15 Utilization of Emergency Department Services among Children with Neurodevelopmental Diagnoses: A Scoping Review
Notice bibliographique
Résumé
Abstract Background Children with neurodevelopmental diagnoses (NDDs) have complex health system needs which are often not adequately addressed due to the lack of suitable community services. As a result, these children use comparatively more healthcare resources and caregivers have no choice but to rely on emergency departments (EDs).The chaotic ED environment can be particularly challenging for children with sensory, communication, and behavioural issues, leading to increased stress and higher instances of sedation and restraint. A significant gap in the knowledge, experience, and training of ED staff regarding the care of neurodivergent patients only further exacerbates barriers to accessing quality care. Existing reviews tend to focus on a single NDD, often overlooking the shared features and frequent co-occurrence of these conditions. Objectives This scoping review aims to examine the extent of the literature for various NDDs related to ED utilization, identify common behavioural presentations to the ED, and highlight challenges faced by children with NDDs in this setting. Design/Methods The review was registered on the Open Science Framework. A systematic search was conducted across multiple databases to identify relevant studies (Embase, PSYCHINFO, MEDLINE, Web of Science, and CINAHL). The inclusion criteria focused on peer-reviewed articles involving children/youth (under 18) with a neurodevelopmental diagnosis, specifically examining hospital ED usage or visitation. A total of 5447 studies were screened using Covidence software, with 502 proceeding to full-text screening, including 61 case reports. Results Case reports included several behavioural presentations from conditions including Down syndrome, autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and intellectual disability. ASD and ADHD emerged as the most common NDDs presenting to the ED, comprising about 41% of all 502 studies. Children with NDDs incurred higher healthcare costs and faced more barriers to adequate care compared to their neurotypical peers. Additionally, autistic children were brought to the ED for various health concerns, including physical injuries from attempted suicide, bone fractures, constipation, psychiatric hospitalizations, and non-traumatic dental conditions Conclusion The findings of this review have significant practical implications for healthcare systems, policymakers, and clinicians, as they can inform strategies to improve access to appropriate care and support for neurodivergent children, alleviating the burden on EDs. Our review will also highlight gaps in the literature requiring further research to provide equitable care to children with NDDs.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,007 | 0,038 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,005 |
| Bibliométrie | 0,025 | 0,022 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».