Nav: Home

Adolescents with autism four times more likely to visit emergency department

February 28, 2017

Adolescents with autism spectrum disorder (ASD) use emergency-department services four times as often as their peers without autism, according to Penn State College of Medicine researchers. The findings suggest that youth with autism may need better access to primary care and specialist services.

The researchers looked at private insurance healthcare claims from 2005 to 2013 in 12- to 21-year-olds. Adolescents with autism included in the study received at least two separate diagnoses of ASD over the timeframe. Two diagnoses reduce the chance of including misdiagnoses.

Although there was no significant increase in autism rates among adolescents in the study over the nine-year period, emergency-department use in adolescents with autism increased five-fold, from 3 percent in 2005 to 16 percent in 2013. During the same time period, emergency-department use in adolescents without an autism diagnosis remained steady at around 3 percent. Researchers report their results in the Journal of Autism and Developmental Disorders.

On average, adolescents with autism had a four-times higher risk of visiting the emergency department than adolescents without ASD. Older adolescents with autism also visited the emergency department more often than their younger counterparts. A third of middle and late adolescents in this group had medical emergencies, compared to just one-tenth of early adolescents. Females were more likely to visit the emergency room than males and individuals living in rural areas were more likely to visit the emergency room than those living in urban areas.

There was an increase over the study period in adolescents with autism who visited the emergency department for a mental health crisis. By 2013, 22 percent of emergency-department visits included a behavioral health concern, compared to 12 percent in 2005.

Previous research has shown that although youth with autism should be visiting primary care doctors and specialists more often than their peers, these services are underused in adolescents with ASD.

Guodong Liu, assistant professor of public health sciences and lead author of the study, said there could be a link between this underuse of preventive care services and overuse of emergency-department services.

"We believe if their regular medical and behavioral specialist services served them better, a big portion of them would end up with fewer emergency-department visits," he said.

In addition, Liu said, changes related to puberty and the transition to adulthood may be more difficult to manage for youth with autism compared to their peers. However, their parents and other caregivers may not be aware that they need extra guidance and support at this vulnerable time.

Some adolescents with ASD may injure themselves physically during times of stress, by cutting themselves, for example.

"The consequence is they're more likely to end up in the emergency department," Liu said.

Liu hopes the study brings more attention to the behavioral and physical health needs of autistic adolescents, whom he said are both underserved and understudied -- especially compared to younger children with ASD.

He wants to see more data on adolescents with ASD to confirm his findings. He is planning a similar study of emergency-department use in adolescent Medicaid patients with autism. His goal is to plot an unbiased nationally representative picture of how this special population fares in terms of their emergency-department usage and, in related work, hospitalizations.

With an extensive background in data mining, Liu is also searching for modifiable factors that could be addressed to reduce emergency visits and resulting hospitalizations in adolescents with autism.

For now, he says, "These patients need to be actively taken care of and monitored. There should be better communication between these adolescents and their caregivers and with their regular pediatricians and specialists. If we can do those kinds of things we may help them have less frequent emergencies."
-end-
Other researchers on this study were Amanda M. Pearl and Michael J. Murray, Department of Psychiatry; Lan Kong, Division of Biostatistics and Bioinformatics, Department of Public Health Sciences; and Douglas L. Leslie, Division of Health Services and Behavioral Research, Department of Public Health Sciences, all at Penn State College of Medicine.

The National Institutes of Health and Penn State College of Medicine Junior Faculty Development Program funded this research.

Penn State

Related Autism Articles:

Genes, ozone, and autism
Exposure to ozone in the environment puts individuals with high levels of genetic variation at an even higher risk for developing autism than would be expected just by adding the two risk factors together, a new analysis shows.
A blood test for autism
An algorithm based on levels of metabolites found in a blood sample can accurately predict whether a child is on the autism spectrum of disorder (ASD), based upon a recent study.
New form of autism found
Autism spectrum disorders (ASD) affect around one percent of the world's population and are characterized by a range of difficulties in social interaction and communication.
Autism Speaks MSSNG study expands understanding of autism's complex genetics
A new study from Autism Speaks' MSSNG program expands understanding of autism's complex causes and may hold clues for the future development of targeted treatments.
Paths to Autism: One or Many?
A new report in Biological Psychiatry reports that brain alterations in infants at risk for autism may be widespread and affect multiple systems, in contrast to the widely held assumption of impairment specifically in social brain networks.
Raising a child with autism
Humans are resilient, even facing the toughest of life's challenges.
Explaining autism
Recognizing a need to better understand the biology that produces Autism Spectrum Disorder (ASD) symptoms, scientists at Duke-NUS Medical School (Duke-NUS) and the National Neuroscience Institute (NNI), Singapore, have teamed up and identified a novel mechanism that potentially links abnormal brain development to the cause of ASDs.
Autism breakthrough
Using a visual test that is known to prompt different reactions in autistic and normal brains, Harvard researchers have shown that those differences were associated with a breakdown in the signaling pathway used by GABA, one of the brain's chief inhibitory neurotransmitters.
New options for treating autism
The release of oxytocin leads to an increase in the production of anandamide, which causes mice to display a preference for interacting socially.
The Autism Science Foundation launches the Autism Sisters Project
The Autism Science Foundation, a not-for-profit organization dedicated to supporting and funding autism research, today announced the launch of the Autism Sisters Project, a new initiative that will give unaffected sisters of individuals with autism the opportunity to take an active role in accelerating research into the 'Female Protective Effect.'

Related Autism Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#529 Do You Really Want to Find Out Who's Your Daddy?
At least some of you by now have probably spit into a tube and mailed it off to find out who your closest relatives are, where you might be from, and what terrible diseases might await you. But what exactly did you find out? And what did you give away? In this live panel at Awesome Con we bring in science writer Tina Saey to talk about all her DNA testing, and bioethicist Debra Mathews, to determine whether Tina should have done it at all. Related links: What FamilyTreeDNA sharing genetic data with police means for you Crime solvers embraced...