Children With Autism Spectrum Disorder at a Pediatric Hospital
Children With Autism Spectrum Disorder at a Pediatric Hospital
The aims of this review are to describe the behaviors that are challenging to HCPs and identify strategies used to address challenging behaviors when children with ASD are hospitalized.
This systematic review followed the steps of Cooper, Patel, and Lindsay (2009): 1) problem formulation, 2) data collection, 3) data evaluation, 4) analysis and interpretation, and 5) presentation of results. A search was completed for health care sources in CINAHL, Proquest, PsycINFO, and Medline 1997-present. Items were excluded if they were dissertations, books, or editorials, or if the focus was on parent experience related to receiving the diagnosis of autism for their child, measurement tools, siblings, and adults with autism. Multiple words were used to search for research and clinical practice references to literature on experiences surrounding the health care/hospitalization of children with ASD. Search terms were placed in online indices individually, and then in combination with one another: autism, autismspectrum disorder, ASD, Asperger's, childlife specialist, nursing, staff, behaviors,procedure, hospital, acute care hospitalization,staff, and parent. The inclusion criteria were a) parent or HCP and a child with ASD in acute health care or outpatient settings, such as dental visits; and b) publication in English language. All abstracts were reviewed based on their relevance to the review.
Eleven research or theory-based studies and 23 clinical practice articles covered the research questions. The selected literature was appraised to assess validity. Melnyk and Fineout- Overholt's (2005) system of seven levels of evidence from highest to lowest was used for the appraisal: (I) a systematic review or randomized controlled trials (RCT), (II) a minimum of one RCT, (III) controlled trials without randomization, (IV) case-control and cohort studies, (V) systematic reviews of qualitative and descriptive studies, (VI) single descriptive or qualitative study, and (VII) opinion of authorities or expert committees. Discerning and reporting the level of evidence was vital to the process of determining the clinical usefulness of the information on how to help children with ASD when they interface with the medical community. Level I evidence is superior to level VII evidence. However, themes across level VII can be a useful way to inform nursing strategies in lieu of higher level of evidence studies that are not available. In this review, two researchers independently discerned the categories for challenging behaviors and the strategies for dealing with these behaviors.
Aims of the Systematic Review
The aims of this review are to describe the behaviors that are challenging to HCPs and identify strategies used to address challenging behaviors when children with ASD are hospitalized.
Methods
This systematic review followed the steps of Cooper, Patel, and Lindsay (2009): 1) problem formulation, 2) data collection, 3) data evaluation, 4) analysis and interpretation, and 5) presentation of results. A search was completed for health care sources in CINAHL, Proquest, PsycINFO, and Medline 1997-present. Items were excluded if they were dissertations, books, or editorials, or if the focus was on parent experience related to receiving the diagnosis of autism for their child, measurement tools, siblings, and adults with autism. Multiple words were used to search for research and clinical practice references to literature on experiences surrounding the health care/hospitalization of children with ASD. Search terms were placed in online indices individually, and then in combination with one another: autism, autismspectrum disorder, ASD, Asperger's, childlife specialist, nursing, staff, behaviors,procedure, hospital, acute care hospitalization,staff, and parent. The inclusion criteria were a) parent or HCP and a child with ASD in acute health care or outpatient settings, such as dental visits; and b) publication in English language. All abstracts were reviewed based on their relevance to the review.
Eleven research or theory-based studies and 23 clinical practice articles covered the research questions. The selected literature was appraised to assess validity. Melnyk and Fineout- Overholt's (2005) system of seven levels of evidence from highest to lowest was used for the appraisal: (I) a systematic review or randomized controlled trials (RCT), (II) a minimum of one RCT, (III) controlled trials without randomization, (IV) case-control and cohort studies, (V) systematic reviews of qualitative and descriptive studies, (VI) single descriptive or qualitative study, and (VII) opinion of authorities or expert committees. Discerning and reporting the level of evidence was vital to the process of determining the clinical usefulness of the information on how to help children with ASD when they interface with the medical community. Level I evidence is superior to level VII evidence. However, themes across level VII can be a useful way to inform nursing strategies in lieu of higher level of evidence studies that are not available. In this review, two researchers independently discerned the categories for challenging behaviors and the strategies for dealing with these behaviors.
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