The Periodic Risk Evaluation: A new tool to link Medicaid-enrolled autistic adults to services and support / Lindsay SHEA in Research in Autism Spectrum Disorders, 98 (October 2022)  

Public ISBD [article]  inResearch in Autism Spectrum Disorders > 98 (October 2022) . - 102037 Titre : The Periodic Risk Evaluation: A new tool to link Medicaid-enrolled autistic adults to services and support Type de document : Texte imprimé et/ou numérique Auteurs : Lindsay SHEA, Auteur ; Kaitlin H. KOFFER MILLER, Auteur ; Stacy L. NONNEMACHER, Auteur ; Alec BECKER, Auteur ; Pamela TREADWAY, Auteur ; Amy ALFORD, Auteur ; Craig NEWSCHAFFER, Auteur ; Brian K. LEE, Auteur Article en page(s) : 102037 Langues : Anglais (eng) Mots-clés : Autism  Medicaid  Risk  Tool  Adult  Service use Index. décimale : PER Périodiques Résumé : Background The Periodic Risk Evaluation (PRE) is a new questionnaire-based tool to identify autistic adults enrolled in Medicaid programs who are at risk for adverse outcomes including mental health and medical conditions, law enforcement interaction, stressful life events, substance use, presence of natural supports, and suboptimal living conditions. The PRE is completed by direct service providers and informs case conceptualization to drive changes in needed supports. Method The PRE was tested in a sample of 674 autistic adults with a mean age of 31 years across a large, northeastern state. A random forest model was developed to predict complex case status using the PRE items. Sensitivity, specificity, positive predictive value, and negative predictive value for different PRE score cutoffs were evaluated as the performance measures of interest. Expert clinical assessment, the gold standard for case status, identified 131 individuals (19.4 %) as complex cases in need of modified services and supports. Results The final PRE model identified complex cases in unseen data with 75.5 % accuracy, 71.9 % sensitivity, 76.3 % specificity, 41.8 % positive predictive value, and 92.0 % negative predictive value. Conclusions The PRE may be a useful tool for triaging service needs and delivery to adults on the spectrum. The use of the PRE in the Medicaid system is critical because Medicaid is among the only insurers available during the transition to and throughout adulthood for autistic individuals. Adequate planning and assessment of risk can assist direct support staff in triaging and mitigating risk to minimize adverse outcomes. En ligne : https://doi.org/10.1016/j.rasd.2022.102037 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=490 [article] The Periodic Risk Evaluation: A new tool to link Medicaid-enrolled autistic adults to services and support [Texte imprimé et/ou numérique] / Lindsay SHEA, Auteur ; Kaitlin H. KOFFER MILLER, Auteur ; Stacy L. NONNEMACHER, Auteur ; Alec BECKER, Auteur ; Pamela TREADWAY, Auteur ; Amy ALFORD, Auteur ; Craig NEWSCHAFFER, Auteur ; Brian K. LEE, Auteur . - 102037. Langues : Anglais (eng) in Research in Autism Spectrum Disorders > 98 (October 2022) . - 102037 Mots-clés : Autism  Medicaid  Risk  Tool  Adult  Service use Index. décimale : PER Périodiques Résumé : Background The Periodic Risk Evaluation (PRE) is a new questionnaire-based tool to identify autistic adults enrolled in Medicaid programs who are at risk for adverse outcomes including mental health and medical conditions, law enforcement interaction, stressful life events, substance use, presence of natural supports, and suboptimal living conditions. The PRE is completed by direct service providers and informs case conceptualization to drive changes in needed supports. Method The PRE was tested in a sample of 674 autistic adults with a mean age of 31 years across a large, northeastern state. A random forest model was developed to predict complex case status using the PRE items. Sensitivity, specificity, positive predictive value, and negative predictive value for different PRE score cutoffs were evaluated as the performance measures of interest. Expert clinical assessment, the gold standard for case status, identified 131 individuals (19.4 %) as complex cases in need of modified services and supports. Results The final PRE model identified complex cases in unseen data with 75.5 % accuracy, 71.9 % sensitivity, 76.3 % specificity, 41.8 % positive predictive value, and 92.0 % negative predictive value. Conclusions The PRE may be a useful tool for triaging service needs and delivery to adults on the spectrum. The use of the PRE in the Medicaid system is critical because Medicaid is among the only insurers available during the transition to and throughout adulthood for autistic individuals. Adequate planning and assessment of risk can assist direct support staff in triaging and mitigating risk to minimize adverse outcomes. En ligne : https://doi.org/10.1016/j.rasd.2022.102037 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=490

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