By the Numbers: Polypharmacy, outpatient autism care, pandemic behaviors | Spectrum
Illustration by Laurène Boglio
Welcome to the second edition of the By the Numbers newsletter. At Spectrum, we do our best to summarize the latest in autism research – and sometimes the best summary comes in the form of a chart or map. In this newsletter we bring interesting new research results to the point, which are conveyed most concisely through simple data visualizations.
Let us know what you think of the newsletter at news@spectrumnews.org or tell us about your own data-rich work.
According to a new study, people with autism often switch medications to control common co-occurring conditions like anxiety and attention deficit hyperactivity disorder (ADHD).
And about 30 percent of autistic people take three or more psychiatric drugs to treat these comorbidities, the study found.
“We were very surprised by the wide range and variety of drugs that are used to treat the same comorbidities and how often these have been changed in patients,” says Paul Avillach, Assistant Professor of Biomedical Informatics at Harvard Medical School. who directed the course.
The new paper analyzed insurance claims and completed prescriptions from approximately 27,000 autistic people enrolled in a major US health insurance company and looked at 24 commonly prescribed drugs in three broad categories: drugs to treat arousal and irritation; those who treat hyperactivity and ADHD; and those that treat mood and anxiety disorders.
Almost half of the people in the dataset, 40.6 percent, were prescribed only one drug, while 29.1 percent had two, 16.9 percent three, and 3.4 percent five.
The drugs prescribed by clinicians have also been inconsistent to treat the same co-occurring conditions. Of the people with autism and anxiety, 16.1 percent were prescribed aripiprazole, 30.1 percent quetiapine, and 13.1 percent risperidone.
The results appeared in JAMA Pediatrics in June.
Private psychiatric centers are most likely to offer autism treatments
Access to autism care is scattered across the United States. According to a new survey, children living in low-income rural areas have particularly limited access to outpatient psychosocial treatment facilities that offer autism treatments.
The researchers called 6,156 facilities listed in the Behavioral Health Treatment Services Locator of the Substance Abuse and Mental Health Services Administration (SAMHSA) in December 2018. Only half said they cared for children with autism. Those who do this are usually located near cities, with more non-white residents and more people living above the federal poverty line. Institutions that accept Medicaid or operate privately are also more likely to provide psychological services to autistic children than publicly operated institutions or those that do not accept Medicaid.
“We called every mental health facility in the country, which was a lot of work,” said senior investigator Jonathan Cantor, associate policy researcher at RAND Corporation, a not-for-profit think tank in Santa Monica, California. “In an ideal world, this would be just an additional question the government would ask every year when they review all mental health facilities.”
Cantor’s team published the results in Autism in June.
Autism behavior has changed during the pandemic
When schools closed and children with autism sat at home during the COVID-19 pandemic, many became distracted and hyperactive, according to a new online survey of 200 parents and carers.
In June 2020, 74 percent of respondents said the pandemic had “moderate to major effects” on their child’s behavior. But this influence was not evenly distributed:
Children in households with the lowest incomes were most likely to experience negative behavioral changes.
About 70 percent of the parents and carers surveyed said their child was more distracting and arguing more often than before the pandemic; 66 percent reported increased hyperactivity; and about half said their child had more aggressive behavior. However, the study relied solely on reports from parents and carers, so these results may be biased.
Researchers reported the results in Research in Developmental Disabilities in June.
Spectrum index:
9 times: The likelihood of a person with autism and intellectual disabilities being hospitalized due to COVID-19 compared to people without the conditions, according to a study in the Journal of Autism and Developmental Disorders in May.
18 percent: The percentage of 12 to 18 year olds from a group of more than 1,000 who were diagnosed with autism while attending an emergency psychiatric service in the Netherlands in 2016. Autistic girls who went to emergency services were more likely to be afraid than their non-autistic peers. Autistic boys and girls both had more severe psychiatric symptoms than their non-autistic peers, according to the study published in Autism in June.
1.5x: The likelihood of a family with an autistic child suffering from food insecurity due to financial pressures compared to families who do not have an autistic child, according to three-year data from the National Survey of Children’s Health. The results appeared in Autism in June.
About the same: The proportion of carers for children with or without autism – nearly three quarters – who report that hospital doctors listen carefully to their concerns and treat them with respect. However, carers for children with autism are less likely to recommend the hospital, researchers reported in Hospital Pediatrics in June.
Quote this article: https://doi.org/10.53053/ZXWM9893
