Date of Graduation

12-2023

Document Type

Thesis

Degree Name

Master of Arts in Psychology (MA)

Degree Level

Graduate

Department

Psychological Science

Advisor/Mentor

Quetsch, Lauren B.

Committee Member

Cavell, Timothy A.

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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