284 - Integrated Mental Health Outcomes in Dual-Diagnosis Autistic Youth

Publication Number: 3273.284

Steven Merahn, Perimeter Healthcare, Orchard Lake, MI, United States; Shyanne Anthony, Perimeter Behavioral of Missouri, Waynesville, MO, United States; Brandy Pfeifer, Perimeter Behavioral Healthcare, Angier, NC, United States; Barbara H. Radebaugh, Perimeter Healthcare, Fort Collins, CO, United States

Background: Autistic youth in mental health crisis often present with complex clinical profiles, including multiple psychiatric conditions, emotional dysregulation, and trauma-related symptoms. These overlapping challenges necessitate multimodal interventions that target mental health needs in the context of autistic features. Based on a growing number of residential treatment referrals of youth with an autism diagnosis we developed a specialized model of care and treatment milieu grounded in the Autistic SPACE framework for autism-tailored care.

Objective: To determine the clinical and statistical significance of a specialized model of residential care and evaluate the implications for program efficacy and future development.

Design/Methods: Participants were 14 autistic youth (9 girls/5 boys) 12-17y (mean 14.8y ) admitted for residential treatment for primary psychiatric diagnoses with varying durations of care (3-8 months; mean 4.7 months), assessed on admission and discharge for psychiatric stability (Brief Psychiatric Rating Scale [BPRS]), interoceptive capacities (Multidimensional Assessment of Interoceptive Awareness for Youth [MAIA-Y]), trauma symptoms (Child and Adolescent Trauma Screen [CATS]), and autism-specific functional and behavioral domains (Core Autism Trait Inventory [CATI]). Statistical analyses included paired-sample t-tests, effect size calculations (Cohen's d), and descriptive analyses.

Results: The group showed statistically significant reductions in psychiatric symptoms with a large negative effect size. However, only one patient had a statistically significant downward trend; a second had a borderline p-value, and two participants had increases over time. Improvements in interoceptive awareness were highly significant overall and across all subscales; the largest improvements were in Self-Regulation, Emotional Awareness, and Trusting. Reduction in trauma symptoms was not statistically significant; the small-to-moderate effect size showed scores trending downward on average. This may reflect limited treatment time, small sample size, and instrument validity with neurodivergent populations. Autistic traits improved significantly overall and for each subscale. The strongest gains were in Sensory Sensitivity, Social Interaction, Cognitive Rigidity, and Communication.

Conclusion(s): This analysis supports the effectiveness of a multi-domain autism-informed mental health intervention model for autistic youth in residential care. Statistically significant improvements in psychiatric, functional, and interoceptive domains support the program's continued implementation and evolution.

Table 1
Admission Characteristics of 14 Autistic Youth Admitted to Residential Treatment

Table 2
Cohort-Level Assessment Results

Table 3
Subscale Results on Multidimensional Assessment of Interoceptive Awareness for Youth [MAIA-Y] and Core Autism Trait Inventory [CATI].