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      A scoping review of disparities in health and health-care service provisions experienced by adults with autism spectrum disorder

      e-literature-review

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          Abstract

          Purpose

          Adults with autism spectrum disorder (ASD) are more likely to have a poor health status because of being diagnosed with a range of physical and mental health conditions and experience disparities in health care. The purpose of this study is to find barriers to health care experienced by adults with ASD and find gaps in health care which health-care providers can work to fill.

          Design/methodology/approach

          This scoping review aimed to identify studies that report on disparities in health and health-care service provisions experienced by adults with ASD. The authors included articles that described health-care disparities for patients with ASD and were published in peer-reviewed journals between January 2010 and April 2022. The authors searched the following databases and medical journals to search for eligible studies: Google Scholar, Pubmed, Elsevier, Sage Publications and Embase. The authors comprehensively searched key terms related to ASD, health care and disparities.

          Findings

          The core defining features of ASD, which include communication and social impairments and deficits in sensory processing, were found to be barriers in the health-care experience of adults with ASD. Continued research and changes in health care, such as developing interventions to empower patients, adequately training providers and increasing the accessibility of the health-care system, are necessary to ensure adults with ASD receive adequate medical care.

          Research limitations/implications

          Additionally, clarifying the current literature on this topic can guide future research efforts to explore the influence of factors such as gender and the spectrum of autism itself leading to various levels of abilities and their influence on the health-care experience of adults with ASD.

          Practical implications

          Overall, the findings from this scoping review underline the importance of providing readily accessible evidence-based, age-appropriate primary and hospital health care for adults with ASD.

          Social implications

          Further interventions are needed to empower patients, adequately train providers, increase the accessibility of the health-care system, increase support for ASD patients and decrease discrimination.

          Originality/value

          This paper is a scoping literature review of the original work done by researchers in the field of developmental disorders and health care.

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          Most cited references12

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          • Abstract: found
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          Is Open Access

          Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach

          Background Scoping reviews are a relatively new approach to evidence synthesis and currently there exists little guidance regarding the decision to choose between a systematic review or scoping review approach when synthesising evidence. The purpose of this article is to clearly describe the differences in indications between scoping reviews and systematic reviews and to provide guidance for when a scoping review is (and is not) appropriate. Results Researchers may conduct scoping reviews instead of systematic reviews where the purpose of the review is to identify knowledge gaps, scope a body of literature, clarify concepts or to investigate research conduct. While useful in their own right, scoping reviews may also be helpful precursors to systematic reviews and can be used to confirm the relevance of inclusion criteria and potential questions. Conclusions Scoping reviews are a useful tool in the ever increasing arsenal of evidence synthesis approaches. Although conducted for different purposes compared to systematic reviews, scoping reviews still require rigorous and transparent methods in their conduct to ensure that the results are trustworthy. Our hope is that with clear guidance available regarding whether to conduct a scoping review or a systematic review, there will be less scoping reviews being performed for inappropriate indications better served by a systematic review, and vice-versa.
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            The health status of adults on the autism spectrum.

            Compared to the general pediatric population, children with autism have higher rates of co-occurring medical and psychiatric illnesses, yet very little is known about the general health status of adults with autism. The objective of this study was to describe the frequency of psychiatric and medical conditions among a large, diverse, insured population of adults with autism in the United States. Participants were adult members of Kaiser Permanente Northern California enrolled from 2008 to 2012. Autism spectrum disorder cases (N = 1507) were adults with autism spectrum disorder diagnoses (International Classification of Diseases-9-Clinical Modification codes 299.0, 299.8, 299.9) recorded in medical records on at least two separate occasions. Controls (N = 15,070) were adults without any autism spectrum disorder diagnoses sampled at a 10:1 ratio and frequency matched to cases on sex and age. Adults with autism had significantly increased rates of all major psychiatric disorders including depression, anxiety, bipolar disorder, obsessive-compulsive disorder, schizophrenia, and suicide attempts. Nearly all medical conditions were significantly more common in adults with autism, including immune conditions, gastrointestinal and sleep disorders, seizure, obesity, dyslipidemia, hypertension, and diabetes. Rarer conditions, such as stroke and Parkinson's disease, were also significantly more common among adults with autism. Future research is needed to understand the social, healthcare access, and biological factors underlying these observations.
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              The self system in reciprocal determinism.

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                Author and article information

                Contributors
                Journal
                AIA
                10.1108/AIA
                Advances in Autism
                AIA
                Emerald Publishing
                2056-3868
                2056-3868
                16 August 2022
                18 January 2023
                : 9
                : 1
                : 82-93
                Affiliations
                [1]Mailman School of Public Health, Columbia University , New York, New York, USA
                Author notes
                Harsimran Kaur Sidhu can be contacted at: hksidhu110@gmail.com
                Article
                690092 AIA-03-2022-0015.pdf AIA-03-2022-0015
                10.1108/AIA-03-2022-0015
                17536677-dbe1-4674-a9b3-6c0a0983aa17
                © Emerald Publishing Limited
                History
                : 28 March 2022
                : 26 April 2022
                : 25 July 2022
                Page count
                Figures: 2, Tables: 1, Equations: 0, References: 13, Pages: 12, Words: 6263
                Categories
                e-literature-review, Literature review
                cat-HSC, Health & social care
                cat-LID, Learning & intellectual disabilities
                Custom metadata
                M
                Web-ready article package
                Yes
                Yes
                JOURNAL
                included

                Health & Social care
                Developmental disability,Autism spectrum disorder,Health care,Cognitive factors,Behavioral factors,Barriers to health care,Health,Intellectual disability,Adults

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