Psychiatric hospitalization is a common occurrence for children with Autism Spectrum Disorder (ASD) and similar developmental disorders, with rates of admission six times higher than those for children without ASD[1]. However, specialized units for children with ASD are limited so these patients often receive treatment in general child and adolescent psychiatric units[2]. Overall, children with a diagnosis of ASD make up 7.4% of all children in MHO’s database discharged from an inpatient stay in years 2020-23. As such, understanding the unique needs and experiences of these children is crucial for improving their overall satisfaction and well-being.
Are children with ASD as satisfied with inpatient treatment as their non-ASD counterparts?
Overall, patients with ASD report similar levels of satisfaction as those without ASD (average satisfaction of 4.40 vs. 4.41; Net Promoter Scores of 39.3 vs. 39.1). However, the two groups do differ by age where ASD children are younger (10.2 vs 10.5 years old) and less likely to complete their own satisfaction survey rather than a caregiver doing so (92.3% vs 97.9%). We previously found that both age and who completes the survey impact satisfaction scores, so it is necessary to analyze ASD vs. non-ASD satisfaction with this in mind.
While we do tend to see the same pattern of higher satisfaction and lower Net Promoter Scores in ASD patients who complete their own satisfaction surveys vs when caregivers do so, we do not see meaningful differences in these metrics within the patient completed or caregiver completed groups. That is, when children complete their own satisfaction surveys, ASD and non-ASD patients provide similar scores and when caregivers complete satisfaction surveys, caregivers of ASD and non-ASD children score similarly.
Figure 1. Average satisfaction scores are similar among children and caregivers regardless of ASD status.
Figure 2. Children with and without ASD are more likely to be detractors than caregivers. 
Concluding words
Inpatient children with ASD are capable of providing their own opinions of their care, and their scores summarizing their satisfaction with their experience of care are similar to those without ASD. Facilities looking to better serve this population should consider incorporating specialized unit best practices that are also good candidates for general units, such as obtaining information from caregivers on the child’s features that may be specific to ASD (e.g., means of communication, effective calming techniques, or dangerous behaviors), creating spaces and activities appropriate for children with ASD, and training staff to work with children with ASD[1].
[1] McGuire K, Erickson C, Gabriels RL, Kaplan D, Mazefsky C, McGonigle J, Meservy J, Pedapati E, Pierri J, Wink L, Siegel M. Psychiatric Hospitalization of Children With Autism or Intellectual Disability: Consensus Statements on Best Practices. J Am Acad Child Adolesc Psychiatry. 2015 Dec;54(12):969-71. doi: 10.1016/j.jaac.2015.08.017. PMID: 26598469; PMCID: PMC4847534.
[2] Taylor, B.J., Sanders, K.B., Kyle, M. et al. Inpatient Psychiatric Treatment of Serious Behavioral Problems in Children with Autism Spectrum Disorder (ASD): Specialized Versus General Inpatient Units. J Autism Dev Disord 49, 1242–1249 (2019). https://doi.org/10.1007/s10803-018-3816-2