Effectiveness of Adaptive Care Plans for Children with Developmental Disabilities During Outpatient Clinic Appointments

• In Event: Poster Session 09
  In Poster Session: PS 09 Topic - Developmental Disabilities

Abstract

Background: Many children with developmental disabilities have co-occurring medical conditions requiring visits to medical providers, but also demonstrate problematic behaviors and struggle to cooperate with these healthcare experiences (Bultas et al., 2016; Schieve et al., 2012). For example, Kogan et al. (2008) found that children with autism who have emotional or behavioral problems are more likely to have unmet healthcare needs, experience delayed or foregone care, or receive ineffective care compared to children without autism who have special healthcare needs. Therefore, it is important to examine interventions that may improve the healthcare experiences of children with developmental disabilities.
The current study examined the effectiveness of adaptive care plans, which are individualized patient-centered plans created to minimize the harmful effects of hospital experiences, and address the challenges that children with developmental disabilities experience during healthcare encounters (Liddle, Birkett, Bonjour, & Risma, 2018). Adaptive care plans are created through collaboration between caregivers of children with developmental disabilities and medical staff in an attempt to anticipate the psychosocial challenges that may be experienced by children with developmental disabilities in a healthcare setting. When adaptive care plans are utilized by medical personnel for the treatment of children with developmental disabilities, parents find the plans to be effective in addressing their child’s healthcare challenges (Balakas et al., 2015; Broder-Fingert et al.; 2016; Wittling et al., 2018).
Objectives & Methodology: The current study examines if adaptive care plans can positively affect psychosocial outcomes for children with developmental disabilities (specifically autism spectrum disorder) who have difficulties coping with medical encounters compared to children with other developmental disabilities who do not have adaptive care plans. Specifically, the current research is the first study to evaluate the effectiveness of adaptive care plans for children with ASD using an objective measure of psychosocial distress reported by child life specialists (i.e., as assessed by scores on the Psychosocial Risk Assessment in Pediatrics [PRAP]; Staab, Kalyman, & Lin, 2014). It was hypothesized that children with ASD would experience more positive psychosocial outcomes (i.e., lower PRAP subscale and overall scores) than those with other developmental disabilities when utilizing adaptive care plans. Analyses include the use of a 2 x 2 between-groups factorial ANOVAs for PRAP subscale and overall scores.
Results: One-hundred and sixty children between 3 and 18 years of age with developmental disabilities and their caregivers (child’s Mage = 8.10, SD = 3.75) participated in the study, and were recruited from outpatient clinics at a large Midwestern pediatric medical center. Data collection has concluded and data are being analyzed in order to determine the effectiveness of adaptive care plans for children with and without ASD.
Conclusion/ Significance: The current study informs future research on the effectiveness of adaptive care plans as an intervention for children with developmental disabilities undergoing healthcare experiences. The results have implications for clinical work by demonstrating which developmental disability or diagnostic group/s may benefit most from the use of adaptive care plans during medical encounters.

Authors

• Melissa Rae Liddle, Cincinnati Children’s Hospital Medical Center
  Presenting Author

• Tammy L. Sonnentag, Xavier University
  Non-Presenting Author