Comparing service use and costs among adolescents with autism spectrum disorders, special needs and typical development / Barbara BARRETT in Autism, 19-5 (July 2015)  

Public ISBD [article]  inAutism > 19-5 (July 2015) . - p.562-569 Titre : Comparing service use and costs among adolescents with autism spectrum disorders, special needs and typical development Type de document : Texte imprimé et/ou numérique Auteurs : Barbara BARRETT, Auteur ; Iris MOSWEU, Auteur ; Catherine R. G. JONES, Auteur ; Tony CHARMAN, Auteur ; Gillian BAIRD, Auteur ; Emily SIMONOFF, Auteur ; Andrew PICKLES, Auteur ; Francesca HAPPE, Auteur ; Sarah BYFORD, Auteur Article en page(s) : p.562-569 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  costs  service use  special educational needs Index. décimale : PER Périodiques Résumé : Autism spectrum disorder is a complex condition that requires specialised care. Knowledge of the costs of autism spectrum disorder, especially in comparison with other conditions, may be useful to galvanise policymakers and leverage investment in education and intervention to mitigate aspects of autism spectrum disorder that negatively impact individuals with the disorder and their families. This article describes the services and associated costs for four groups of individuals: adolescents with autistic disorder, adolescents with other autism spectrum disorders, adolescents with other special educational needs and typically developing adolescents using data from a large, well-characterised cohort assessed as part of the UK Special Needs and Autism Project at the age of 12 years. Average total costs per participant over 6 months were highest in the autistic disorder group (£11,029), followed by the special educational needs group (£9268), the broader autism spectrum disorder group (£8968) and the typically developing group (£2954). Specialised day or residential schooling accounted for the vast majority of costs. In regression analysis, lower age and lower adaptive functioning were associated with higher costs in the groups with an autism spectrum disorder. Sex, ethnicity, number of International Classification of Diseases (10th revision) symptoms, autism spectrum disorder symptom scores and levels of mental health difficulties were not associated with cost. En ligne : http://dx.doi.org/10.1177/1362361314536626 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=261 [article] Comparing service use and costs among adolescents with autism spectrum disorders, special needs and typical development [Texte imprimé et/ou numérique] / Barbara BARRETT, Auteur ; Iris MOSWEU, Auteur ; Catherine R. G. JONES, Auteur ; Tony CHARMAN, Auteur ; Gillian BAIRD, Auteur ; Emily SIMONOFF, Auteur ; Andrew PICKLES, Auteur ; Francesca HAPPE, Auteur ; Sarah BYFORD, Auteur . - p.562-569. Langues : Anglais (eng) in Autism > 19-5 (July 2015) . - p.562-569 Mots-clés : autism spectrum disorders  costs  service use  special educational needs Index. décimale : PER Périodiques Résumé : Autism spectrum disorder is a complex condition that requires specialised care. Knowledge of the costs of autism spectrum disorder, especially in comparison with other conditions, may be useful to galvanise policymakers and leverage investment in education and intervention to mitigate aspects of autism spectrum disorder that negatively impact individuals with the disorder and their families. This article describes the services and associated costs for four groups of individuals: adolescents with autistic disorder, adolescents with other autism spectrum disorders, adolescents with other special educational needs and typically developing adolescents using data from a large, well-characterised cohort assessed as part of the UK Special Needs and Autism Project at the age of 12 years. Average total costs per participant over 6 months were highest in the autistic disorder group (£11,029), followed by the special educational needs group (£9268), the broader autism spectrum disorder group (£8968) and the typically developing group (£2954). Specialised day or residential schooling accounted for the vast majority of costs. In regression analysis, lower age and lower adaptive functioning were associated with higher costs in the groups with an autism spectrum disorder. Sex, ethnicity, number of International Classification of Diseases (10th revision) symptoms, autism spectrum disorder symptom scores and levels of mental health difficulties were not associated with cost. En ligne : http://dx.doi.org/10.1177/1362361314536626 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=261

Predictors of reliable symptom change: Secondary analysis of the Preschool Autism Communication Trial / Kristelle HUDRY in Autism & Developmental Language Impairments, 3 (January-December 2018)  

Public ISBD [article]  inAutism & Developmental Language Impairments > 3 (January-December 2018) Titre : Predictors of reliable symptom change: Secondary analysis of the Preschool Autism Communication Trial Type de document : Texte imprimé et/ou numérique Auteurs : Kristelle HUDRY, Auteur ; Helen MCCONACHIE, Auteur ; Ann LE COUTEUR, Auteur ; Patricia HOWLIN, Auteur ; Barbara BARRETT, Auteur ; Vicky SLONIMS, Auteur Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Background and aimsDespite recent gains in the amount and quality of early autism intervention research, identifying what works for whom remains an ongoing challenge. Exploiting data from the Preschool Autism Communication Trial (PACT), we undertook secondary analysis to explore prognostic indicators and predictors of response to one year of PACT therapy versus treatment as usual within this large and rigorously characterised cohort recruited across three UK trial sites.MethodsIn this secondary analysis of variability in child gains on the primary trial outcome measure ? social-communication symptom severity ? we used a pragmatic and data-driven approach to identify a subgroup of children who showed reliable improvement and a subgroup showing clear lack thereof. We then tested which among several baseline child and family factors ? including measures routinely collected in research trials and clinical practice ? varied as a function of child outcome status and treatment group.ResultsGreater baseline child non-verbal ability was a significant prognostic indicator of symptom reduction over time (i.e. irrespective of treatment group). By contrast, parent synchrony presented as marginal predictor, and trial recruitment site as a significant predictor, of differential outcome by treatment group. Specifically, lower parent synchrony showed some association with poorer outcomes for children from families assigned to treatment as usual (but with no such effect for those assigned to PACT). Similarly, children at one recruitment site were more likely to have poorer outcomes if assigned to treatment as usual, compared to children at the same site assigned to PACT.ConclusionsThe current data contribute to an evidence base indicting that early non-verbal ability is a robust indicator of generally better prognosis for young children with autism. Lower parent synchrony and a broadly more deprived socio-geographical context may inform the appropriate targeting of PACT. That is, given that the former factors predicted poorer outcome in children from families assigned to treatment as usual, the receipt of a relatively low-dose, parent-mediated and communication-focused therapy might be developmentally protective for young children with autism. Nevertheless, results from this study also highlight the paucity of meaningful predictors of outcome among routine clinical characterisation measures such as those investigated here.ImplicationsUnderstanding the factors associated with differential treatment outcomes is critical if we are to individualise treatment decisions for children with autism. Inherently tied to this objective is a need to delineate those factors which specifically predict positive response (or lack of response) to one or other treatment option, versus those that indicate generally better (or poorer) prognosis, irrespective of treatment. En ligne : https://doi.org/10.1177/2396941518764760 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=387 [article] Predictors of reliable symptom change: Secondary analysis of the Preschool Autism Communication Trial [Texte imprimé et/ou numérique] / Kristelle HUDRY, Auteur ; Helen MCCONACHIE, Auteur ; Ann LE COUTEUR, Auteur ; Patricia HOWLIN, Auteur ; Barbara BARRETT, Auteur ; Vicky SLONIMS, Auteur. Langues : Anglais (eng) in Autism & Developmental Language Impairments > 3 (January-December 2018) Index. décimale : PER Périodiques Résumé : Background and aimsDespite recent gains in the amount and quality of early autism intervention research, identifying what works for whom remains an ongoing challenge. Exploiting data from the Preschool Autism Communication Trial (PACT), we undertook secondary analysis to explore prognostic indicators and predictors of response to one year of PACT therapy versus treatment as usual within this large and rigorously characterised cohort recruited across three UK trial sites.MethodsIn this secondary analysis of variability in child gains on the primary trial outcome measure ? social-communication symptom severity ? we used a pragmatic and data-driven approach to identify a subgroup of children who showed reliable improvement and a subgroup showing clear lack thereof. We then tested which among several baseline child and family factors ? including measures routinely collected in research trials and clinical practice ? varied as a function of child outcome status and treatment group.ResultsGreater baseline child non-verbal ability was a significant prognostic indicator of symptom reduction over time (i.e. irrespective of treatment group). By contrast, parent synchrony presented as marginal predictor, and trial recruitment site as a significant predictor, of differential outcome by treatment group. Specifically, lower parent synchrony showed some association with poorer outcomes for children from families assigned to treatment as usual (but with no such effect for those assigned to PACT). Similarly, children at one recruitment site were more likely to have poorer outcomes if assigned to treatment as usual, compared to children at the same site assigned to PACT.ConclusionsThe current data contribute to an evidence base indicting that early non-verbal ability is a robust indicator of generally better prognosis for young children with autism. Lower parent synchrony and a broadly more deprived socio-geographical context may inform the appropriate targeting of PACT. That is, given that the former factors predicted poorer outcome in children from families assigned to treatment as usual, the receipt of a relatively low-dose, parent-mediated and communication-focused therapy might be developmentally protective for young children with autism. Nevertheless, results from this study also highlight the paucity of meaningful predictors of outcome among routine clinical characterisation measures such as those investigated here.ImplicationsUnderstanding the factors associated with differential treatment outcomes is critical if we are to individualise treatment decisions for children with autism. Inherently tied to this objective is a need to delineate those factors which specifically predict positive response (or lack of response) to one or other treatment option, versus those that indicate generally better (or poorer) prognosis, irrespective of treatment. En ligne : https://doi.org/10.1177/2396941518764760 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=387

Service and Wider Societal Costs of Very Young Children with Autism in the UK / Barbara BARRETT in Journal of Autism and Developmental Disorders, 42-5 (May 2012)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 42-5 (May 2012) . - p.797-804 Titre : Service and Wider Societal Costs of Very Young Children with Autism in the UK Type de document : Texte imprimé et/ou numérique Auteurs : Barbara BARRETT, Auteur ; Sarah BYFORD, Auteur ; Jessica SHARAC, Auteur ; Kristelle HUDRY, Auteur ; Kathy LEADBITTER, Auteur ; Kathryn TEMPLE, Auteur ; Catherine ALDRED, Auteur ; Vicky SLONIMS, Auteur ; Jonathan GREEN, Auteur ; PACT CONSORTIUM, Auteur Année de publication : 2012 Article en page(s) : p.797-804 Langues : Anglais (eng) Mots-clés : Cost  Very young children  Autism  Service use Index. décimale : PER Périodiques Résumé : Autism spectrum disorders (ASD) are associated with a substantial economic burden, but there is little evidence of the costs in the early years; the period in which children are increasingly likely to be diagnosed. We describe the services used by 152 children aged 24–60 months with autism, report family out-of-pocket expenses and productivity losses, and explore the relationship between family characteristics and costs. Children received a wide range of hospital and community services including relatively high levels of contact with speech and language therapists and paediatricians. Total service costs varied greatly (mean £430 per month; range £53 to £1,116), with some families receiving little statutory support. Higher costs were associated with increasing age and symptom severity. En ligne : http://dx.doi.org/10.1007/s10803-011-1306-x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=154 [article] Service and Wider Societal Costs of Very Young Children with Autism in the UK [Texte imprimé et/ou numérique] / Barbara BARRETT, Auteur ; Sarah BYFORD, Auteur ; Jessica SHARAC, Auteur ; Kristelle HUDRY, Auteur ; Kathy LEADBITTER, Auteur ; Kathryn TEMPLE, Auteur ; Catherine ALDRED, Auteur ; Vicky SLONIMS, Auteur ; Jonathan GREEN, Auteur ; PACT CONSORTIUM, Auteur . - 2012 . - p.797-804. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 42-5 (May 2012) . - p.797-804 Mots-clés : Cost  Very young children  Autism  Service use Index. décimale : PER Périodiques Résumé : Autism spectrum disorders (ASD) are associated with a substantial economic burden, but there is little evidence of the costs in the early years; the period in which children are increasingly likely to be diagnosed. We describe the services used by 152 children aged 24–60 months with autism, report family out-of-pocket expenses and productivity losses, and explore the relationship between family characteristics and costs. Children received a wide range of hospital and community services including relatively high levels of contact with speech and language therapists and paediatricians. Total service costs varied greatly (mean £430 per month; range £53 to £1,116), with some families receiving little statutory support. Higher costs were associated with increasing age and symptom severity. En ligne : http://dx.doi.org/10.1007/s10803-011-1306-x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=154

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