Service Use Among Transition-Age Youth with Autism Spectrum Disorder

Ishler, Karen J.; Biegel, David E.; Wang, Fei; Olgac, Tugba; Lytle, Sarah; Miner, Stacy; Edguer, Marjorie Nigar; Kaplan, Ronna

doi:10.1007/s10803-021-04999-6

Cited by 20 publications

(29 citation statements)

References 39 publications

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“…The decision to have intellectual disability separately, rather than collapsing it with the other psychiatric diagnoses was done in an effort to speak to the unique relationship between an ID diagnosis and service complexity among this sample of autistic youth, separate from the discussion around other psychiatric and medical co-occurrences. This is aligned with recent scholarly works that have recommended researchers examine ID independent of other co-occurring psychiatric diagnoses ( Ishler et al, 2022 , p. 1,062). Therefore, intellectual disability in the current study is a dichotomous variable coded as 0 (IQs above 70) or 1 (IQs below 70); youth with IQs above 70 were collapsed into a group and compared to youth with IQs below 70.…”

Section: Methodssupporting

confidence: 80%

“…Autistic youth require several treatment resources for co-occurring medical (e.g., epilepsy, respiratory diseases) and psychiatric diagnoses (e.g., anxiety, depression; Mazurek et al, 2020 , p. 401 Brooks et al, 2021 , p. 634) and the overlap of diagnoses contributes to the complexity of ASD treatment ( Stewart et al, 2021a , p. 2). However, there are a limited number of studies focused on specific factors related to service use ( Ishler et al, 2022 , p. 1,052). This study addresses several limitations identified in the existing literature by utilizing a large sample size, adopting a conceptual framework to guide the analyses and focuses on both medical and psychiatric diagnoses.…”

Section: Discussionmentioning

confidence: 99%

“…The overlap of diagnoses contributes to the complexity of ASD treatment ( Stewart et al, 2021a , p. 2) and an increased prevalence of ASD translates into a greater demand for supports ( Kogan et al, 2008 , p. 1,150; Menezes et al, 2021 , p. 2,200) which often exceeds the resources available to youth and their families ( Stewart et al, 2021a , p. 2). Despite the gap between service need and corresponding service use, there are a limited number of studies focused on specific factors related to how this population accesses services ( Ishler et al, 2022 , p. 1,052).…”

Section: Introductionmentioning

confidence: 99%

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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: Methodssupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…1) ADHD symptoms in non-autistic adults are associated with greater distress and lower physical, psychological, social, and environmental quality of life (Nicastro et al, 2018), and 2) ADHD's influence may be outsized in adulthood because there are higher expectations for independence and fewer structural supports (caregivers, educational system) in place for adults than children (Ishler et al, 2021;Shattuck et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Impacts of Co-Occurring ADHD Symptoms on Critical Markers of Outcome for Autistic Adults

Yerys¹,

McQuaid²,

Lee³

et al. 2021

Preprint

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Outcomes for autistic adults are generally poor across multiple foundational metrics, including quality of life and activities of daily living. Co occurring psychiatric conditions, including depression and anxiety, contribute to these poor outcomes. Attention-deficit/hyperactivity disorder (ADHD) is one of the most common co-occurring conditions in autistic individuals, yet its association with adult outcomes is largely unknown. 628 autistic adults (18-83 years; 58% female) recruited from the Simons Foundation Powering Autism Research for Knowledge cohort completed questionnaires on demographics, co occurring mental health conditions, activities of daily living and subjective quality of life. After controlling for age, birth-sex, socioeconomic status, autistic traits, and ADHD medications, ADHD symptoms explained an additional 2 to 9% of variance across activities of daily living and all domains of subjective quality of life. This is the first study to demonstrate an association between self-reported ADHD symptoms and lower activities of daily living and subjective quality of life ratings by autistic adults. These findings highlight that additional research and better supports for co-occurring ADHD symptoms may be critical to enhancing independence and quality of life for autistic adults.

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“…It may be that some youth-such as those with cognitive impairments or behavioral challenges-will need ongoing support to maintain their initial employment status (Awsumb et al, 2022). Likewise, it is possible that youth who exit the education system end up losing services critical to sustaining work over time (Ishler et al, 2022). Changing the employment trajectories of youth with disabilities requires tracking their work pathways and outcomes over time to ensure ongoing engagement in workforce.…”

Section: Discussionmentioning

confidence: 99%

Elevating the employment outcomes of transition-age youth with disabilities: Four decades of intervention research

Schutz

Carter

2022

JVR

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BACKGROUND: Preparing students with disabilities for future employment is a primary purpose of special education and secondary transition services. OBJECTIVE: Knowing which interventions lead to subsequent employment is essential for establishing a strong evidence base that can guide the field. METHODS: We systematically reviewed available experimental and quasi-experimental studies that evaluated interventions addressing employment outcomes for transition-age youth with disabilities (ages 14–22). RESULTS: These 25 studies were of varied methodological quality, and most interventions improved employment status for youth. Collectively, these findings emphasize the importance and impact of connecting youth with disabilities to career development experiences while they are still receiving transition supports. CONCLUSION: We offer recommendations for future research focused on unpacking the key features of these multi-component interventions as well as guidance on assessing meaningful employment outcomes for youth with disabilities.

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Service Use Among Transition-Age Youth with Autism Spectrum Disorder

Cited by 20 publications

References 39 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

Impacts of Co-Occurring ADHD Symptoms on Critical Markers of Outcome for Autistic Adults

Elevating the employment outcomes of transition-age youth with disabilities: Four decades of intervention research

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