Suchergebnisse

Enrollment in Medicaid facilitates access to needed services among transition-age youth on the autism spectrum and youth with intellectual disability (ID). There are long-standing programs to ensure that individuals with ID remain enrolled as they age; similar programs for autistic youth are newer, not as widespread, and may not be as effective. We compared Medicaid disenrollment and re-enrollment between transition-age youth on the autism spectrum, youth with ID, and youth with both diagnoses using a national claims-based prospective cohort study from 2008 through 2012. Autistic youth were most likely to disenroll and least likely to re-enroll. Disenrollment peaked for all three groups at ages 19 and 21. Transition-age youth on the autism spectrum experience more disruptions in access to Medicaid-reimbursed services than youth with ID. More equitable Medicaid enrollment options for autistic individuals are needed to ensure their access to critical health care as they age.

Objective: This study examines whether the Child Behavior Checklist (CBCL) can be used as an accurate psychiatric screening tool for children in community mental health settings. Method: Associations, logistic regression models, and receiver operating characteristic (ROC) analysis were used to test the predictive relationship between the CBCL and structured interview-derived diagnoses. Results: Associations between CBCL subscales and specific diagnoses were found, replicating results of previous research. Multivariate models and ROC scoring led to correct diagnostic predictions in a large majority of participants. Corresponding sensitivities, however, were deemed inadequate as they indicated that the screen would miss an unacceptably high number of cases. Conclusions: Using the CBCL as a diagnostic screening tool would result in a large number of cases being missed by the screen. Although the CBCL is unlikely to accurately identify children with specific diagnoses, it could be used as a triage tool to inform practitioners if an in-depth structured diagnostic interview is necessary.

Objective: This pilot study examined the effect of structural family therapy (SFT) on children's impairment and depressive symptomatology and mothers' depressive symptomatology and anxiety for 31 families served by a community mental health clinic. Method: A one group predesign/postdesign, with a baseline and two follow-up time points, was used. Results: A series of repeated measures analyses of variance showed significant improvement for mothers' depression, F(2, 36) = 6.93, p = .003, η2 = .278, and anxiety, F(2, 34) = 6.44, p = .004, η2 = .275. Mothers' ratings of their children's impairment significantly improved, F(2, 42) = 6.27, p = .005, η2 = .270, though children's self-rated impairment and depressive symptomatology did not change. Results were confirmed using random regression analyses. Conclusion: SFT has promise for simultaneously addressing mothers' and children's needs in community mental health settings. However, structural barriers impacting feasibility were identified and discussed.