cross-sectional examination of service complexity in youths with co-occurring autism spectrum disorder and psychiatric or medical diagnoses across service sectors

et al. 2023

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IntroductionAutism spectrum disorder (ASD) is a heterogeneous, life-long, and complex condition. Youth diagnosed with ASD require several supports addressing core symptoms associated with the disorder, but also those resulting from co-occurring mental and physical health conditions. As a result, their care is overseen by numerous professionals spanning various service sectors, but communication between sectors is hindered due to the absence of a standardized assessment system to identify and triage youth to services. A paucity of information surrounding this population’s service use lingers and a siloed delivery system persists.MethodsUsing archival data collected from 1,020 youth between 12 and 18 years of age, this study explored service complexity among autistic youth with and without psychiatric and medical co-occurring conditions in Ontario, Canada. In doing so, a negative binomial regression was utilized to investigate which predisposing, enabling, and need variables were associated with service complexity.ResultsResults revealed that experiencing financial difficulties was not associated with service complexity. However, age, sex, caregiver distress, comorbidity, intellectual disability, and evaluated health status were significant predictors. More specifically, female youth and youth with distressed caregivers had greater mental health service complexity scores. Additionally, youth diagnosed with two or more conditions in addition to ASD who required longer durations of programming, controlling for other predictors, had greater mental health service complexity scores. Yet, youth with an intellectual disability had lower service complexity scores.DiscussionClinical implications of this study are discussed to inform future investments into mental health efforts for autistic youth.

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Section: Methodsmentioning

confidence: 99%

A cross-sectional examination of service complexity in youths with co-occurring autism spectrum disorder and psychiatric or medical diagnoses across service sectors

et al. 2023

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“…Strong reliability and validity for the scales and algorithms on the interRAI ChYMH and ChYMH-DD have been found ( 38 – 42 ). These instruments have several applications including outcome measurement, resource allocation, and case-mix systems ( 34 , 35 , 43 – 46 ).…”

Section: Methodsmentioning

confidence: 99%

Autism Spectrum Screening Checklist (ASSC): The Development of a Scale to Identify High-Risk Individuals Within the Children's Mental Health System

et al. 2021

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Autism Spectrum Disorder (ASD) is a complex childhood onset neurodevelopmental disorder that has become the fastest growing developmental disability. Due to the increased demand for diagnostic assessments and subsequent increased wait times, standardized screening as part of regular clinical practice is needed. More specifically, there is an important need for the development of a more streamlined screening tool within an existing assessment system to identify those at greatest risk of having ASD. The current study utilized data from ~17,000 assessments obtained within the province of Ontario, based on the interRAI Child and Youth Mental Health (ChYMH) and Child and Youth Mental Health and Developmental Disability (ChYMH-DD), to develop a scale to identify children who have a higher likelihood of having autism. The scale was then tested on a trial population with data from the interRAI Early Years instrument. Further analyses examined the predictive validity of the scale. The Autism Spectrum Screening Checklist (ASSC) was found to be a good predictor of ASD with a sensitivity of 0.73 and specificity of 0.62, at the recommended cut-point of 2+. The results were consistent across several age ranges, specifically from 2 to 21 years of age. The ASSC scale provides an initial screen to help identify children and youth at heightened risk for autism within larger populations being assessed as part of routine practice. The main goal for the development and implementation of the ASSC scale is to harness the power of the existing interRAI assessment system to provide a more efficient, effective screening and referral process. This will ultimately help improve patient outcomes through needs-based care.

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“…Similar to the ChYMH, the interRAI ChYMH-DD ( 48 ) provides a comprehensive, standardized, and empirically-supported mental health measure to support comprehensive care planning ( 66 , 67 ), outcome measurement ( 62 , 68 ); quality indicators ( 69 ) and case-mix classification ( 70 ) to estimate relative resource intensity ( 48 , 65 , 70 ). However, this measure is specifically intended for use with children and youth with developmental disabilities ( 48 ).…”

Section: Methodsmentioning

confidence: 99%

Following the Epidemic Waves: Child and Youth Mental Health Assessments in Ontario Through Multiple Pandemic Waves

et al. 2021

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Emerging studies across the globe are reporting the impact of COVID-19 and its related virus containment measures, such as school closures and social distancing, on the mental health presentations and service utilization of children and youth during the early stages of lockdowns in their respective countries. However, there remains a need for studies which examine the impact of COVID-19 on children and youth's mental health needs and service utilization across multiple waves of the pandemic. The present study used data from 35,162 interRAI Child and Youth Mental Health (ChYMH) assessments across 53 participating mental health agencies in Ontario, Canada, to assess the mental health presentations and referral trends of children and youth across the first two waves of the COVID-19 pandemic in the province. Wave 1 consisted of data from March to June 2020, with Wave 2 consisting of data from September 2020 to January 2021. Data from each wave were compared to each other and to the equivalent period one year prior. While assessment volumes declined during both pandemic waves, during the second wave, child and youth assessments in low-income neighborhoods declined more than those within high-income neighborhoods. There were changes in family stressors noted in both waves. Notably, the proportion of children exposed to domestic violence and recent parental stressors increased in both waves of the pandemic, whereas there were decreases noted in the proportion of parents expressing feelings of distress, anger, or depression and reporting recent family involvement with child protection services. When comparing the two waves, while depressive symptoms and recent self-injurious attempts were more prevalent in the second wave of the pandemic when compared to the first, a decrease was noted in the prevalence of disruptive/aggressive behaviors and risk of injury to others from Wave 1 to Wave 2. These findings highlight the multifaceted impact of multiple pandemic waves on children and youth's mental health needs and underscore the need for future research into factors impacting children and youth's access to mental health agencies during this time.

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A Case-Mix System for Children and Youth With Developmental Disabilities

Cited by 12 publications

References 22 publications

A cross-sectional examination of service complexity in youths with co-occurring autism spectrum disorder and psychiatric or medical diagnoses across service sectors

A cross-sectional examination of service complexity in youths with co-occurring autism spectrum disorder and psychiatric or medical diagnoses across service sectors

Autism Spectrum Screening Checklist (ASSC): The Development of a Scale to Identify High-Risk Individuals Within the Children's Mental Health System

Following the Epidemic Waves: Child and Youth Mental Health Assessments in Ontario Through Multiple Pandemic Waves

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