Development and evaluation of a novel caregiver-report tool to assess barriers to physical healthcare for people on the autism spectrum / Catherine WALSH in Research in Autism Spectrum Disorders, 79 (November 2020)  

Public ISBD [article]  inResearch in Autism Spectrum Disorders > 79 (November 2020) . - 101680 Titre : Development and evaluation of a novel caregiver-report tool to assess barriers to physical healthcare for people on the autism spectrum Type de document : texte imprimé Auteurs : Catherine WALSH, Auteur ; Sinéad LYDON, Auteur ; A. HEHIR, Auteur ; Paul E. O’CONNOR, Auteur Article en page(s) : 101680 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder  Healthcare access  Reasonable adjustments  Healthcare equity  Healthcare disparities  Health Index. décimale : PER Périodiques Résumé : Introduction People on the autism spectrum often experience poorer health than the general population despite higher engagement with the health services. This suggests a disparity in the accessibility of appropriate healthcare for autistic individuals. To improve access, barriers the autism community experience in healthcare first need to be identified. This paper aimed to: 1) develop and evaluate a caregiver-report tool; 2) identify barriers to physical healthcare for autistic individuals; and 3) identify potential contributing factors. Methods A previously established taxonomy of barriers to healthcare for autistic individuals informed the development of the tool; this was then distributed to caregivers of autistic adults and children. Exploratory factor analysis (EFA) assessed validity and reliability of the tool. Multiple Regressions were performed to identify predictors of barriers. Results In total, caregivers of 194 autistic children or adults participated in the study. The EFA produced four factors: 1) patient-level barriers; 2) healthcare provider-level (HCP) barriers; 3) healthcare system-level barriers; and 4) barriers related to managing healthcare. The greatest barriers included difficulties with identifying/reporting symptoms (endorsed by 62.4% of participants); difficulties handling the waiting area (60.3% of participants); and a lack of HCP knowledge regarding autism (52.1% of participants). Autism severity, general adjustment problems, anxiety, age and having unmet needs predicted the frequency and/or severity of barriers. Conclusions A tool that allows assessment of patient-, HCP-, and system-level barriers to healthcare was developed and evaluated. Patient-level barriers appear to occur frequently and pose substantial challenges. This tool will help identify areas most in need of intervention and support intervention evaluation. En ligne : https://doi.org/10.1016/j.rasd.2020.101680 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=434 [article] Development and evaluation of a novel caregiver-report tool to assess barriers to physical healthcare for people on the autism spectrum [texte imprimé] / Catherine WALSH, Auteur ; Sinéad LYDON, Auteur ; A. HEHIR, Auteur ; Paul E. O’CONNOR, Auteur . - 101680. Langues : Anglais (eng) in Research in Autism Spectrum Disorders > 79 (November 2020) . - 101680 Mots-clés : Autism spectrum disorder  Healthcare access  Reasonable adjustments  Healthcare equity  Healthcare disparities  Health Index. décimale : PER Périodiques Résumé : Introduction People on the autism spectrum often experience poorer health than the general population despite higher engagement with the health services. This suggests a disparity in the accessibility of appropriate healthcare for autistic individuals. To improve access, barriers the autism community experience in healthcare first need to be identified. This paper aimed to: 1) develop and evaluate a caregiver-report tool; 2) identify barriers to physical healthcare for autistic individuals; and 3) identify potential contributing factors. Methods A previously established taxonomy of barriers to healthcare for autistic individuals informed the development of the tool; this was then distributed to caregivers of autistic adults and children. Exploratory factor analysis (EFA) assessed validity and reliability of the tool. Multiple Regressions were performed to identify predictors of barriers. Results In total, caregivers of 194 autistic children or adults participated in the study. The EFA produced four factors: 1) patient-level barriers; 2) healthcare provider-level (HCP) barriers; 3) healthcare system-level barriers; and 4) barriers related to managing healthcare. The greatest barriers included difficulties with identifying/reporting symptoms (endorsed by 62.4% of participants); difficulties handling the waiting area (60.3% of participants); and a lack of HCP knowledge regarding autism (52.1% of participants). Autism severity, general adjustment problems, anxiety, age and having unmet needs predicted the frequency and/or severity of barriers. Conclusions A tool that allows assessment of patient-, HCP-, and system-level barriers to healthcare was developed and evaluated. Patient-level barriers appear to occur frequently and pose substantial challenges. This tool will help identify areas most in need of intervention and support intervention evaluation. En ligne : https://doi.org/10.1016/j.rasd.2020.101680 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=434

Salivary cortisol levels and challenging behavior in children with autism spectrum disorder / Sinéad LYDON in Research in Autism Spectrum Disorders, 10 (February 2015)  

Public ISBD [article]  inResearch in Autism Spectrum Disorders > 10 (February 2015) . - p.78-92 Titre : Salivary cortisol levels and challenging behavior in children with autism spectrum disorder Type de document : texte imprimé Auteurs : Sinéad LYDON, Auteur ; Olive HEALY, Auteur ; Michelle ROCHE, Auteur ; Rebecca HENRY, Auteur ; Teresa MULHERN, Auteur ; Brian M. HUGHES, Auteur Article en page(s) : p.78-92 Langues : Anglais (eng) Mots-clés : Autism  Stress  Cortisol  Challenging behavior  Stereotypy  Repetitive behavior Index. décimale : PER Périodiques Résumé : A relationship between stress and challenging behavior in individuals with autism spectrum disorder (ASD) has been theorized but infrequently examined empirically. The current study sought to examine the relationship between a parent-reported measure of stress, a physiological measure of stress (diurnal salivary cortisol), and various topographies of challenging behavior among 61 children and adolescents diagnosed with ASD between the ages of three and 18 years. Significant differences in cortisol levels between those engaging in high and low rates of stereotyped behavior were observed such that higher levels of stereotypy appeared an overt manifestation of higher levels of stress. A comparison between a subset of participants with ASD and typically developing peers matched on age, gender, and pubertal status failed to yield any differences in diurnal cortisol levels or cortisol variability between the two groups. The results of the current study suggest that similar levels of stress may exist among children with autism and their typically developing peers, but that for a subset of individuals with ASD, stereotyped behavior may be an indicator of elevated cortisol levels. En ligne : http://dx.doi.org/10.1016/j.rasd.2014.10.020 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=260 [article] Salivary cortisol levels and challenging behavior in children with autism spectrum disorder [texte imprimé] / Sinéad LYDON, Auteur ; Olive HEALY, Auteur ; Michelle ROCHE, Auteur ; Rebecca HENRY, Auteur ; Teresa MULHERN, Auteur ; Brian M. HUGHES, Auteur . - p.78-92. Langues : Anglais (eng) in Research in Autism Spectrum Disorders > 10 (February 2015) . - p.78-92 Mots-clés : Autism  Stress  Cortisol  Challenging behavior  Stereotypy  Repetitive behavior Index. décimale : PER Périodiques Résumé : A relationship between stress and challenging behavior in individuals with autism spectrum disorder (ASD) has been theorized but infrequently examined empirically. The current study sought to examine the relationship between a parent-reported measure of stress, a physiological measure of stress (diurnal salivary cortisol), and various topographies of challenging behavior among 61 children and adolescents diagnosed with ASD between the ages of three and 18 years. Significant differences in cortisol levels between those engaging in high and low rates of stereotyped behavior were observed such that higher levels of stereotypy appeared an overt manifestation of higher levels of stress. A comparison between a subset of participants with ASD and typically developing peers matched on age, gender, and pubertal status failed to yield any differences in diurnal cortisol levels or cortisol variability between the two groups. The results of the current study suggest that similar levels of stress may exist among children with autism and their typically developing peers, but that for a subset of individuals with ASD, stereotyped behavior may be an indicator of elevated cortisol levels. En ligne : http://dx.doi.org/10.1016/j.rasd.2014.10.020 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=260

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