Clinical Characteristics of Youth with Autism or Developmental Disability during Inpatient Psychiatric Admission

Neuhaus, Emily; Osuna, Anthony; Tagavi, Daina; Shah-Hosseini, Sina; Simmons, Shannon; Gerdts, Jennifer; Thompson, Alysha D.

doi:10.3390/jcm11216328

Cited by 5 publications

(1 citation statement)

References 43 publications

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“…An essential component in characterizing the behavioral phenotype of these conditions is to consider the presence of psychiatric features within specific gene groups. Regardless of etiology, individuals with ASD more broadly exhibit elevated rates of mental health diagnoses and subclinical symptoms relative to the general population [ 26 , 33 , 45 ], and genetic conditions associated with ASD may thus carry a similar concern. According to population-derived estimates, approximately 70% of children and adolescents with ASD have at least one mental health condition, with 40% experiencing multiple conditions [ 55 ].…”

Section: Introductionmentioning

confidence: 99%

Shared and divergent mental health characteristics of ADNP-, CHD8- and DYRK1A-related neurodevelopmental conditions

Neuhaus,

Rea,

Jones

et al. 2024

J Neurodevelop Disord

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Background Neurodevelopmental conditions such as intellectual disability (ID) and autism spectrum disorder (ASD) can stem from a broad array of inherited and de novo genetic differences, with marked physiological and behavioral impacts. We currently know little about the psychiatric phenotypes of rare genetic variants associated with ASD, despite heightened risk of psychiatric concerns in ASD more broadly. Understanding behavioral features of these variants can identify shared versus specific phenotypes across gene groups, facilitate mechanistic models, and provide prognostic insights to inform clinical practice. In this paper, we evaluate behavioral features within three gene groups associated with ID and ASD – ADNP, CHD8, and DYRK1A – with two aims: (1) characterize phenotypes across behavioral domains of anxiety, depression, ADHD, and challenging behavior; and (2) understand whether age and early developmental milestones are associated with later mental health outcomes. Methods Phenotypic data were obtained for youth with disruptive variants in ADNP, CHD8, or DYRK1A (N = 65, mean age = 8.7 years, 40% female) within a long-running, genetics-first study. Standardized caregiver-report measures of mental health features (anxiety, depression, attention-deficit/hyperactivity, oppositional behavior) and developmental history were extracted and analyzed for effects of gene group, age, and early developmental milestones on mental health features. Results Patterns of mental health features varied by group, with anxiety most prominent for CHD8, oppositional features overrepresented among ADNP, and attentional and depressive features most prominent for DYRK1A. For the full sample, age was positively associated with anxiety features, such that elevations in anxiety relative to same-age and same-sex peers may worsen with increasing age. Predictive utility of early developmental milestones was limited, with evidence of early language delays predicting greater difficulties across behavioral domains only for the CHD8 group. Conclusions Despite shared associations with autism and intellectual disability, disruptive variants in ADNP, CHD8, and DYRK1A may yield variable psychiatric phenotypes among children and adolescents. With replication in larger samples over time, efforts such as these may contribute to improved clinical care for affected children and adolescents, allow for earlier identification of emerging mental health difficulties, and promote early intervention to alleviate concerns and improve quality of life.

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Section: Introductionmentioning

confidence: 99%

Shared and divergent mental health characteristics of ADNP-, CHD8- and DYRK1A-related neurodevelopmental conditions

Neuhaus,

Rea,

Jones

et al. 2024

J Neurodevelop Disord

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Rates and risk factors of coercive measure use in inpatient child and adolescent mental health services: a systematic review and narrative synthesis

Moell,

Lyle,

Rozental

et al. 2024

The Lancet Psychiatry

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The Relationship Between Augmentative and Alternative Communication Use by Pediatric Psychiatric Inpatients With Autism Spectrum Disorder and Interfering Behaviors

Clarke

Siegel

Williams

2023

Am J Speech Lang Pathol

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Purpose: Previous research conducted by Williams et al. (2018) using data from the Autism Inpatient Collection (AIC) found a weak and inconsistent association between verbal ability and the severity of interfering behaviors; however, adapting/coping scores were significantly associated with self-injury, stereotypy, and irritability (including aggression and tantrums). The previous study did not account for access to or use of alternative forms of communication in their sample population. This study uses retrospective data to investigate the association between verbal ability and augmentative and alternative communication (AAC) use and the presence of interfering behaviors in individuals with autism who have complex behavioral profiles. Method: The sample included 260 autistic inpatients, ages 4–20 years, from six psychiatric facilities, enrolled during the second phase of the AIC when detailed information about AAC use was collected. Measures included AAC use, method, and function; comprehension and production of language; receptive vocabulary; nonverbal IQ; severity of interfering behaviors; and the presence and severity of repetitive behaviors. Results: Lower language/communication abilities were related to increased repetitive behaviors and stereotypies. More specifically, these interfering behaviors appeared to be related to communication in those individuals who were candidates for AAC but who were not reported to have access to it. Although the use of AAC did not predict a decrease in interfering behaviors, receptive vocabulary scores—as measured by the Peabody Picture Vocabulary Test–Fourth Edition—were positively correlated with the presence of interfering behaviors in participants with the most complex communication needs. Conclusions: The communication needs of some individuals with autism may be unmet, prompting the use of interfering behaviors as a form of communication. Further investigation of the functions of interfering behaviors and the related functions of communication skills may provide greater support for an increased focus on the provision of AAC to prevent and ameliorate interfering behaviors in individuals with autism.

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Clinical Characteristics of Youth with Autism or Developmental Disability during Inpatient Psychiatric Admission

Cited by 5 publications

References 43 publications

Shared and divergent mental health characteristics of ADNP-, CHD8- and DYRK1A-related neurodevelopmental conditions

Shared and divergent mental health characteristics of ADNP-, CHD8- and DYRK1A-related neurodevelopmental conditions

Rates and risk factors of coercive measure use in inpatient child and adolescent mental health services: a systematic review and narrative synthesis

The Relationship Between Augmentative and Alternative Communication Use by Pediatric Psychiatric Inpatients With Autism Spectrum Disorder and Interfering Behaviors

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