Characteristics of Children with Autistic Spectrum Disorders Served in Comprehensive Community-based Mental Health Settings

Mandell, David S.; Walrath, Christine; Manteuffel, Brigitte; Sgro, Gina; Pinto‐Martin, Jennifer

doi:10.1007/s10803-005-3296-z

Cited by 85 publications

(60 citation statements)

References 29 publications

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“…The gender percentage reproduces the ratio of four boys to one girl found in autism prevalence studies (Hill;Zuckerman;Fombonne, 2014) and in previously cited studies of US services (Mandell et al, 2005;Brookman-Frazee;Taylor;Garland, 2010). The majority (64%) of autistics is in the 10 to 19 age group, with a much smaller number of young children in the services.…”

Section: Discussionsupporting

confidence: 79%

“…As for psychosocial data, like the US study cited (Mandell et al, 2005), few patients do not live with their families/caregivers. This indicates that only a minority of this population resides in shelters in the Rio de Janeiro metropolitan area, which does not mean that the services should neglect mapping and interacting with institutional sheltering organizations in their regions, aiming to overcome existing modes of exclusion and segregation.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to psychoactive drugs, 63% had already used them compared to 48% of children with other diagnoses. A small number (6.3% of autistic and 11.8% of Asperger patients) lived in institutions compared to children with other diagnoses (19.4%) (Mandell et al, 2005).…”

Section: Introductionmentioning

confidence: 94%

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Atenção psicossocial a crianças e adolescentes com autismo nos CAPSi da região metropolitana do Rio de Janeiro

et al. 2017

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Resumo Os Centros de Atenção Psicossocial Infanto-juvenil (CAPSi) são equipamentos públicos destinados ao cuidado de crianças e adolescentes com problemas mentais graves, incluindo aqueles com transtornos do espectro do autismo (TEA). Revisão da literatura nacional indica falta de informações sistematizadas sobre o tratamento oferecido a esta clientela. O artigo apresenta e discute dados referentes a perfil psicossocial e projetos terapêuticos para usuários com autismo e seus familiares, em CAPSi situados na região metropolitana do Rio de Janeiro. Metodologia: estudo descritivo, quantitativo, baseado em questionários enviados a 14 CAPSi em 2011. Resultados: havia 782 usuários com diagnóstico de autismo nos CAPSi pesquisados, constituindo 1/3 dos usuários em atendimento. A maioria era do sexo masculino, na faixa dos 10 aos 19 anos. A maior parte residia com a família, na área de abrangência do serviço, e estava em regime assistencial semi-intensivo, com atendimentos individuais e coletivos, incluindo os familiares. Cerca de 1/5 estava fora da escola e menos de 1/3 recebia o Benefício de Prestação Continuada da Lei Orgânica da Assistência Social (BPC - Loas). Concluiu-se que os CAPSi da região ofereciam cuidado a número expressivo de autistas, requerendo, no entanto, investimento em articulações intersetoriais para ampliar condições de inclusão social, aprimoramento das informações sobre o cuidado oferecido e incentivo para o uso de metodologias avaliativas visando a qualificar a assistência a usuários com autismo e a outros sob seu cuidado.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

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Atenção psicossocial a crianças e adolescentes com autismo nos CAPSi da região metropolitana do Rio de Janeiro

et al. 2017

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“…19,22 Other studies also have found rural/urban 23 and ethnic differences in ASD identification. 24,25 Little is known, however, about how child characteristics and local resources influence medication treatment; therefore, in addition to estimating the prevalence of psychotropic medication use among children with ASDs, we explored the relative contributions of child, county, and state characteristics to its use. Child Characteristics-Demographic characteristics, including age, race/ethnicity, gender, and county of residence, were abstracted from the Medicaid eligibility file.…”

mentioning

confidence: 99%

Psychotropic Medication Use Among Medicaid-Enrolled Children With Autism Spectrum Disorders

et al. 2008

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OBJECTIVE-The objective of this study was to provide national estimates of psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders and to examine child and health system characteristics associated with psychotropic medication use.METHODS-This cross-sectional study used Medicaid claims for calendar year 2001 from all 50 states and Washington, DC, to examine 60 641 children with an autism spectrum disorder diagnosis. Logistic regression with random effects was used to examine the child, county, and state factors associated with psychotropic medication use.RESULTS-Of the sample, 56% used at least 1 psychotropic medication, 20% of whom were prescribed ≥3 medications concurrently. Use was common even in children aged 0 to 2 years (18%) and 3 to 5 years (32%). Neuroleptic drugs were the most common psychotropic class (31%), followed by antidepressants (25%) and stimulants (22%). In adjusted analyses, male, older, and white children; those who were in foster care or in the Medicaid disability category; those who received additional psychiatric diagnoses; and those who used more autism spectrum disorder services were more likely to have used psychotropic drugs. Children who had a diagnosis of autistic disorder or who lived in counties with a lower percentage of white residents or greater urban density were less likely to use such medications.CONCLUSIONS-Psychotropic medication use is common among even very young children with autism spectrum disorders. Factors unrelated to clinical presentation seem highly associated with prescribing practices. Given the limited evidence base, there is an urgent need to assess the risks, There is ongoing debate regarding the role of psychotropic agents in ASD management. 2,3 Although no medications are known to address the core symptoms of ASDs, they often are prescribed as adjunctive therapy to address symptoms such as aggression, self-injurious behaviors, stereotypies, and hyperactivity. [4][5][6] Many medications have been tested with varying levels of scientific rigor, 7 but only risperidone, an atypical neuroleptic that reduces aggression and irritability, has received Food and Drug Administration approval for the treatment of these symptoms in individuals with ASDs. 8Medication use is common among children with ASDs and seems to be increasing. A 1995 survey found that 30% of children with ASDs were using some psychotropic medication 9 ; follow-up studies 6 years later found 46% using them. 10,11 Neuroleptic agents were most common in 2 of 3 studies, 9,11 with antidepressants the most common in the third. 10 In 2001, 21% were using >1 drug, compared with 8% in 1995. A 2005 international Internet survey found that 52% of parents reported that their children were using psychotropic drugs. 12 These studies provided important information regarding psychotropic medication use in children with ASDs, but all relied on parent report, the validity of which is unknown. With 1 exception, 12 they sampled relatively small geographic areas, and all exc...

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“…We hypothesized that the diagnoses children received prior to receiving a diagnosis of autism once they entered specialty care-especially given that parents of children with autism and those of children with other disorders often present for treatment with the same complaints (Mandell, Walrath, Manteuffel, Sgro, & Pinto-Martin, 2005b)-might provide insight into clinicians' thought processes and family behavior that lead to delayed diagnosis. The goal of this study therefore was to determine, among a sample of Medicaid-eligible children, the extent to which children ultimately diagnosed with autism were first diagnosed with other disorders and whether those diagnoses differ by ethnicity.…”

mentioning

confidence: 99%

Disparities in Diagnoses Received Prior to a Diagnosis of Autism Spectrum Disorder

Mandell

Ittenbach

Levy

et al. 2006

J Autism Dev Disord

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358

224

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This study estimated differences by ethnicity in the diagnoses assigned prior to the diagnosis of autism. In this sample of 406 Medicaid-eligible children, African-Americans were 2.6 times less likely than white children to receive an autism diagnosis on their first specialty care visit. Among children who did not receive an autism diagnosis on their first visit, ADHD was the most common diagnosis. African-American children were 5.1 times more likely than white children to receive a diagnosis of adjustment disorder than of ADHD, and 2.4 times more likely to receive a diagnosis of conduct disorder than of ADHD. Differences in diagnostic patterns by ethnicity suggest possible variations in parents' descriptions of symptoms, clinician interpretations and expectations, or symptom presentation.

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Characteristics of Children with Autistic Spectrum Disorders Served in Comprehensive Community-based Mental Health Settings

Cited by 85 publications

References 29 publications

Atenção psicossocial a crianças e adolescentes com autismo nos CAPSi da região metropolitana do Rio de Janeiro

Atenção psicossocial a crianças e adolescentes com autismo nos CAPSi da região metropolitana do Rio de Janeiro

Psychotropic Medication Use Among Medicaid-Enrolled Children With Autism Spectrum Disorders

Disparities in Diagnoses Received Prior to a Diagnosis of Autism Spectrum Disorder

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