Romani Patrick W, Luehring Mathew C, Koerner Angelique M, Baikie Shanna M
Department of Psychiatry, University of Colorado School of Medicine, 1635 Victor St., Aurora, CO, 80045, USA.
Children's Hospital Colorado, Aurora, USA.
J Autism Dev Disord. 2024 Nov 12. doi: 10.1007/s10803-024-06640-8.
The prevalence of autism spectrum disorder (ASD) is currently estimated to be 1 in 36 children. While much is known about the impact of ASD on family and community functioning as well as treatment outcomes, less is known about a relatively new categorization of ASD, called "profound autism."
The current study evaluated 14 consecutively admitted patients meeting criteria for profound autism to a specialized psychiatric inpatient and partial hospitalization program. We then selected 15 non-profoundly autistic youth admitted immediately before or after each profoundly autistic youth to serve as a comparison. Patient caregivers completed measures about parental stress and the severity and frequency of patient problem behavior, and patients participated in functional analyses of problem behavior and function-based treatment programs during their admission.
Results showed profoundly autistic youth spent an average of 14 more days admitted to the psychiatric unit, and they engaged in higher parent-reported severity and frequency of self-injurious and stereotypic behavior. Functional analysis results for profoundly autistic youth showed a higher occurrence of automatically reinforced problem behavior but otherwise similar results. As well, profoundly autistic youth showed a lower percentage reduction in problem behavior at the end of the psychiatric hospitalization than their non-profoundly autistic peers.
Profoundly autistic youth seem to require a high level of behavioral support, even after psychiatric hospitalization. Insurance companies and therapists need to recognize these challenges and invest sufficient resources to meet their treatment needs.
目前估计自闭症谱系障碍（ASD）在儿童中的患病率为1/36。虽然人们对ASD对家庭和社区功能以及治疗结果的影响了解很多，但对于一种相对较新的ASD分类，即“重度自闭症”，了解较少。
本研究评估了14名连续入院的符合重度自闭症标准的患者，他们被收治到一个专门的精神科住院及部分住院治疗项目中。然后，我们选择了15名在每名重度自闭症青少年之前或之后立即入院的非重度自闭症青少年作为对照。患者的照顾者完成了关于父母压力以及患者问题行为的严重程度和频率的测量，患者在住院期间参与了问题行为的功能分析和基于功能的治疗项目。
结果显示，重度自闭症青少年在精神科病房的平均住院天数多14天，并且他们的父母报告的自我伤害和刻板行为的严重程度和频率更高。重度自闭症青少年的功能分析结果显示，自动强化的问题行为发生率更高，但其他方面结果相似。此外，重度自闭症青少年在精神科住院结束时问题行为的减少百分比低于非重度自闭症同龄人。
重度自闭症青少年似乎即使在精神科住院后也需要高水平的行为支持。保险公司和治疗师需要认识到这些挑战，并投入足够的资源来满足他们的治疗需求。
