Date of Graduation

12-2023

Document Type

Thesis

Degree Name

Master of Arts in Psychology (MA)

Degree Level

Graduate

Department

Psychological Science

Advisor/Mentor

Lauren Quetsch

Committee Member

Cavell, Timothy

Second Committee Member

Kucharczyk, Suzanne

Keywords

autism spectrum disorder, emergency services, healthcare, problem behaviors

Abstract

Autistic youth are at an increased risk for needing emergency services as compared to neurotypical peers. In fact, approximately 20% of autistic youth will interact with police by the age of 21, and rates of emergency department visits are 30 – 70% higher among autistic individuals than neurotypical peers. While research has begun to explore the nature of emergency service use in this group, researchers have not yet assessed important individual-, family-, and community-level factors that may be associated with these encounters. This study aimed to address this gap in the field by 1) characterizing families of autistic children who utilize emergency services; 2) determining significant individual, family, and environmental correlates of family emergency service utilization; and 3) exploring family experiences and satisfaction with emergency service encounters. The current study employed a mixed-methods design to survey 77 caregivers of autistic individuals who endorsed current challenging child behavior. A subset of caregivers (N = 8) provided in-depth interviews about their experiences with emergency services. Approximately half of the sample (N = 38) endorsed emergency service use in the last 5 years due to a behavioral health or psychiatric concern. Child psychiatric comorbidities and child aggressive behavior were most associated with differences in emergency service use. In qualitative interviews, caregivers described a range of facilitators and barriers to emergency care. These findings shed light on clinical characteristics that may be important for developing prevention efforts. Additionally, caregiver accounts indicate a significant need for broad reform at the intersection of emergency care and autism services.

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