Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study.

ABSTRACT:

Objectives

To determine predictors of emergency department (ED) visits in a cohort of adolescents and adults with autism spectrum disorder (ASD).

Design

Prospective cohort study.

Setting

Community-based study from Ontario, Canada.

Participants

Parents reported on their adult sons and daughters with ASD living in the community (n=284).

Main outcome measures

ED visits for any reason, ED visits for medical reasons and ED visits for psychiatric reasons over 1?year.

Results

Among individuals with ASD, those with ED visits for any reason were reported to have greater family distress at baseline (p<0.01), a history of visiting the ED during the year prior (p<0.01) and experienced two or more negative life events at baseline (p<0.05) as compared with those who did not visit the ED. Unique predictors of medical versus psychiatric ED visits emerged. Low neighbourhood income (p<0.01) and living in a rural neighbourhood (p<0.05) were associated with medical but not psychiatric ED visits, whereas a history of aggression (p<0.05) as well as being from an immigrant family (p<0.05) predicted psychiatric but not medical emergencies.

Conclusions

A combination of individual and contextual variables may be important for targeting preventative community-based supports for individuals with ASD and their families. In particular, attention should be paid to how caregiver supports, integrative crisis planning and community-based services may assist in preventing or minimising ED use for this vulnerable population.

SUBMITTER: Lunsky Y 

PROVIDER: S-EPMC5541491 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature