The determinants of service complexity in children with intellectual disabilities

TitleThe determinants of service complexity in children with intellectual disabilities
Publication TypeJournal Article
Year of Publication2017
AuthorsStewart S.L, K. Hassani F, Poss J., Hirdes J.
JournalJ Intellect Disabil Res
Volume61
Issue11
Pagination1055-1068
Date PublishedNov
ISBN Number0964-2633
Accession Number29024219
Keywords*autism spectrum disorder, *bullying, *intellectual disability, *InterRAI, *learning disorder, *Mental health services, Adolescent, Autism Spectrum Disorder/epidemiology/*therapy, Bullying/*statistics & numerical data, Child, Child, Preschool, Comorbidity, Cross-Sectional Studies, Disabled Children/*statistics & numerical data, Female, Humans, Intellectual Disability/epidemiology/*therapy, Male, Mental Health Services/*statistics & numerical data, Mentally Disabled Persons/*statistics & numerical data, Ontario/epidemiology
Abstract

BACKGROUND: To date, little is known about the predictors of healthcare service utilisation in children with intellectual disability (ID). The aim of this study was to identify the factors associated with service complexity in children with ID in Ontario, Canada. METHODS: The population of this cross-sectional study consisted of 330 children with ID ages 4 to 18 years who accessed mental health services from November of 2012 to June of 2016 in four agencies. All participants completed the interRAI Child and Youth Mental Health and Developmental Disability Assessment Instrument, which is a semi-structured clinician-rated assessment that covers a range of common issues in children with ID. The outcome of this study was a service complexity variable based on (1) mental health service utilisation including any services provided to the child and (2) the management involved in providing that care. Eight individual items were summed, resulting in a scale that ranged from 0 to 8. Scores were then dichotomised into two groups: a score of 0-2 identified children with a low service complexity and a score of 3 or higher identified children with a high service complexity. RESULTS: After adjustment for other covariates, gender was not associated with service complexity. Children aged 11-14 years and children with autism spectrum disorder used over twofold higher levels of service complexity than children aged equal to or less than 10 years or children with other causes of ID. Moreover, victims of bullying, high scores on the family functioning scale or learning or communication disorder were associated with greater service complexity. CONCLUSIONS: The findings of this study indicate that a variety of factors are related to service complexity ranged from children's nonclinical (age and experiences of bullying) to clinical (e.g. aggression, learning/communication problems and autism spectrum disorder) characteristics.

URLhttps://www.ncbi.nlm.nih.gov/pubmed/29024219
DOI10.1111/jir.12423
Short TitleJournal of intellectual disability research : JIDRJournal of intellectual disability research : JIDR
Alternate JournalJournal of intellectual disability research : JIDR