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Ong N, Ahuja H, de Lima J, Tomsic G, Garg P, Silove N, Henao Urrego B, Weatherall A. Perioperative pathways for children with neurodevelopmental conditions and behaviours that challenge: An evaluation of parent experiences for service improvement. J Perioper Pract 2025; 35:258-268. [PMID: 39108057 DOI: 10.1177/17504589241253487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2025]
Abstract
Previous research shows that children and young people with neurodevelopmental conditions experience greater challenges accessing care in hospitals and having their health needs met. AIM To elicit experiences of parents of children with neurodevelopmental conditions using a new perioperative pathway. METHOD Parents of children accessing an adapted perioperative clinical pathway in a tertiary children's hospital between July 2019 and December 2020 were invited to participate. A mixed method study was conducted comprising a short survey questionnaire followed by telephonic interviews. RESULTS From 67 postal surveys sent out, 20 were completed. Six out of 20 parents participated in phone interviews and one parent submitted written prose. Parents were positive about their experiences. Six themes emerged: Negative past experiences (highlighting the need for adapted perioperative pathways); Reasonable adjustments (improving child and parent's hospital journey); Facilitating communication, convenience and collaboration; Parent's satisfaction and relief; Barriers to overcome and Areas in need of improvement were discussed. CONCLUSION Parents of children with neurodevelopmental conditions report great satisfaction and relief from their experiences of a more efficient, streamlined and stress-free way for their child to have tests or procedures done. Parents report improved communication, convenience and collaboration with staff resulted in timely, safe and high-quality care.
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Affiliation(s)
- Natalie Ong
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Child Development Unit, The Children's Hospital at Westmead, The Sydney Children's Hospitals Network, Westmead, NSW, Australia
| | - Hema Ahuja
- Child Development Unit, The Children's Hospital at Westmead, The Sydney Children's Hospitals Network, Westmead, NSW, Australia
| | - Jonathan de Lima
- Department of Anaesthesia, The Children's Hospital at Westmead, The Sydney Children's Hospitals Network, Westmead, NSW, Australia
| | - Gail Tomsic
- Child Development Unit, The Children's Hospital at Westmead, The Sydney Children's Hospitals Network, Westmead, NSW, Australia
| | - Pankaj Garg
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
- Specialist Intellectual Disability Health Team, Department of Community Paediatrics, South Western Sydney Local Health District, Warwick Farm, NSW, Australia
| | - Natalie Silove
- Child Development Unit, The Children's Hospital at Westmead, The Sydney Children's Hospitals Network, Westmead, NSW, Australia
| | - Bobbi Henao Urrego
- Executive Unit, The Sydney Children's Hospitals Network, Westmead, Australia
| | - Andrew Weatherall
- Department of Anaesthesia, The Children's Hospital at Westmead, The Sydney Children's Hospitals Network, Westmead, NSW, Australia
- Division of Child and Adolescent Health, The University of Sydney, Camperdown, NSW, Australia
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Snow SL, Smith IM, Latimer M, Stirling Cameron E, Fox J, Chorney J. A balancing act: An interpretive description of healthcare providers' and families' perspective on the surgical experiences of children with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:839-848. [PMID: 34320870 PMCID: PMC9014760 DOI: 10.1177/13623613211034057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children with an autism spectrum disorder (autism) are vulnerable to
negative experiences within the surgical setting. This qualitative
study used Interpretive Description. Individual interviews were
conducted with 8 parents of children with autism who had recently
undergone surgery, and 15 healthcare providers (HCPs) with experience
caring for children with autism. Participants were asked open-ended
questions on the approaches used to support children with autism
around the time of surgery and their effectiveness, how the surgical
experience could be improved, and the barriers and facilitators to
potential improvements. Results yielded three main themes within an
overarching metaphor of a balancing act. The first theme, finding your
footing through an uncertain journey, described individual factors
(e.g. anticipatory anxiety) that set the foundation for
surgery-related experiences. The second theme, relationships can help
to keep everyone steady, highlighted how interpersonal dynamics (e.g.
collaboration and empathy) influence the experience. Finally, the
systems shape the experience theme captured the impact of systemic
factors (e.g. the hospital environment) on the balancing act. These
findings enriched our understanding of how individual, interpersonal,
and systemic factors influence the surgical experiences of children
with autism, families, and HCPs. Insights gained from this study can
be used to inform future interventions.
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Affiliation(s)
| | - Isabel M Smith
- IWK Health Halifax, Canada.,Dalhousie University, Halifax, NS, Canada
| | - Margot Latimer
- IWK Health Halifax, Canada.,Dalhousie University, Halifax, NS, Canada
| | | | | | - Jill Chorney
- IWK Health Halifax, Canada.,Dalhousie University, Halifax, NS, Canada
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Inoue N, Okanishi T, Inoue M, Maegaki Y. Psychological Preparations Affecting the Emotions of Children with Developmental Disorders Toward Hospitals. Yonago Acta Med 2021; 64:92-97. [PMID: 33642907 PMCID: PMC7902174 DOI: 10.33160/yam.2021.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/23/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND The psychological preparation factors associated with positive or negative emotions in pediatric patients with developmental disorders are not well known. We aimed to clarify which psychological preparation factors affect positive (favorable) or negative (fear) emotions toward hospitals in pediatric patients with autism spectrum disorder (ASD) or attention deficit hypertensive disorder (ADHD), using the questionnaires for the patients and guardians. METHODS The questionnaires were sent by mail via prefectural patient-family groups to pediatric patients (6 to 15 years old; diagnosed with ASD or ADHD) and their guardians living in seven prefectures in Japan. Thereafter, we statistically analyzed the associations between the background factors or psychological preparations and the patients' positive or negative emotions toward the hospital. RESULTS The questionnaire results of 68 patients (age: 6-15 years; 15 = females; 53 = males) and their guardians indicated the main diagnoses for patients were ASD (n = 54) and ADHD (n = 14). Intellectual disability and hypersensitivity were positively associated with fear experiences in the hospital. In contrast, the staff's explanations during interventions negatively associated with patients' fear experiences. The psychological preparations performed by doctors during the medical checks were positively associated with the patient's positive emotions toward the hospital. CONCLUSION Regarding the psychological preparations for patients with ASD or ADHD, interpersonal communication with doctors and staff promotes positive emotions and reduces anxiety in the hospital.
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Affiliation(s)
- Naho Inoue
- Student Support Center, Organization for Educational Support and International Affairs, Tottori University, Tottori 680-8550, Japan
- Division of Child Neurology, Brain and Neuroscience, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Tohru Okanishi
- Division of Child Neurology, Brain and Neuroscience, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Masahiko Inoue
- Department of Clinical Psychology, Graduate School of Medical Sciences, Tottori University, Yonago 683-8503, Japan
| | - Yoshihiro Maegaki
- Division of Child Neurology, Brain and Neuroscience, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
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Selvey P, Stypulkowski K, Waisbren S. Surgical management of the patient living with autism. Surg Open Sci 2020; 1:90-96. [PMID: 32754699 PMCID: PMC7391914 DOI: 10.1016/j.sopen.2019.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/11/2019] [Accepted: 06/17/2019] [Indexed: 11/26/2022] Open
Abstract
Background Although 1 in 59 children currently born are diagnosed with autism spectrum disorder (ASD), little is known on how to best manage those patients who require surgical intervention. The purpose of this study is to (1) investigate the best care strategies for surgical patients living with autism spectrum disorder (2) provide recommendations on how to apply those strategies to clinical practice. Methods A literature review was conducted to investigate the best clinical practices for optimizing surgical care for individuals living with autism spectrum disorder. Relevant articles were selected and examined, and individual references from those articles were manually searched using Ovid Medline and Google Scholar. Results The wide spectrum of symptoms associated with autism spectrum disorder pose unique challenges for surgical management. Early coordination with the patient and family optimizes the development of an effective care plan. Strategies include identifying triggers for anxiety as well as soothing mechanisms, performing surgery in the morning, completing preoperative paperwork prior to surgery, choosing appropriate analgesia and anxiolytics, and fast resumption of normal routines. Based on these findings a surgical checklist was created to aid in treating the patient with autism spectrum disorder. The checklist provides insight into navigating the surgical experience and emphasizes planning surgical interventions to most effectively fit individual patient needs. Conclusion The surgical treatment of those living with autism spectrum disorder poses unique challenges for the health care team. The widespread adoption of such individualized approaches encompassing pre/intra/post-operative will become more important as these children grow into adults with increased needs for surgical services.
Early coordination optimizes development of an effective care plan. Identifying triggers for anxiety as well as soothing mechanisms can be helpful. Performing surgery first in the morning decreases deviation from normal routines. Completing preoperative paperwork prior to surgery reduces surgical day work. Choosing appropriate analgesia and anxiolytics assists in surgical interventions.
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Affiliation(s)
- Paige Selvey
- University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, United States
| | - Katie Stypulkowski
- University of Colorado Colorado Springs, 1420 Austin Bluffs Pkwy, Colorado Springs, CO 80918, United States
| | - Steven Waisbren
- University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, United States.,Minneapolis VA Health Care System, 1 Veterans Drive Ste 2J, Minneapolis, MN 55417, United States
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Straus J, Coburn S, Maskell S, Pappagianopoulos J, Cantrell K. Medical Encounters for Youth With Autism Spectrum Disorder: A Comprehensive Review of Environmental Considerations and Interventions. CLINICAL MEDICINE INSIGHTS-PEDIATRICS 2019; 13:1179556519842816. [PMID: 31065222 PMCID: PMC6488780 DOI: 10.1177/1179556519842816] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 03/13/2019] [Indexed: 11/30/2022]
Abstract
Approximately 1 in 59 youth are currently diagnosed with autism spectrum disorder
(ASD), a neurodevelopmental disorder. In comparison to typically developing
peers, youth with ASD encounter hospitalization at higher rates due to their
heightened health care needs. While visiting the hospital is a stressor for
youth with neurotypical needs, the experience contains unique challenges for
those with ASD. This systematic literature review highlights research that
considers the psychosocial impact of the hospital environment on the coping and
adjustment of youth with ASD. Specifically, the review focuses on
recommendations and interventions that may be used by health care professionals
while supporting this population as they encounter the health care system.
Ninety-six articles were identified as meeting inclusion and exclusion criteria.
The findings suggest that practicing clinicians should implement a wide variety
of interventions for youth with ASD including diversion techniques, comfort
positions, and picture schedules. Although there are published evidence-based
interventions for supporting youth with ASD in the hospital, most clinicians
lack ASD-specific training. This article concludes with recommendations for
future research.
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Affiliation(s)
- Jolie Straus
- Department of Child Study and Human Development, Tufts University, Medford, MA, USA
| | - Sarah Coburn
- Department of Child Study and Human Development, Tufts University, Medford, MA, USA
| | - Stephanie Maskell
- Department of Child Study and Human Development, Tufts University, Medford, MA, USA
| | | | - Kathryn Cantrell
- Department of Child Study and Human Development, Tufts University, Medford, MA, USA
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Czornobay LFM, Munhoz EA, Lisboa ML, Rath IBS, de Camargo AR. Autism spectrum disorder: Review of literature and dental management. World J Stomatol 2018; 6:11-18. [DOI: 10.5321/wjs.v6.i2.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/16/2018] [Accepted: 11/14/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Luiz Fernando M Czornobay
- Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Etiene Andrade Munhoz
- Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Mariah L Lisboa
- University Hospital Professor Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis 88036-800, Brazil
| | - Inês Beatriz S Rath
- Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Alessandra R de Camargo
- Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
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Wilson SA, Peterson CC. Medical care experiences of children with autism and their parents: A scoping review. Child Care Health Dev 2018; 44:807-817. [PMID: 30136407 DOI: 10.1111/cch.12611] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 07/08/2018] [Accepted: 07/23/2018] [Indexed: 11/29/2022]
Abstract
Children with autism spectrum disorder (ASD) and their families may benefit from the provision of additional supports in health care settings, particularly when preparing for and attending medical appointments. This review examined literature that describes experiences in medical care settings from the perspective of patients under age 18 with ASD and their caregivers. A scoping review was conducted to examine the experiences of children with ASD and their families in medical care settings. Twenty-nine studies meeting inclusion criteria were identified and reviewed. The review indicated a number of challenges (e.g., parent-reported problems in parent-provider communication and overwhelming environments) as well as factors that facilitate positive experiences (e.g., providing positive reinforcement and explaining exam steps) during medical appointments. Children with ASD and their families are faced with many challenges while receiving care in medical settings. The present review identified many challenges families face, as well as facilitators of positive experiences. Understanding the unique experiences of patients with ASD and their parents will help to improve experiences in medical care settings for children, caregivers, and health care providers.
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Affiliation(s)
- Shelby A Wilson
- Department of Applied Behavior Analysis Services, The Children Center of Wayne County, Detroit, Michigan
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8
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Brown JJ, Gray JM, Roback MG, Sethuraman U, Farooqi A, Kannikeswaran N. Procedural sedation in children with autism spectrum disorders in the emergency department. Am J Emerg Med 2018; 37:1404-1408. [PMID: 30528052 DOI: 10.1016/j.ajem.2018.10.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/11/2018] [Accepted: 10/15/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Children with autism spectrum disorder (ASD) present more frequently to the emergency department (ED) than children with normal development, and frequently have injuries requiring procedural sedation. Our objective was to describe sedation practice and outcomes in children with ASD in the ED. METHODS We performed a retrospective chart review of children with ASD who underwent sedation at two tertiary care EDs between January 2009-December 2016. Data were collected on children 1-18 years of age with ASD who were sedated in the ED. RESULTS There were 6020 ED visits by children with ASD, 126 (2.1%) of whom received sedation. The most frequent indications for sedation were laceration repair (24.6%), incision and drainage (17.5%), diagnostic imaging (14.3%), and physical examination (11.9%). The most common sedatives used were ketamine (50.8%) and midazolam (50.8%). Ketamine was most commonly given intravenously (71.9%), while midazolam was usually given intranasally (71.9%). Procedures could not be completed in 4 (3.2%) patients, and adverse events were noted in 23 (18.3%) patients. Only four (3.2%) patients required supplemental oxygenation, and one received positive pressure ventilation. CONCLUSIONS Children with autism in the ED commonly received sedation; one in four of which were for non-painful diagnostic procedures or physical examination. Over one-third received sedation via a non-parenteral route for intended minimal sedation. Sedative medication dosing and observed adverse events were similar to those reported previously in children without ASD. Emergency providers must be prepared to meet the unique sedation needs of children with ASD.
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Affiliation(s)
- James J Brown
- Wayne State University School of Medicine, Carman and Ann Adams Department of Pediatrics, Division of Emergency Medicine, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201, United States of America.
| | - James M Gray
- University of Minnesota Medical School, Division of Emergency Medicine, University of Minnesota Masonic Children's Hospital, 2450 Riverside Avenue, Minneapolis, MN 55454, United States of America
| | - Mark G Roback
- University of Minnesota Medical School, Division of Emergency Medicine, University of Minnesota Masonic Children's Hospital, 2450 Riverside Avenue, Minneapolis, MN 55454, United States of America
| | - Usha Sethuraman
- Wayne State University School of Medicine, Carman and Ann Adams Department of Pediatrics, Division of Emergency Medicine, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201, United States of America
| | - Ahmad Farooqi
- Wayne State University School of Medicine, Carman and Ann Adams Department of Pediatrics, Division of Emergency Medicine, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201, United States of America
| | - Nirupama Kannikeswaran
- Wayne State University School of Medicine, Carman and Ann Adams Department of Pediatrics, Division of Emergency Medicine, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201, United States of America
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Morris R, Muskat B, Greenblatt A. Working with children with autism and their families: pediatric hospital social worker perceptions of family needs and the role of social work. SOCIAL WORK IN HEALTH CARE 2018; 57:483-501. [PMID: 29667506 DOI: 10.1080/00981389.2018.1461730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Social workers with knowledge of autism can be valuable contributors to client- and family-centered healthcare services. This study utilized a qualitative design to explore pediatric hospital social workers' experiences and perceptions when working with children and youth with autism and their families. Interviews with 14 social workers in a Canadian urban pediatric hospital highlighted perceptions of the needs of families of children with autism in the hospital and challenges and benefits related to the role of social work with these families. Results suggest that pediatric social workers may benefit from opportunities to develop autism-relevant knowledge and skills.
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Affiliation(s)
- Rae Morris
- a The Redpath Centre , Toronto , Canada
- b School of Social Work , University of British Columbia , Vancouver , Canada
| | - Barbara Muskat
- c Department of Social Work , The Hospital for Sick Children , Toronto , Canada
| | - Andrea Greenblatt
- c Department of Social Work , The Hospital for Sick Children , Toronto , Canada
- d Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
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Koski S, Gabriels RL, Beresford C. Interventions for paediatric surgery patients with comorbid autism spectrum disorder: a systematic literature review. Arch Dis Child 2016; 101:1090-1094. [PMID: 27226525 DOI: 10.1136/archdischild-2016-310814] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 04/27/2016] [Accepted: 05/09/2016] [Indexed: 01/05/2023]
Abstract
AIMS To survey perioperative management practices for paediatric patients diagnosed with autism spectrum disorder (ASD). METHODS A systematic review was carried out of empirical studies and case reports published in peer-reviewed journals of current best practices and behavioural interventions for paediatric patients with ASD who had undergone surgery. RESULTS The final sample included 11 articles published between 1997 and 2016 that met broad inclusion criteria of surveying perioperative interventions for the ASD population. There is broad endorsement across the scant publications on this topic of the following practices: increased attention to individual patient needs, rehearsal and other desensitisation efforts, departure from a sole focus on sedation or restraint of the combative or uncooperative patient and engaging caregivers in tuning perioperative management to individual needs. CONCLUSIONS This review supports the need for an individualised structure and approach to the perioperative care of these unique patients.
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Affiliation(s)
- Scott Koski
- University of Colorado Anschutz Medical Campus and the Children's Hospital Colorado, Aurora, Colorado, USA
| | - Robin L Gabriels
- University of Colorado Anschutz Medical Campus and the Children's Hospital Colorado, Aurora, Colorado, USA
| | - Carol Beresford
- University of Colorado Anschutz Medical Campus and the Children's Hospital Colorado, Aurora, Colorado, USA
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11
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Thompson DG, Tielsch-Goddard A. Improving management of patients with autism spectrum disorder having scheduled surgery: optimizing practice. J Pediatr Health Care 2014; 28:394-403. [PMID: 24287372 DOI: 10.1016/j.pedhc.2013.09.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 09/17/2013] [Accepted: 09/20/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Surgical preparation for children with autism spectrum disorders can be a challenge to perioperative staff because of the unique individual needs and behaviors in this population. Most children with autism function best in predictable, routine environments, and being in the hospital and other health care settings can create a stressful situation. This prospective, descriptive, quality improvement project was conducted to optimize best practices for perioperative staff and better individualize the plan of care for the autistic child and his or her family. METHODS Forty-three patients with a diagnosis of autism or autistic spectrum disorder were seen over 6 months at a suburban pediatric hospital affiliated with a major urban pediatric hospital and had an upcoming scheduled surgery or procedure requiring anesthesia. Caregivers were interviewed before and after surgery to collect information to better help their child cope with their hospital visit. RESULTS In an evaluation of project outcomes, data were tabulated and summarized and interview data were qualitatively coded for emerging themes to improve the perioperative process for the child. DISCUSSION Findings showed that staff members were able to recognize potential and actual stressors and help identify individual needs of surgical patients with autism. The families were pleased and appreciative of the individual attention and focus on their child's special needs. Investigators also found increased staff interest in optimizing the surgical experience for autistic children.
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Abstract
OBJECTIVE Children with autism spectrum disorders (CWASDs) have more difficulty tolerating hospital procedures than many other children. The aim of this study was to identify parent and provider perspectives on barriers and facilitators to procedural care for CWASDs. METHODS Semistructured interviews were conducted with medical staff and parents of CWASDs. Those parents whose child with autism required a procedure in a tertiary care sedation unit and those whose child was enrolled in autismMatch (a research registry for individuals with autism) were recruited. Staff providing direct patient care in the tertiary care sedation unit were recruited. Participants were asked open-ended questions about factors contributing to or interfering with successful completion of medical procedures for CWASDs. Interviews were audio-recorded, transcribed verbatim, coded, and analyzed using modified grounded theory techniques. RESULTS Twenty mothers and 20 medical staff members were interviewed. Participants described 2 domains essential to care of CWASDs but in which barriers existed: (1) productive interactions between providers and families, largely dependent on advanced preparation and (2) modifications to healthcare organization and delivery in the areas of patient flow and clinical environment. Individualized care is essential to quality care in both domains. CONCLUSIONS Children with autism spectrum disorders require individualized interventions to maximize the quality of procedural care. However, many hospitals and providers are not sufficiently equipped to accommodate these children's needs. This study suggests that targeted improvements in preparation and communication between providers and families as well as modifications in patient flow and clinical environments have the potential to improve the quality and successful completion of procedures.
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Gandhi RP, Klein U. Autism spectrum disorders: an update on oral health management. J Evid Based Dent Pract 2014; 14 Suppl:115-26. [PMID: 24929596 DOI: 10.1016/j.jebdp.2014.03.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
UNLABELLED Dental professionals caring for patients with a diagnosis of autism spectrum disorder (ASD) will need to provide oral health care based on a family-centered approach that involves a comprehensive understanding of parental concerns and preferences, as well as the unique medical management, behaviors, and needs of the individual patient. BACKGROUND With the rising prevalence of autism spectrum disorders (ASD), oral health providers will find themselves increasingly likely to care for these patients in their daily practice. The purpose of this article is to provide a comprehensive update on the medical and oral health management of patients with autism spectrum disorders. METHODS The authors conducted a literature review by searching for relevant articles written in English in the PubMed database pertaining to the medical and oral health management of autism, including caries status, preventive, behavioral, trauma, and restorative considerations. CONCLUSIONS A detailed family centered approach based on parental preferences and concerns, the patient's challenging behaviors, and related comorbidities can serve to improve the treatment planning and oral health management of dental patients with ASD.
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Affiliation(s)
- Roopa P Gandhi
- Department of Pediatric Dentistry, Children's Hospital Colorado and University of Colorado School of Dental Medicine, Aurora, CO, USA.
| | - Ulrich Klein
- Department of Pediatric Dentistry, Children's Hospital Colorado and University of Colorado School of Dental Medicine, Aurora, CO, USA
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Lindberg S, von Post I, Eriksson K. The experiences of parents of children with severe autism in connection with their children’s anaesthetics, in the presence and absence of the perioperative dialogue: a hermeneutic study. Scand J Caring Sci 2012; 26:627-34. [DOI: 10.1111/j.1471-6712.2012.00971.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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