Implementation of the HANDS in Autism® coordinated care continuum: Changes in caregiver-reported patient problem behavior presence and intensity secondary to the implementation of HANDS in Autism® Model across home and school settings following acute inpatient hospitalization

Abstract

The HANDS in Autism® model focuses on providing follow-up services for adolescents aged 12-18 with autism spectrum disorder (ASD) or developmental disorders (DD), aiding their transition back to community life after acute inpatient hospitalization. This model emphasizes training and community team facilitation for sustainable coordinated care outcomes, targeting primarily families in the home environment while also supporting school and community teams. The study explored changes in patient problem behaviors in both home and school settings, using the Home Situation Questionnaire (HSQ) and School Situation Questionnaire (SSQ) completed by caregivers and school teams. These questionnaires assessed the presence and intensity of problem behaviors before hospital admission and throughout the year after discharge. Preliminary findings show a decrease in problem behaviors’ presence and intensity in both settings post-discharge, with a notable continuous decrease in the home setting over 12 months, underscoring the model's effectiveness in its primary intervention target. However, an increase in problem behavior intensity was observed in the school setting after 12 months, hinting at the potential influence of school personnel/district engagement levels on the intervention's effectiveness in educational environments.