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. 2024 Apr;24(3):394-407.
doi: 10.1016/j.acap.2023.11.006. Epub 2023 Nov 10.

Optimizing Care for Autistic Patients in Health Care Settings: A Scoping Review and Call to Action

Holly K Harris  1 , Laura Weissman  2 , Eron Y Friedlaender  3 , Ann M Neumeyer  4 , Alexander J Friedman  5 , Sarah J Spence  6 , Chloe Rotman  7 , Shari Krauss  5 , Sarabeth Broder-Fingert  8 , Carol Weitzman  2
Affiliations

Optimizing Care for Autistic Patients in Health Care Settings: A Scoping Review and Call to Action

Holly K Harris et al. Acad Pediatr. 2024 Apr.

Abstract

Objective: We conducted a scoping review of interventions designed to improve the health care experiences of autistic individuals and assessed the methodology and outcomes used to evaluate them.

Methods: Literature from January 2005 to October 2020 was searched using PubMed, Excerpta Medica dataBASE (EMBASE), Cumulated Index to Nursing and Allied Health Literature (CINAHL), PsycINFO as well as hand searching. Studies included described an intervention for autistic individuals in inpatient or outpatient settings and evaluated the intervention using standardized methodology. Results were exported to Covidence software. Ten reviewers completed abstract screening, full text review, and then systematic data extraction of the remaining articles. Two reviewers evaluated each article at each stage, with a third reviewer arbitrating differences.

Results: A total of 38 studies, including three randomized controlled trials (RCTs) were included. Twenty-six (68%) took place in dental, psychiatric, or procedural settings. Interventions primarily focused on visit preparation and comprehensive care plans or pathways (N = 29, 76%). The most frequent outcome was procedural compliance (N = 15), followed by intervention acceptability (N = 7) and parent satisfaction (N = 6). Two studies involved autistic individuals and caregivers in study design, and no studies assessed racial/ethnic diversity on intervention impact.

Conclusions: Well-designed evaluations of interventions to support autistic individuals in pediatric health care settings are limited. There is a need to conduct large multi-site intervention implementation studies.

Keywords: autism; health equity; inpatient care; outpatient care.

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Conflict of interest statement

Declaration of Competing Interest This statement is to declare that the authors have no potential conflicts of interest relevant to this article.

Figures

Figure 1:
Figure 1:
Modified PRISMA Flow Diagram for Scoping Review *Reasons for exclusion at full text level: No clear outcome, n = 85; No full text available, n = 40; No clear study design, n = 38; Review article only, n = 16;No clear intervention, n = 12; Wrong patient population, n = 9; Wrong setting, n = 3; Letters to the Editor, n = 2; Consensus paper, n = 1 ; Dissertation, n =1 ; Duplicate, n= 1
See this image and copyright information in PMC

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