Patterns of presentation to a Children's Hospital Emergency Department of patients with autism and/or intellectual disability with behaviours of concern

Daryl Efron; Emily Cull; James Fowler; Karen Dunn; Chidambaram Prakash

doi:10.3109/13668250.2022.2109824

Patterns of presentation to a Children's Hospital Emergency Department of patients with autism and/or intellectual disability with behaviours of concern

J Intellect Dev Disabil. 2023 Mar;48(1):40-45. doi: 10.3109/13668250.2022.2109824. Epub 2022 Sep 8.

Authors

Daryl Efron^{1

2

3}, Emily Cull¹, James Fowler^{1

4}, Karen Dunn⁴, Chidambaram Prakash⁵

Affiliations

¹ Health Services, Murdoch Children's Research Institute, Parkville, VIC, Australia.
² Department of General Medicine, The Royal Children's Hospital, Parkville, VIC, Australia.
³ Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.
⁴ Department of Emergency Medicine, The Royal Children's Hospital, Parkville, VIC, Australia.
⁵ Department of Mental Health, The Royal Children's Hospital, Parkville, VIC, Australia.

PMID: 39815858
DOI: 10.3109/13668250.2022.2109824

Abstract

Background: The aim of this study was to investigate the demographic, clinical characteristics, and service systems of patients with autism spectrum disorder (ASD) and/or intellectual disability presenting to a large paediatric hospital emergency department (ED) with behaviours of concern (BOC) over a two-year period.

Method: Retrospective audit of ED presentations with BOC in patients with ASD and/or intellectual disability from 1 January 2019 to 31 December 2020, at the Royal Children's Hospital, Melbourne, Australia.

Results: There were 124 presentations (84 patients) in 2019 and 129 presentations (82 patients) in 2020. The mean age was 11.7 years. 55% arrived by ambulance, 24% required physical restraint, and 26% required sedation. Re-presentation was predicted by single-parent household, child protection involvement, and requirement of an interpreter.

Conclusions: Children and adolescents with ASD and/or intellectual disability regularly present to ED with BOC. New models of care are required to better support this highly vulnerable patient group.

Keywords: Autism spectrum disorder; behaviours of concern; intellectual disability.