State Infant/Toddler Program Policies for Eligibility and Services Provision for Young Children with Autism

Stahmer, Aubyn C.; Mandell, David S.

doi:10.1007/s10488-006-0060-4

Cited by 81 publications

(57 citation statements)

References 41 publications

(25 reference statements)

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“…These regular (Jacobson and Mulick 2000) and crisis (Sheidow et al 2004) interventions are expensive and many communities have little infrastructure to deliver them at the required intensity (Heidgerken et al 2005;Stahmer 2006;Stahmer and Mandell 2006). Increased investment in these services, however, has the potential to significantly reduce the need for more costly inpatient services.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, private insurance companies often exclude autism as a covered diagnosis or limit coverage of related services (Birenbaum et al 1990;Krauss et al 2003), which may ultimately lead to the need for more intensive and restrictive care. Given this latter set of factors and the fact that few localities have decision rules governing care for children with ASD (Stahmer and Mandell 2006), risk for hospitalization may vary depending on the resources families bring to bear on the process of negotiating for services .…”

Section: Introductionmentioning

confidence: 99%

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Psychiatric Hospitalization Among Children with Autism Spectrum Disorders

Mandell

2007

J Autism Dev Disord

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154

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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 selfinjurious behaviors may reduce hospitalizations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Psychiatric Hospitalization Among Children with Autism Spectrum Disorders

Mandell

2007

J Autism Dev Disord

Self Cite

154

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“…The design of the present study's interview schedule (see Table 1) was based upon a review of previously developed interview schedules within the disability literature (for examples, see Stahmer & Mandell, 2007;Taylor & Houghton, 2008). Prior to its administration, the interview schedule was reviewed by four faculty members, who commented on the schedule's content suitability and made suggestions as to how the questions could be refined.…”

Section: Interview Schedulementioning

confidence: 99%

Students With ASD in Mainstream Primary Education Settings: Teachers' Experiences in Western Australian Classrooms

Soto-Chodiman

Pooley

Cohen

et al. 2012

Australas. j. spec. educ.

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The shift to inclusive education within Australia has resulted in increasing numbers of students with autism spectrum disorders (ASD) being placed in mainstream educational settings. This move has created new demands on teachers who are not necessarily trained to meet the challenge. Therefore, the present study aimed to develop an understanding of how 12 Western Australian primary school (K–7) teachers adapted to the challenge of having a student with ASD in their mainstream classroom. Using an interpretivist framework, data from semistructured interviews revealed that teachers perceived a need to first recognise and accept the challenges associated with having a student with ASD in their mainstream classroom before they could move to accessing avenues of support. The implications of this finding are discussed.

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“…We then linked state-and county-level characteristics to the Medicaid records to explore variation in the use of these medications among children with ASDs as a function of area-level characteristics as well as children's demographic and clinical characteristics. Given that the rising numbers of children who receive a diagnosis of ASD 14, 15 combined with the considerable expense associated with their care16 -18 has caused states and local jurisdictions to take varied approaches to addressing their needs, [19][20][21] understanding what may drive geographic variation in medication use is of great policy significance. What is known is that there is considerable county-and state-level variation in the identification of children with ASD, which has been associated with education-related spending, urbanicity, and health care resources.…”

Section: Introductionmentioning

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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State Infant/Toddler Program Policies for Eligibility and Services Provision for Young Children with Autism

Cited by 81 publications

References 41 publications

Psychiatric Hospitalization Among Children with Autism Spectrum Disorders

Psychiatric Hospitalization Among Children with Autism Spectrum Disorders

Students With ASD in Mainstream Primary Education Settings: Teachers' Experiences in Western Australian Classrooms

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

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