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      Healthcare access for autistic adults : A systematic review

      review-article
      , BHSc (Hons) , , BSc (Hons), MSc (JU), MApp Science (CQU), PhD (UQ), GradCertTeachLearn(HEd), , BScApp, BAppHSc (Hons), MHort, PhD, , BAppSc(OT), GCHE, PGDip(Biomech), PhD
      Medicine
      Wolters Kluwer Health
      adults, autism spectrum disorder, barriers, enablers, healthcare access

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          Abstract

          Supplemental Digital Content is available in the text

          Abstract

          Background:

          People with autism spectrum disorder (ASD) have an increased susceptibility for many chronic health conditions compared with their peers. An increasing number of adolescents are transitioning from pediatric to adult healthcare services. Thus, being able to access appropriate healthcare services that can not only address specific needs of the person but enable them to better manage healthcare conditions and decrease the development of preventable disease is necessary. A systematic review was conducted to identify barriers and enablers of healthcare access for autistic adults.

          Methods:

          The studies included in the review were quantitative and qualitative and were published between 2003 and 2019. The participants for the review are considered to be adults (over 18 years of age) with a primary diagnosis of ASD.

          Results:

          In total, 1290 studies were initially identified and 13 studies were included based on the inclusion and exclusion criteria outlined in a previous protocol paper. The analysis of these studies identified areas of concern to access appropriate healthcare, such as clinician knowledge, the environment, and life events.

          Conclusion:

          Identifying the barriers to healthcare, highlights ways healthcare services can regulate scope of practice, the physical environment, and the process of managing health conditions, thus, autistic adults can strive for optimal health. This review contributes to peer-reviewed evidence for future research and up-to-date information when developing and piloting health interventions for autistic adults.

          Ethics and dissemination:

          There are no human participants, data, or tissue being directly studied for the purposes of the review; therefore, ethics approval and consent to participate is not applicable.

          Registration and Status:

          PROSPERO 2018 CRD42018116093

          Related collections

          Most cited references31

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          A systematic review of early intensive intervention for autism spectrum disorders.

          Early intensive behavioral and developmental interventions for young children with autism spectrum disorders (ASDs) may enhance developmental outcomes. To systematically review evidence regarding such interventions for children aged 12 and younger with ASDs. We searched Medline, PsycINFO, and ERIC (Education Resources Information Center) from 2000 to May 2010. Two reviewers independently assessed studies against predetermined inclusion/exclusion criteria. Two reviewers independently extracted data regarding participant and intervention characteristics, assessment techniques, and outcomes and assigned overall quality and strength-of-evidence ratings using predetermined criteria. Thirty-four unique studies met inclusion criteria. Seventeen studies were case series; 2 were randomized controlled trials. We rated 1 study as good quality, 10 as fair quality, and 23 as poor quality. The strength of the evidence overall ranged from insufficient to low. Studies of University of California Los Angeles/Lovaas-based interventions and variants reported clinically significant gains in language and cognitive skills in some children, as did 1 randomized controlled trial of an early intensive developmental intervention approach (the Early Start Denver Model). Specific parent-training approaches yielded gains in short-term language function and some challenging behaviors. Data suggest that subgroups of children displayed more prominent gains across studies, but participant characteristics associated with greater gains are not well understood. Studies of Lovaas-based approaches and early intensive behavioral intervention variants and the Early Start Denver Model resulted in some improvements in cognitive performance, language skills, and adaptive behavior skills in some young children with ASDs, although the literature is limited by methodologic concerns.
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            A revised tool for assessing risk of bias in randomized trials

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              • Article: not found

              Social participation among young adults with an autism spectrum disorder.

              Investigating social participation of young adults with an autism spectrum disorder (ASD) is important given the increasing number of youth aging into young adulthood. Social participation is an indicator of life quality and overall functioning. Using data from the National Longitudinal Transition Study 2, we examined rates of participation in social activities among young adults who received special education services for autism (ASD group), compared to young adults who received special education for intellectual disability, emotional/behavioral disability, or a learning disability. Young adults with an ASD were significantly more likely to never see friends, never get called by friends, never be invited to activities, and be socially isolated. Among those with an ASD, lower conversation ability, lower functional skills, and living with a parent were predictors of less social participation.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                17 July 2020
                17 July 2020
                : 99
                : 29
                : e20899
                Affiliations
                Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn.
                Author notes
                []Correspondence: Shenae Calleja, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC 3122, Australia (e-mail: scalleja@ 123456swin.edu.au ).
                Article
                MD-D-19-09129 20899
                10.1097/MD.0000000000020899
                7373620
                32702830
                2542dbbd-a862-4091-b267-d1331f040e84
                Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 21 November 2019
                : 22 January 2020
                : 16 May 2020
                Categories
                5400
                Research Article
                Systematic Review and Meta-Analysis
                Custom metadata
                TRUE

                adults,autism spectrum disorder,barriers,enablers,healthcare access

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