Mental Health Services for Autistic People with Intellectual Disability: An Exploratory Study on Patient and Treatment Characteristics, and Intervention - Outcome Associations

Figures & data

Table 1. Standardized assessment protocol for the AUP multicenter study.

	Time point
Assessments	T1	T2	T3
Medical assessment	X	X	X
Environmental factors^a), b)	X	X	X
Contextual factors^a)	X	X	X
Vineland^c)	X
SCQ	X
ABC^d)	X	X	X
PAC^e)	X	X	X
Psychiatric symptoms	X	X	X
Carer evaluation		X
Diagnosis	Final diagnosis and time for diagnosis registered
Interventions	Continuous registration of interventions and professionals involved

Assessments applied in the current studyin bold characters.

^a)Norwegian-developed checklist

^b)To be rated during the three first months of assessment

^c)Assessment is repeated at T3 for individuals with schizophrenia or those who have undergone large changes: Vineland Adaptive Behavior Scales II, expanded version.

^d)ABC, Aberrant Behaviour Checklist.

^e)PAC, Psychopathology in Autism Checklist.

Table 2. Demographics, diagnostic distribution and health region affiliation of participants receiving outpatient or inpatient treatment.

Variables	Outpatient treatment n = 74(49%)	Inpatient treatment n = 77(51%)	Df	p	φc	χ^2	F	ds
Gender^a)			1	.605	0.04	0.26
Females	26(35.1%)	24(31.2%)
Males	48(64.9%)	53(68.8%)
Age at consent^b)			149	.655			0.27	−0.07 95% CI {−.39, .25}^c)
Min-max	10–60	10–68
Mean (Median)	27.2 (23), SD = 11.1, iqrd) = 17	27.9 (26), SD = 1.7, iqr = 16
Level of ID^a)			1	.037*	0.17	4.33
Mild/moderate	44(59.5%)	58(75.3%)
Severe/profound	30(40.5%)	19(24.7%)
Diagnostic groups^a)			2	<.001**	0.32	15.37
Severe mental disorder	11(14.9%)	32(41.6%)
Other mental disorder	33(44.6%)	30(39.0%)
No mental disorder	30(4.5%)	15(19.5%)
Health Region affiliation^a)			3	<.001**	0.59	51.78
North	14(6.9%)	0(.0%)
Middle	22(29.7%)	6(7.8%)
West	10(13.5%)	0(.0%)
Southeast	28(37.8%)	71(92.2%)

*p < .05, **p < .001.

^a)Pearson’s Chi-Square Test of Independence, Cramer’s V for effect size.

^b)Independent Samples T-test. Cohen`s d_s for effect size.

^c)Lower and Upper 95% Confidence Interval for Cohen`s d_s.

^d)Interquartile range

Table 3. Interventions in outpatient and inpatient treatment groups.

Interventions	Outpatient treatment n = 74(49%)	Inpatient treatment n = 77(51%)	Df	p	φc	χ^2	t	F	ds
Patientdirected interventions
Psychotherapy n = 146	7(10.0%)	38(50.0%)	1	<.001**	0.433	27.34
Psychopharmacological treatment n = 148^a)	41(56.9%)	65(85.5%)	1	<.001**	0.317	14.86
Differentiated intervention plan n = 145^a)	24(34.3%)	40(53.3%)	1	.032*	0.021	5.32
Crisis management plan n = 150^a)	20(27.4%)	40(51.9%)	1	.002*	0.250	9.41
Warning signs identified n = 150^a)	39(53.4%)	50(64.9%)	1	.051	0.110	2.05
Supportive Interventions
Collaborative meetings n = 151^a)	62(83.8%)	72(93.5%)	1	.103	0.154	0.16
Community staff supervision/training n = 151^a), d)	72(97.3%)	74(96.1%)	1	1.000	0.033	0.00
Supervision of county level health services n = 150^a)	25(16.7%)	60(77.9%)	1	<.001**	0.441	29.11
Conversations with patients family n = 151^a)	31(41.9%)	47(61%)	1	.028*	0.192	5.54
Total number of interventions n = 143^b)			141	<.001**			−5.70	0.04	0.95 95% CI {.60, 1.30}^e)
Min-max	1–9	1–9
Mean (Median)	4.49 (4), SD = 1.881, iqr^f) = 3	6.36 (7), SD= 2.038, iqr = 3
Duration of treatment in months n = 114^c)			1(45.7)	<.001**				40.8	1.53 95% CI {1.10, 1.96}
Min-max	1–52	1–24
Mean (Median)	18.60 (18), SD=12.812, iqr = 17	5.86 (5), SD =3.453, iqr = 4

*p < .05, **p < .001.

^a)Pearson’s Chi-Square Test of Independence, Kramer’s V for effect size.

^b)Welch’s Independent Samples T-test. Cohen`s ds for effect size.

^c)Welch`s F-test was used for robust testing of equality of means due to non-normally distribution and differences in skewness.

^d)Yates ‘continuity correction for 2 × 2tables.

Table 4. Between-subjects effects of treatment intervention on PAC & ABC during treatment period from T1 to T2.

	PAC				ABC
Intervention	df	F	P	η^2p	df	F	p	η^2p
Inpatient/outpatient treatment	1,85	0.73	.397	0.008	1,90	4.41	0.039*	0.047
Psychopharmacological treatment	1,85	0.65	.422	0.008	1,90	0.27	0.604	0.003
Individual therapy	1,85	4.34	.040*	0.049	1,90	6.42	0.013*	0.067
Duration of treatment	1,85	1.51	.223	0.017	1,90	2.56	0.113	0.028
Age	1,85	0.93	.339	0.011	1,98	0.02	0.892	0.000
T1	1,85	27.95	.000*	0.247	1,90	8.91	0.004*	0.090

*p < .05, large effect sizes in bold.

Duration of treatment, age, and sum scores at T1 were used as covariates.

Table 5. Mean sum scores on PAC & ABC at the three time points for inpatients vs outpatients and pairwise comparisons of mean difference between time points, Bonferroni correction for multiple comparisons.

		T1		T1-T2		T2		T2-T3		T3		T1-T3
Measure		M	SD	Mean difference	p	M	SD	Mean difference	P	M	SD	Mean difference	p
PAC				12.2	<.001**			3.6	.037*			15.8	<.001**
	Outpatients n = 62	90.1	17.6			79.4	15.1			73.9	16.9
	Inpatients n = 63	87.9	22.0			74.3	15.1			72.5	19.5
ABC				17.7	<.001**			5.6	.018*			23.3	<.001**
	Outpatients n = 63	63.7	29.5			48.4	25.6			39.4	26.1
	Inpatients n = 61	55.4	32.8			35.2	26.2			33.1	24.5

*p<.05, **p<.001.

PAC range: 42(min)-168(max), ABC range: 0(min)-174(max).

Table

Scale	Number of items	α
General adjustment problems	12	.69
Psychosis	10	.76
OCD	7	.75
Depression	7	.76
Anxiety	6	.67

Table

Scale	Number of items	α
Irritability	15	.87
Lethargy	16	.88
Stereotypy	7	.77
Hyperactivity	16	.82
Inappropriate speech	4	.69