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Study Finds Inpatient Autism Treatment On The Rise


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The number of children with autism who are being hospitalized — often due to mental health concerns — is on the rise, particularly among teens with the developmental disorder, new research suggests.

In a study looking at data on over 2 million hospitalizations of California children ages 1 to 18, researchers at the Stanford University School of Medicine found that between 1999 and 2009, inpatient treatment related to autism nearly tripled.

The rise came as the number of hospitalizations related to other developmental disabilities including cerebral palsy, Down syndrome and intellectual disability remained largely steady, according to findings published in the May issue of the Journal of Autism and Developmental Disorders.

While the risk of hospitalization rose for kids with autism across all age groups, researchers found that the increase was most pronounced for those older than 11. Once children reached the ages of 15 to 18, individuals with autism were three-and-a-half times more likely than their peers without the developmental disorder to be hospitalized, the study found.

In all but the youngest children studied, mental health diagnoses were the most common reason those with autism were treated.

It’s unclear what precisely is driving the growth in hospitalizations, but researchers said that it could be due to a lack of outpatient and community resources as the number of people with autism has grown.

“Overwhelmed parents, schools and community providers of mental health resources may have been unable to meet the needs of these patients and this failure to treat adequately in the outpatient sector may have led to a direct increase in hospitalizations,” the study authors wrote.

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Comments (11 Responses)

  1. Jon K. Evans says:

    My only problem lies in what the treatment during these hospitalizations entail. If that treatment entails some form of invasive testing or treatment, then I say nuts to it. I have heard too many stories of children having needles put in private places to advocate it blindly. If the treatment entails working with the child, and treating him/her as a partner, then I say go for it.

  2. Hilary Moore says:

    It is very distressing to read this as the behaviours and feelings for people with ASD are perceived to be treatable conditions such as depression, stress & anxiety, phobias and perceived anti-social behaviours. For generations the medical sector has taken charge of these conditions and have been the leading professionals for diagnosing autism. Psychiatrists, speech therapists, occupational therapists and to a lesser degree psychologists have all held the decision making roles and treatment models for people with autism. This culture seeks to cure and looks at deficits compared to NORMAL they do not work from a strengths perspective or see the person as the expert in their own life.
    I am a social worker with children and family members who have Asperger syndrome or high functioning autism as is now called, I feel that a social work view around social challenges and functioning, with regards to the persons life, strengths and abilities is the way forward in the functional support of people with ASD. But social workers are also treated with distain from the medical sector and this is where the problem lies.

  3. Lisa V. says:

    My sister-in-law has been a psychiatric nurse for over 20 years and is currently working at a hospital where, she told me, the majority of her patients have behavioral issues (are on the spectrum), not psychiatric issues, but are not being serviced in the community, so their behaviors land them on the psych unit. She says this is not where they belong, that they should be in a less restrictive environment. It’s such a vicious circle.

  4. Rylin Hansen says:

    One factor perhaps being overlooked is the fact that for young people with Autism the world can become exponentially more unmanageable as adolescent hormones hit the mix, and as well as that, neurotypical peers begin to manifest more of the social behavior that is so challenging for Autistic kids. My perception of my own difficulties was that they stemmed from those causes.

  5. vmgillen says:

    This would be meaningful if hospital admissions were differentiated… for example, my daughter (Downs) was in more often for things like respiratory issues than my son (ASD) – but every psych admission was horrible! Initiated by school and bus company. in one case I found my 12 y.o. handcuffed to a metal chair. In all cases no one had any experience, let alone training, in ASD; the state legal advocate had to intervene to prevent medicating the kid into a coma.

    Lisa V., your SiL has it right. Psych is the respite/holding pen of last resort, used to fill the holes in support and training.

  6. Dadvocate says:

    Sadly, Lisa V.’s sister in law appears to have spotted an emerging trend, supported by the authors of this piece.

    Expect a lot more (likely avoidable) hospital admissions going forward. As physically manageable small children with autism plus challenging behaviors or co-morbid mental health issues grow into larger teens and young adults, the melt down or aggression once dealt with by a “pick up and run” exit may, if it involves an adult, quite easily escalate into a high risk incident involving (armed) first responders, some trained – some not. These community based scenarios are especially risky for the person on the spectrum in crisis. An admission into a highly restrictive hospital or institutional setting may be the only alternative to arrest (or worse.) so I’m not going to condemn the practice. These admissions may be the best way to avoid a possible catastrophic the community.

    What is clearly needed by the WHOLE of the autism community is a continuum of options and settings to meet the needs of each individual at various points and times in their lives. Depending on those needs it could be a largely independent and lightly supported setting in the community at large, a highly restrictive hospital setting…or any number of less restrictive, but structured, settings in-between these extremes. The tragedy is that the disability rights ideologues at HHS CMS DOJ NCD and many broad non DD advocacy groups don’t understand, appreciate, or even want to acknowledge that a “many sizes and shapes” approach to providing services and supports needs to operate alongside independent living, and the choice of setting decision should be left in the hands of the individual. In their current rigid civil rights based approach, these advocates have demonstrated an all too eager desire to eliminate any and all of the “in-between” service options that don’t meet their absurdly narrow and tortured definition of “community based”. More civil rights based litigation and threats of action lead to more restrictive institutional admissions, imagine that!

  7. wanda says:

    my son was put in the hospital because of his behavoirs the kid is put on med because of their temper i blame my self for letting this happen in my case because they didnt learn how to be have .or taut the med done it for them in my they are in the courts system and they think there bad kids .some thing need to be done to stop the from putting then in these hospital we need othere help with our kid not the courts or hospitals

  8. John Allan says:

    I think that a large proportion of this increase is because many people who are ‘diagnosed’ as having autism (ASD) do not actually have an ASD, but have primarily a psychiatric condition. Not a popular statement I know. It has come to the point now that any behavior whatsoever that is in the DSM under ASD, (but are also included under anxiety d/o, ADHD, bipolar d/o, sensory, etc), is assumed more now to be ‘autistic.’ It is what’s currently popular. A parent does not want a ‘mentally ill’ child, but an autistic child or child with autism is more acceptable for a variety of reasons in our current culture. Obviously this does NOT discount the people who do have autism and lack proper services and help.

  9. Alicia W says:

    I am the mother of an ASD 3 year old boy and I find this article and some aspects of the comments made so far frightening. His future according to this is either incarceration or hospitalization.

    There is nothing convenient in having a diagnosis of ASD for your child. You want the best for your beautiful baby and then you worry that you have drawn a bullseye on their back. All the sudden anything they do, that any undiagnosed kid of the same age would do, is considered spectrum behavior. Staring becomes stemming. I made up my mind when we got the diagnosis a year ago to be “all in” and accept the label. I also gave myself permission to set a no medicinal intervention limit. Those two decisions allowed me to move forward and to be open with friends and family. Wow what was I thinking! People show you who they are everyday. Now that I was listening on his behalf I could easily see which minds were open and which were closed.

    Professionals at all levels should be willing to support the community that they claim to work on behalf of in the least medically restrictive way. The facts are that these young boys become strong young men. As the numbers of diagnosis increases the need to make early intervention, parent support & education AND removal of fear and stigmatization skyrockets.

    Are we still in a place add a society where we “put away” anyone that does not meet our current “norms”? How many Stephen Hawking will we throw away this generation?

  10. Ines says:

    The trend for teens in the spectrum to be hospitalized will continue sadly. As noted earlier kids transition to their teens with the so various physical, biological, emotional etc,changes that are the same for neurotypicas but issues, reactions can be magnified or more difficult for a child in the spectrum. In addition, many kids in the spectrum can have comorbidities that makes it more challenging such as intellectual disbility, anxiety, depression, and other wihich translates into behavioral consequences. Definitely there is a need for hospitalization as last resource if needed. The experience does not have to be traumatic for the child if the staff were trained and equipped to treat the children in the spectrum. In addition, the need for competent supportive services is key as well, programs aimed to prepare parents. Medication management extremely key for providing a lifeline for some kids to be able to function in the community and keep them at home where there could be other risks without. Behavioral interventions to be learned by parents. Schools/staff need to really worked in what they document and proposed so nicely in their behavioral intervention plans and IEPs and not be so afraid of being more accountable to these kids and their families. Parents ultimately have to be their children’s own advocate, learn and educate about their child’s diagnoses and their rights and responsibilities.

  11. Alan Freestone says:

    Interesting results.
    Is the incidence of autism rising rapidly in the Cali area and THAT’s the reason for in increase in admissions, are doctors getting more ‘trigger happy’ with prescribing psych meds to these children, or is their some other reason? The article suggests that community services may be unable to cope with these children’s needs, but that doesn’t explain the tripling of admissions over a 10 year period!
    Alan Freestone

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