Anne-Marie N. Huyghen

Little is known about psychological and pharmacological treatment of patients with an autism spectrum disorder (ASD) and comorbid obsessive-compulsive disorder (OCD). We systematically searched PubMed, Embase, and PsycInfo for intervention studies evaluating treatment effects for patients with concurrent diagnoses of ASD and OCD. The search yielded 6594 articles of which after sequential checks of duplicates, title, abstract and full text, eight articles could be included. One study concerned a RCT, four were before-after studies with a control group, and three remaining studies were before-after studies without a control group. All studied the effect of cognitive behavioral therapy (CBT), which appears to be generally effective in treatment of OCD in people with ASD. Further research is needed to determine whether ASD specific CBT protocols are more effective in reducing OCD symptoms than regular CBT.

Behavioral and emotional problems can lead to severe restrictions in the functioning of children and to an impaired development. The types of support for children vary greatly between care providers. The aim of this study is to apply the Taxonomy of Care for Youth (TOCFY) and to make an inventory of the core elements and program elements of the various types of support for children with behavioral and emotional problems that were offered overall and per main types of providers in a delineated region. We assessed the types of support to children (N = 621) by applying TOCFY. The study showed that by using Tocfy we could make an inventory of the various types of support offered. ‘Individual child support’ and ‘family support’ were provided most often, and therefore, most interventions were aimed at the child or at the child and his/her parents/caretakers. Support was mostly provided without judicial interference and within an ambulatory/outpatient or home-based setting. TOCFY could be helpful by mapping of information on the support offered to children across various types of care providers. More information on the core and program elements of these types of support may help to optimize care for children and their families.

Summary: Classifying the care provided to children with emotional and behavioural problems can provide empirical insights into the relationship between child characteristics, the care offered and outcomes after leaving care. The Taxonomy of Care for Youth (TOCFY) has recently been shown to validly classify this care in six domains covering all aspects of care. The aim of this study was to assess the inter-rater reliability and feasibility of TOCFY. Two raters independently classified the care provided to 200 children (50 per organisation) from organisations in primary health care, child and youth care, and mental health care (two organisations), based on their care records. We assessed inter-rater reliability and the degree to which TOCFY categories could be applied anyhow, that is its feasibility. Findings: Mean agreement was 89.8% between raters; excluding the cases scored as ‘unknown’, the mean agreement was 82.2%. TOCFY-categories could be applied for over 90% regarding each of the six domains. Applications: TOCFY is a valid, reliable and feasible instrument to classify care within different types of care organisations. Give these promising findings, application and further evaluation of TOCFY is recommended.

The Taxonomy of Care for Youth was developed to gather information about the care offered to children and adolescents with behavioral and emotional problems in various care settings. The aim was to determine similarities and differences in the content of care and thereby to classify the care offered to these children and youth within and across care organizations. Interventions (N = 56) offered in primary health care, child and youth care, and mental health care were assessed by using descriptors. Professionals scored the degree of applicability of these descriptors and interventions with similar descriptors were merged. As a result, the interventions could be classified into 7 main types of support and the total number of interventions reduced to 27. The descriptors used in this study were able to classify the various kinds of care offered based on their content, thereby creating an overview of distinct interventions.