Dataset Information

Toward Autism-Friendly Magnetic Resonance Imaging: Exploring Autistic Individuals' Experiences of Magnetic Resonance Imaging Scans in the United Kingdom, a Cross-Sectional Survey.

ABSTRACT:

Background

Autistic individuals might undergo a magnetic resonance imaging (MRI) examination for clinical concerns or research. Increased sensory stimulation, lack of appropriate environmental adjustments, or lack of streamlined communication in the MRI suite may pose challenges to autistic patients and render MRI scans inaccessible. This study aimed at (i) exploring the MRI scan experiences of autistic adults in the United Kingdom; (ii) identifying barriers and enablers toward successful and safe MRI examinations; (iii) assessing autistic individuals' satisfaction with MRI service; and (iv) informing future recommendations for practice improvement.

Methods

We distributed an online survey to the autistic community on social media, using snowball sampling. Inclusion criteria were: being older than 16, have an autism diagnosis or self-diagnosis, self-reported capacity to consent, and having had an MRI scan in the United Kingdom. We used descriptive statistics for demographics, inferential statistics for group comparisons/correlations, and content analysis for qualitative data.

Results

We received 112 responses. A total of 29.6% of the respondents reported not being sent any information before the scan. Most participants (68%) confirmed that radiographers provided detailed information on the day of the examination, but only 17.1% reported that radiographers offered some reasonable environmental adjustments. Only 23.2% of them confirmed they disclosed their autistic identity when booking MRI scanning. We found that quality of communication, physical environment, patient emotions, staff training, and confounding societal factors impacted their MRI experiences. Autistic individuals rated their overall MRI experience as neutral and reported high levels of claustrophobia (44.8%).

Conclusion

This study highlighted a lack of effective communication and coordination of care, either between health care services or between patients and radiographers, and lack of reasonable adjustments as vital for more accessible and person-centered MRI scanning for autistic individuals. Enablers of successful scans included effective communication, adjusted MRI environment, scans tailored to individuals' needs/preferences, and well-trained staff.

SUBMITTER: Stogiannos N

PROVIDER: S-EPMC10468562 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Toward Autism-Friendly Magnetic Resonance Imaging: Exploring Autistic Individuals' Experiences of Magnetic Resonance Imaging Scans in the United Kingdom, a Cross-Sectional Survey.

Stogiannos Nikolaos N Harvey-Lloyd Jane M JM Brammer Andrea A Cleaver Karen K McNulty Jonathan P JP Dos Reis Cláudia Sá CS Nugent Barbara B Simcock Clare C O'Regan Tracy T Bowler Dermot D Parveen Sophia S Marais Keith K Pavlopoulou Georgia G Papadopoulos Chris C Gaigg Sebastian B SB Malamateniou Christina C

Autism in adulthood : challenges and management 20230830 3

<h4>Background</h4>Autistic individuals might undergo a magnetic resonance imaging (MRI) examination for clinical concerns or research. Increased sensory stimulation, lack of appropriate environmental adjustments, or lack of streamlined communication in the MRI suite may pose challenges to autistic patients and render MRI scans inaccessible. This study aimed at (i) exploring the MRI scan experiences of autistic adults in the United Kingdom; (ii) identifying barriers and enablers toward successfu ...[more]

PMID: 37663444

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Project description:PurposePeople with autism face significant barriers when accessing healthcare services. Eye examinations present unique challenges. Accessibility of this healthcare sector for people with autism has not been investigated previously. The aim of this research was to investigate eye examination accessibility for autistic adults and produce recommendations for autism-friendly eyecare.MethodsTwo qualitative studies were conducted. In Study 1, 18 autistic adults took part in focus groups to elicit their eye examination experiences. Transcripts of the recorded discussions were thematically analysed. Study 1 findings were used to design autism-friendly eye examinations for autistic adults. These were conducted in Study 2. Twenty-four autistic adults participated in these examinations, during which they were interviewed about their experience and how it might be improved by reasonable modifications. Audio recordings of the interviews were content analysed.ResultsKnowledge of what to expect, in advance of the eye examination, could greatly reduce anxiety. Participants liked the logical structure of the examination, and the interesting instrumentation used. However, the examination and practice environment did include sensory challenges, due to lights, sound and touch. Changes in practice layout, and interacting with multiple staff members, was anxiety provoking. Participants expressed a need for thorough explanations from the optometrist that outlined the significance of each test, and what the patient was expected to do.ConclusionA number of accessiblity barriers were identified. These suggested that UK eye examinations are not very accessible for autistic adults. Barriers began at the point of booking the appointment and continued through to the dispensing of spectacles. These caused anxiety and stress for this population, but could be reduced with easy-to-implement adaptations. Based on the findings, recommendations are presented here for the whole eyecare team which suggest how more autism-friendly eye examinations can be provided.

Project description:Group differences in resting state functional magnetic resonance imaging connectivity between individuals with autism and typically developing controls have been widely replicated for a small number of discrete brain regions, yet the whole-brain distribution of connectivity abnormalities in autism is not well characterized. It is also unclear whether functional connectivity is sufficiently robust to be used as a diagnostic or prognostic metric in individual patients with autism. We obtained pairwise functional connectivity measurements from a lattice of 7266 regions of interest covering the entire grey matter (26.4 million connections) in a well-characterized set of 40 male adolescents and young adults with autism and 40 age-, sex- and IQ-matched typically developing subjects. A single resting state blood oxygen level-dependent scan of 8 min was used for the classification in each subject. A leave-one-out classifier successfully distinguished autism from control subjects with 83% sensitivity and 75% specificity for a total accuracy of 79% (P = 1.1 × 10(-7)). In subjects <20 years of age, the classifier performed at 89% accuracy (P = 5.4 × 10(-7)). In a replication dataset consisting of 21 individuals from six families with both affected and unaffected siblings, the classifier performed at 71% accuracy (91% accuracy for subjects <20 years of age). Classification scores in subjects with autism were significantly correlated with the Social Responsiveness Scale (P = 0.05), verbal IQ (P = 0.02) and the Autism Diagnostic Observation Schedule-Generic's combined social and communication subscores (P = 0.05). An analysis of informative connections demonstrated that region of interest pairs with strongest correlation values were most abnormal in autism. Negatively correlated region of interest pairs showed higher correlation in autism (less anticorrelation), possibly representing weaker inhibitory connections, particularly for long connections (Euclidean distance >10 cm). Brain regions showing greatest differences included regions of the default mode network, superior parietal lobule, fusiform gyrus and anterior insula. Overall, classification accuracy was better for younger subjects, with differences between autism and control subjects diminishing after 19 years of age. Classification scores of unaffected siblings of individuals with autism were more similar to those of the control subjects than to those of the subjects with autism. These findings indicate feasibility of a functional connectivity magnetic resonance imaging diagnostic assay for autism.

Project description:BackgroundMagnetic resonance imaging (MRI) is a noninvasive diagnostic tool that is commonly used to visualize soft tissues and anatomical structures. Many patients who undergo MRI scans experience anxiety. This multicenter study was conducted to assess anxiety levels experienced by patients who underwent MRI scans in the Palestinian radiology departments and identify the risk factors associated with higher levels of anxiety experienced by the patients.MethodsThis multicenter cross-sectional study was conducted in the radiology departments of different hospitals in the West Bank of Palestine using a questionnaire. The questionnaire collected different demographic data of the patients. A 100-mm visual analog scale (VAS) was used to assess the level of anxiety experienced by the patients who received MRI scans. The data were analyzed using SPSS version 28.ResultsA total of 383 patients participated in this study. Of the patients, 255 (66.6%) reported experiencing low, moderate, or high anxiety levels during the MRI scan. The median anxiety was 20.0 with an interquartile range (IQR) of 0.0-50.0 as measured using the 100-mm VAS. Higher anxiety levels were reported by the patients who were female (p-value < 0.001), unemployed (p-value = 0.009), and did not receive an MRI scan before (p-value = 0.001). In addition, the patients who received pelvis scans reported higher levels of anxiety compared to those who received scans for upper extremities (p-value = 0.031), abdomen (p-value = 0.033), pelvis (p-value = 0.043), and lower extremities (p-value = 0.016). In addition, the patients who received scans for the head/neck reported higher levels of anxiety compared to the patients who received scans for the lower extremities (p-value = 0.021).ConclusionThe findings of this study showed that a considerable proportion of the patients who received MRI scans in Palestinian hospitals experience anxiety. Radiologists and other decision-makers in the healthcare system should design effective measures to reduce anxiety and improve the experiences of patients who are female, unemployed, and those who are scheduled to receive MRI scans for the first time. Moreover, these interventions should particularly focus on the patients who are scheduled to receive scans for the pelvis and head/neck.

Dataset Information

Toward Autism-Friendly Magnetic Resonance Imaging: Exploring Autistic Individuals' Experiences of Magnetic Resonance Imaging Scans in the United Kingdom, a Cross-Sectional Survey.

Background

Methods

Results

Conclusion

Publications

Toward Autism-Friendly Magnetic Resonance Imaging: Exploring Autistic Individuals' Experiences of Magnetic Resonance Imaging Scans in the United Kingdom, a Cross-Sectional Survey.

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