Roma A. Vasa MD (is Director, Psychiatric Services, Center for Autism Services, Science and Innovation, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, and Professor of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine.), Vamsi K. Kalari MD, MS (was Child and Adolescent Psychiatrist, Kennedy Krieger Institute, and Instructor, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine.), Christopher A. Kitchen MS (is Senior Programmer Analyst, Johns Hopkins Bloomberg School of Public Health.), Hadi Kharrazi MD, PhD (is Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health.), John V. Campo MD (is Vice President, Psychiatric Services, Kennedy Krieger Institute, and Professor and Director, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine.), Holly C. Wilcox PhD, MS (is Professor, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health and Division of Child and Adolescent Psychiatry, Johns Hopkins School of Medicine. Please address correspondence to Holly C. Wilcox)
{"title":"急诊科自闭症谱系障碍儿童和青少年自杀风险筛查","authors":"Roma A. Vasa MD (is Director, Psychiatric Services, Center for Autism Services, Science and Innovation, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, and Professor of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine.), Vamsi K. Kalari MD, MS (was Child and Adolescent Psychiatrist, Kennedy Krieger Institute, and Instructor, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine.), Christopher A. Kitchen MS (is Senior Programmer Analyst, Johns Hopkins Bloomberg School of Public Health.), Hadi Kharrazi MD, PhD (is Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health.), John V. Campo MD (is Vice President, Psychiatric Services, Kennedy Krieger Institute, and Professor and Director, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine.), Holly C. Wilcox PhD, MS (is Professor, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health and Division of Child and Adolescent Psychiatry, Johns Hopkins School of Medicine. Please address correspondence to Holly C. Wilcox)","doi":"10.1016/j.jcjq.2024.11.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Youth with autism spectrum disorder (ASD) are over three times more likely to experience suicidal thoughts and behaviors (STB) than children in the general population. Screening to detect suicide risk is therefore critical for youth with ASD. This study examines the capacity of the Ask Suicide-Screening Questions (ASQ), a standard suicide screening tool, to detect suicide risk in children and adolescents with ASD who present to the pediatric emergency department (PED).</div></div><div><h3>Methods</h3><div>This is a retrospective chart review of 393 (2.1%) youth with ASD and 17,964 (97.9%) youth without ASD, aged 8 to 21 years, who presented to the PED of a large urban academic medical center between 2017 and 2020. During the study period, the ASQ was universally administered to children and adolescents who presented to the PED for any reason. Data extracted from the electronic health record included demographic information, presenting concerns, ASD diagnosis, and ASQ results.</div></div><div><h3>Results</h3><div>Autistic children and adolescents were more likely to present to the PED with STB at the first PED visit compared to non-autistic children (12.7% vs. 4.4%, <em>p</em> < 0.001). In both autistic and non-autistic groups, presenting concerns about STB were significantly associated with a positive ASQ screen. More autistic youth were found to have a positive ASQ without STB as their chief presenting complaint as compared to non-autistic youth (22.6% vs. 11.6%, <em>p</em> < 0.001). Youth with ASD endorsed each item of the ASQ at roughly twice the rate of those without ASD.</div></div><div><h3>Conclusion</h3><div>This preliminary descriptive study indicates that the ASQ may be a promising screening tool to assess suicide risk in autistic individuals. Further research on the predictive validity and overall reliability of the ASQ in youth with ASD is recommended.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 3","pages":"Pages 192-198"},"PeriodicalIF":2.3000,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Suicide Risk Screening in Children and Adolescents with Autism Spectrum Disorder Presenting to the Emergency Department\",\"authors\":\"Roma A. Vasa MD (is Director, Psychiatric Services, Center for Autism Services, Science and Innovation, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, and Professor of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine.), Vamsi K. Kalari MD, MS (was Child and Adolescent Psychiatrist, Kennedy Krieger Institute, and Instructor, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine.), Christopher A. Kitchen MS (is Senior Programmer Analyst, Johns Hopkins Bloomberg School of Public Health.), Hadi Kharrazi MD, PhD (is Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health.), John V. Campo MD (is Vice President, Psychiatric Services, Kennedy Krieger Institute, and Professor and Director, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine.), Holly C. Wilcox PhD, MS (is Professor, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health and Division of Child and Adolescent Psychiatry, Johns Hopkins School of Medicine. Please address correspondence to Holly C. Wilcox)\",\"doi\":\"10.1016/j.jcjq.2024.11.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Youth with autism spectrum disorder (ASD) are over three times more likely to experience suicidal thoughts and behaviors (STB) than children in the general population. Screening to detect suicide risk is therefore critical for youth with ASD. This study examines the capacity of the Ask Suicide-Screening Questions (ASQ), a standard suicide screening tool, to detect suicide risk in children and adolescents with ASD who present to the pediatric emergency department (PED).</div></div><div><h3>Methods</h3><div>This is a retrospective chart review of 393 (2.1%) youth with ASD and 17,964 (97.9%) youth without ASD, aged 8 to 21 years, who presented to the PED of a large urban academic medical center between 2017 and 2020. During the study period, the ASQ was universally administered to children and adolescents who presented to the PED for any reason. Data extracted from the electronic health record included demographic information, presenting concerns, ASD diagnosis, and ASQ results.</div></div><div><h3>Results</h3><div>Autistic children and adolescents were more likely to present to the PED with STB at the first PED visit compared to non-autistic children (12.7% vs. 4.4%, <em>p</em> < 0.001). In both autistic and non-autistic groups, presenting concerns about STB were significantly associated with a positive ASQ screen. More autistic youth were found to have a positive ASQ without STB as their chief presenting complaint as compared to non-autistic youth (22.6% vs. 11.6%, <em>p</em> < 0.001). Youth with ASD endorsed each item of the ASQ at roughly twice the rate of those without ASD.</div></div><div><h3>Conclusion</h3><div>This preliminary descriptive study indicates that the ASQ may be a promising screening tool to assess suicide risk in autistic individuals. Further research on the predictive validity and overall reliability of the ASQ in youth with ASD is recommended.</div></div>\",\"PeriodicalId\":14835,\"journal\":{\"name\":\"Joint Commission journal on quality and patient safety\",\"volume\":\"51 3\",\"pages\":\"Pages 192-198\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-11-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Joint Commission journal on quality and patient safety\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1553725024003337\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Joint Commission journal on quality and patient safety","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1553725024003337","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Suicide Risk Screening in Children and Adolescents with Autism Spectrum Disorder Presenting to the Emergency Department
Background
Youth with autism spectrum disorder (ASD) are over three times more likely to experience suicidal thoughts and behaviors (STB) than children in the general population. Screening to detect suicide risk is therefore critical for youth with ASD. This study examines the capacity of the Ask Suicide-Screening Questions (ASQ), a standard suicide screening tool, to detect suicide risk in children and adolescents with ASD who present to the pediatric emergency department (PED).
Methods
This is a retrospective chart review of 393 (2.1%) youth with ASD and 17,964 (97.9%) youth without ASD, aged 8 to 21 years, who presented to the PED of a large urban academic medical center between 2017 and 2020. During the study period, the ASQ was universally administered to children and adolescents who presented to the PED for any reason. Data extracted from the electronic health record included demographic information, presenting concerns, ASD diagnosis, and ASQ results.
Results
Autistic children and adolescents were more likely to present to the PED with STB at the first PED visit compared to non-autistic children (12.7% vs. 4.4%, p < 0.001). In both autistic and non-autistic groups, presenting concerns about STB were significantly associated with a positive ASQ screen. More autistic youth were found to have a positive ASQ without STB as their chief presenting complaint as compared to non-autistic youth (22.6% vs. 11.6%, p < 0.001). Youth with ASD endorsed each item of the ASQ at roughly twice the rate of those without ASD.
Conclusion
This preliminary descriptive study indicates that the ASQ may be a promising screening tool to assess suicide risk in autistic individuals. Further research on the predictive validity and overall reliability of the ASQ in youth with ASD is recommended.
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