Sustainability of a Care Pathway for Children and Adolescents with Autism Spectrum Disorder on an Inpatient Psychiatric Service
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Children with autism spectrum disorder (ASD) are frequently hospitalized within general psychiatric settings, which are not usually designed to meet their needs. An initial evaluation of a care pathway developed for youth with ASD receiving services in a general psychiatric inpatient unit (ASD-CP) showed promise in improving outcomes while using few resources (Kuriakose et al. in J Autism Dev Disord 48:4082–4089, 2018). As sustainability of inpatient psychiatric initiatives is imperative but rarely investigated, this study examined the stability of ASD-CP outcomes during an 18-month follow-up period (n = 15) compared to the 18-month initial evaluation (n = 20) and 18-month pre-implementation (n = 17) periods. Decreased use of crisis interventions, including holds/restraints and intramuscular medication use, was sustained in the 18 months after the initial implementation period. Implications and limitations are discussed.
KeywordsAutism spectrum disorder Care pathway Inpatient hospitalization Psychiatric
The training and implementation of the ASD Care Pathway was supported by the New York City Department of Health and Mental Hygiene (816-1515-0436.A01).
PC participated in the design of the study, performed statistical analyses, and helped to draft the manuscript. SK designed the intervention, participated in the study design, and helped to draft the manuscript. LD oversaw the ASD-CP implementation, participated in the study design, and helped to draft the manuscript. BF coordinated the intervention implementation, participated in the study design and coordination, and helped to draft the manuscript. MM co-designed the intervention, designed the study database, and helped to draft the manuscript. EO helped coordinate ASD-CP implementation, coordinated data collection, helped perform statistical analyses, and helped to draft the manuscript. KV assisted with data collection coordination and helped to draft the manuscript. JH oversaw the implementation, participated in its design and coordination, and helped to draft the manuscript. SH designed the study, participated in the interpretation of the data, and helped to draft the manuscript. All authors read and approved the final manuscript.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
A waiver for authorization was granted for this study by the Institutional Review Boards of both institutions.
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