Hugo W. Moser Research at Kennedy Krieger, Inc.
Psychiatric crises are one of the most serious and potentially life-threatening conditions in children, adolescents, and adults with autism spectrum disorder (ASD). Beyond the obvious threat of injury, these crises can result in devastating outcomes such as loss of school/work/home placement as well as caregiver isolation, exhaustion, and financial strain. While knowledge of this problem is gaining awareness, little research is being devoted to understanding the prevalence and factors associated with psychiatric crises or how parents and providers manage these events. We suspect that current crisis response interventions (e.g., police, emergency room) may be traumatic rather than helpful. The goals of this study are to: a) determine the prevalence and correlates (demographic, clinical, and psychosocial) of psychiatric crises in individuals (3-25 years) with ASD; b) understand how parents/caregivers and providers manage these events; and c) develop a measure of psychiatric crisis that can be used for in research and clinical settings. This study will survey two large well-established samples, parents of an individual (child, adolescent, or young adult) with ASD and child psychiatrists. It is expected that over 15% of parents will report a psychiatric crisis involving their youth with ASD within the last 3 months, and that behaviors such as aggression and self-injury will be the leading cause of crises. Based on prior data, variables associated with psychiatric crises will include limited access to care, lower family quality of life, increased property destruction (in the home) and caregiver financial strain. Most caregivers will prefer not to use available crisis response plans but rather manage the crisis at home despite its potentially dangerous consequences. Most community psychiatrists will report lack of training and resources to manage psychiatric crises in individuals with ASD. These data will help develop early screening tools to prevent crises in high-risk individuals, as well as customized response interventions to manage individuals with ASD who are actively in crises. On a larger scale, the findings will be influential in promoting policy and health care changes that will enhance the quality of, and access to, medical (and psychiatric) care for individuals with ASD and improve the health and outcomes of adults with ASD from a lifetime perspective.
Medical/ Psychiatric Comorbidities, Psychiatric Comorbidities, Psychosocial Environment, Environmental Factors, Health Services Research, Prevalence/ Incidence, Risk Assessment, Screening/ Diagnosis/ Phenotyping, Treatment/ Prevention, Children (3-12 Years), Adolescents/ Young Adults (13-25 Years), Adults (>25 Years), Autism Spectrum Disorder, Aspergers/ High-Functioning Individuals With ASD, Low-Functioning/ Non-Verbal Individuals With ASD, Child Psychiatrists