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      A Systematic Review of What Barriers and Facilitators Prevent and Enable Physical Healthcare Services Access for Autistic Adults

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          Abstract

          Autistic people are more likely to: be diagnosed with a range of physical health conditions (i.e. cardio-vascular disease); experience premature mortality (for most disease categories); and experience barriers to effectively accessing healthcare. This systematic review sought to identify studies that report on barriers and facilitators to physical healthcare access for autistic people. A total of 3111 records were screened and six studies were included: two quantitative, two qualitative, and two mixed-methodology studies. Patient-provider communication, sensory sensitivities, and executive functioning/planning issues emerged as important barriers to healthcare. Recommendations for clinicians and those planning services are discussed.

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          The online version of this article (10.1007/s10803-019-04049-2) contains supplementary material, which is available to authorized users.

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          Sensory processing in autism: a review of neurophysiologic findings.

          ELYSA J. MARCO, LEIGHTON HINKLEY, SUSANNA HILL … (2011)
          Atypical sensory-based behaviors are a ubiquitous feature of autism spectrum disorders (ASDs). In this article, we review the neural underpinnings of sensory processing in autism by reviewing the literature on neurophysiological responses to auditory, tactile, and visual stimuli in autistic individuals. We review studies of unimodal sensory processing and multisensory integration that use a variety of neuroimaging techniques, including electroencephalography (EEG), magnetoencephalography (MEG), and functional MRI. We then explore the impact of covert and overt attention on sensory processing. With additional characterization, neurophysiologic profiles of sensory processing in ASD may serve as valuable biomarkers for diagnosis and monitoring of therapeutic interventions for autism and reveal potential strategies and target brain regions for therapeutic interventions.
          Article 0 comments Cited 268 times – based on 0 reviews     Review now
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            Employment and post-secondary educational activities for young adults with autism spectrum disorders during the transition to adulthood.

            Alicia M. Seltzer, Julie Taylor (2011)
            This report describes the post-high school educational and occupational activities for 66 young adults with autism spectrum disorders who had recently exited the secondary school system. Analyses indicated low rates of employment in the community, with the majority of young adults (56%) spending time in sheltered workshops or day activity centers. Young adults with ASD without an intellectual disability were three times more likely to have no daytime activities compared to adults with ASD who had an intellectual disability. Differences in behavioral functioning were observed by employment/day activity group. Our findings suggest that the current service system may be inadequate to accommodate the needs of youths with ASD who do not have intellectual disabilities during the transition to adulthood.
            Article 0 comments Cited 159 times – based on 0 reviews     Review now
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              Sensitivity and specificity of proposed DSM-5 diagnostic criteria for autism spectrum disorder.

              James C. McPartland, Brian Reichow, Fred Volkmar (2012)
              This study evaluated the potential impact of proposed DSM-5 diagnostic criteria for autism spectrum disorder (ASD). The study focused on a sample of 933 participants evaluated during the DSM-IV field trial; 657 carried a clinical diagnosis of an ASD, and 276 were diagnosed with a non-autistic disorder. Sensitivity and specificity for proposed DSM-5 diagnostic criteria were evaluated using field trial symptom checklists as follows: individual field trial checklist items (e.g., nonverbal communication); checklist items grouped together as described by a single DSM-5 symptom (e.g., nonverbal and verbal communication); individual DSM-5 criterion (e.g., social-communicative impairment); and overall diagnostic criteria. When applying proposed DSM-5 diagnostic criteria for ASD, 60.6% (95% confidence interval: 57%-64%) of cases with a clinical diagnosis of an ASD met revised DSM-5 diagnostic criteria for ASD. Overall specificity was high, with 94.9% (95% confidence interval: 92%-97%) of individuals accurately excluded from the spectrum. Sensitivity varied by diagnostic subgroup (autistic disorder = 0.76; Asperger's disorder = 0.25; pervasive developmental disorder-not otherwise specified = 0.28) and cognitive ability (IQ < 70 = 0.70; IQ ≥ 70 = 0.46). Proposed DSM-5 criteria could substantially alter the composition of the autism spectrum. Revised criteria improve specificity but exclude a substantial portion of cognitively able individuals and those with ASDs other than autistic disorder. A more stringent diagnostic rubric holds significant public health ramifications regarding service eligibility and compatibility of historical and future research. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                David Mason: +44 191 282 1379 , David.Mason@newcastle.ac.uk
                Journal
                Journal ID (nlm-ta): J Autism Dev Disord
                Journal ID (iso-abbrev): J Autism Dev Disord
                Title: Journal of Autism and Developmental Disorders
                Publisher: Springer US (New York )
                ISSN (Print): 0162-3257
                ISSN (Electronic): 1573-3432
                Publication date (Electronic): 23 May 2019
                Publication date PMC-release: 23 May 2019
                Publication date (Print): 2019
                Volume: 49
                Issue: 8
                Pages: 3387-3400
                Affiliations
                [1 ]ISNI 0000 0001 0462 7212, GRID grid.1006.7, Institute of Neuroscience, , Newcastle University, ; Sir James Spence Institute level 3, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP UK
                [2 ]GRID grid.451089.1, Northumberland, Tyne & Wear NHS Foundation Trust, ; Newcastle upon Tyne, UK
                [3 ]ISNI 0000 0001 2163 3550, GRID grid.1017.7, Global, Urban and Social Studies, , RMIT University, ; Melbourne, VIC Australia
                [4 ]London, UK
                [5 ]ISNI 0000 0001 0462 7212, GRID grid.1006.7, Newcastle University, ; Newcastle upon Tyne, UK
                [6 ]ISNI 0000000406413260, GRID grid.156122.3, Campus for Ageing and Vitality, , Newcastle General Hospital, ; Newcastle upon Tyne, UK
                [7 ]NHS North Tyneside CCG, North Shields, UK
                [8 ]ISNI 0000 0001 1087 1481, GRID grid.262075.4, Portland State University, ; Portland, USA
                Article
                Publisher ID: 4049
                DOI: 10.1007/s10803-019-04049-2
                PMC ID: 6647496
                PubMed ID: 31124030
                SO-VID: e17a7663-d982-444f-8391-b110fa2785bf
                Copyright © © The Author(s) 2019
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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                Subject: Original Paper
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                issue-copyright-statement © Springer Science+Business Media, LLC, part of Springer Nature 2019

                ScienceOpen disciplines: Neurology
                Keywords: autism,adult,healthcare access,physical health,barriers,sensory sensitivities
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: autism, adult, healthcare access, physical health, barriers, sensory sensitivities

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