Sustainability of a Care Pathway for Children and Adolescents with Autism Spectrum Disorder on an Inpatient Psychiatric Service

Cervantes, Paige E.; Kuriakose, Sarah; Donnelly, Lauren; Filton, Beryl; Marr, Mollie; Okparaeke, Eugene; Voorheis, Katherine; Havens, Jennifer; Horwitz, Sarah M.

doi:10.1007/s10803-019-04029-6

Cited by 18 publications

(25 citation statements)

References 16 publications

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“…There were 20 different studies that investigated aspects of effectiveness associated with admission to a psychiatric in-patient service for children and adolescents. 25,28,30,31,33,[61][62][63][64][65][66][67][90][91][92][93][94][95]138,139 Length of stay Mean length of stay was available from 13 papers for children and adolescents (minimum 13.4 days, maximum 263 days). 28,33,[61][62][63]66,67,[90][91][92][93][94][95] Length-of-stay data indicated that a shorter length of stay was associated with admission to specialist higher-dependency intellectual disability in-patient services compared with secure open in-patient services 93 and GMH in-patient services.…”

Section: Measures Of Effectivenessmentioning

confidence: 99%

“…25,28,30,31,33,[61][62][63][64][65][66][67][90][91][92][93][94][95]138,139 Length of stay Mean length of stay was available from 13 papers for children and adolescents (minimum 13.4 days, maximum 263 days). 28,33,[61][62][63]66,67,[90][91][92][93][94][95] Length-of-stay data indicated that a shorter length of stay was associated with admission to specialist higher-dependency intellectual disability in-patient services compared with secure open in-patient services 93 and GMH in-patient services. 90 Further still, one group of authors reported that there were no differences in length of stay for children and adolescents with or without autism who also had intellectual disabilities.…”

Section: Measures Of Effectivenessmentioning

confidence: 99%

“…61 The findings from three further studies indicated that the implementation of an autism-specific care pathway shortened length of stay for children with autism, but not significantly. 66,67,95 Two papers focused specifically on adolescent GMH in-patient services during the COVID-19 pandemic, 33,62 noting a shorter inpatient length of stay after the COVID-19 outbreak, and although based on small numbers, a shorter length of stay was noted for adolescents with autism compared with those with both autism and intellectual disabilities. 33…”

Section: Measures Of Effectivenessmentioning

confidence: 99%

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A systematic review of in-patient psychiatric care for people with intellectual disabilities and/or autism: effectiveness, patient safety and experience

et al. 2022

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Background An increasing number of children, adolescents and adults with intellectual disabilities and/or autism are being admitted to general psychiatric wards and cared for by general psychiatrists. Aims The aim of this systematic review was to consider the likely effectiveness of in-patient treatment for this population, and compare and contrast differing models of in-patient care. Method A systematic search was completed to identify papers where authors had reported data about the effectiveness of in-patient admissions with reference to one of three domains: treatment effect (e.g. length of stay, clinical outcome, readmission), patient safety (e.g. restrictive practices) and patient experience (e.g. patient or family satisfaction). Where possible, outcomes associated with admission were considered further within the context of differing models of in-patient care (e.g. specialist in-patient services versus general mental health in-patient services). Results A total of 106 studies were included and there was evidence that improvements in mental health, social functioning, behaviour and forensic risk were associated with in-patient admission. There were two main models of in-patient psychiatric care described within the literature: admission to a specialist intellectual disability or general mental health in-patient service. Patients admitted to specialist intellectual disability in-patient services had greater complexity, but there were additional benefits, including fewer out-of-area discharges and lower seclusion rates. Conclusions There was evidence that admission to in-patient services was associated with improvements in mental health for this population. There was some evidence indicating better outcomes for those admitted to specialist services.

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Section: Measures Of Effectivenessmentioning

confidence: 99%

Section: Measures Of Effectivenessmentioning

confidence: 99%

Section: Measures Of Effectivenessmentioning

confidence: 99%

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A systematic review of in-patient psychiatric care for people with intellectual disabilities and/or autism: effectiveness, patient safety and experience

et al. 2022

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“…We also found five additional studies that met our inclusion criteria, through scrutinizing the reference lists of other articles, resulting in a total of 18 papers in the review. Four of the articles described the same two facilities but were included since the evaluations in the studies were made months/years apart [32][33][34][35]. Data extracted from the articles included type of interventions, study design, setting, context, and outcome.…”

Section: Methodsmentioning

confidence: 99%

“…These results were described as clinically relevant. The stability of the results was later evaluated by Cervantes et al (2019) [34]. (Table 1).…”

Section: Autism Spectrum Disorder Care Pathwaymentioning

confidence: 99%

Methods and Strategies for Reducing Seclusion and Restraint in Child and Adolescent Psychiatric Inpatient Care

Perers¹,

Bäckström²,

Johansson

et al. 2021

Psychiatr Q

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Restraints and seclusions are restrictive interventions used in psychiatric inpatient units when there is an imminent risk of harm to the patient or others. Coercive measures are controversial and can lead to negative consequences, including negative emotions, re-traumatization, injuries, or death. The article summarizes the last 10 years of literature regarding methods and strategies used for reducing seclusions and restraints in child and adolescent psychiatric inpatient units, and reports on their outcomes. The literature was reviewed by searching PubMed and PsycInfo for English-language articles published between May 2010 and May 2020. Eighteen articles were found that described methods or strategies aimed at reducing restraint or seclusion utilization in child and adolescent psychiatric inpatient units. The following interventions were evaluated: Trauma-Informed Care (TIC), Six Core Strategies, Child and Family Centered Care (CFCC), Collaborative & Proactive Solutions (CPS), Strength-Based Care, Modified Positive Behavioral Interventions and Supports (M-PBIS), Behavioral Modification Program (BMP), Autism Spectrum Disorder Care Pathway (ASD-CP), Dialectical Behavior Therapy (DBT), sensory rooms, Mindfulness-Based Stress Reduction Training (MBSR) of staff, and Milieu Nurse-Client Shift Assignments. Most of the interventions reduced the use of seclusions and/or restraints. Two child-centered and trauma-informed initiatives eliminated the use of mechanical restraints. This review shows that the use of coercive measures can be reduced and should be prioritized. Successful implementation requires ongoing commitment on all levels of an organization and a willingness to learn. To facilitate comparisons, future models should evaluate different standardized parameters.

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A Care Pathway for Children and Adolescents with Autism Spectrum Disorder on an Inpatient Psychiatric Service

Cervantes¹

2019

Encyclopedia of Autism Spectrum Disorders

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Sustainability of a Care Pathway for Children and Adolescents with Autism Spectrum Disorder on an Inpatient Psychiatric Service

Cited by 18 publications

References 16 publications

A systematic review of in-patient psychiatric care for people with intellectual disabilities and/or autism: effectiveness, patient safety and experience

A systematic review of in-patient psychiatric care for people with intellectual disabilities and/or autism: effectiveness, patient safety and experience

Methods and Strategies for Reducing Seclusion and Restraint in Child and Adolescent Psychiatric Inpatient Care

A Care Pathway for Children and Adolescents with Autism Spectrum Disorder on an Inpatient Psychiatric Service

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