Brief Report: Understanding Crisis Behaviors in Hospitalized Psychiatric Patients with Autism Spectrum Disorder--Iceberg Assessment Interview

Abstract

Children and adolescents with autism spectrum disorder (ASD) are at risk for emotional dysregulation and behavior problems that can escalate to levels requiring psychiatric hospitalization. Evaluating the etiology of such behaviors can be challenging for health care providers, as individuals with ASD can have difficulty self-reporting concerns. This brief report introduces the Iceberg Assessment Interview (IAI), a tool to organize and elucidate the assessment of issues potentially underlying problem behaviors. A summary of IAIs from a chart review of patients ages 5-18 with ASD (n = 23) admitted to a specialized psychiatric hospital unit illustrates the clinical utility of this tool. Summarized IAI data includes presenting crisis behaviors, caregiver-perceived environmental conditions, and underlying psychosocial and medical problems.

Keywords: Adolescents; Autism spectrum disorder; Children; Crisis behaviors; Functional assessment; Psychiatric hospital care.