Objective: This study aims to statistically clarify the association between disability characteristics and school refusal in school-aged children with Autism Spectrum Disorder (ASD).Methods: The subjects were 158 school-aged children with ASD who were prescribed rehabilitation at Narita Hospital of International University of Health and Welfare. The following information was collected from medical records: presence or absence of school refusal, age, gender, the Autism Screening Questionnaire (ASQ) scores, result of the Wechsler Intelligence Test 4th version, the Sensory Profile (SP) scores, the Liebowitz Social Anxiety Scale for Children and Adolescents scores, decline in family functions, bullying, and enrolled class. Poisson regression analysis was conducted using both crude and adjusted models. School refusal was the dependent variable, while ASQ and SP subcategories were the independent variables. Age and other factors were used as covariates in the adjusted model.Results: The “sensory avoidance” of the SP subcategory was significantly associated with school refusal in both the crude and adjusted models (odds ratio, 95% confidence interval: 1.03, 1.01-1.05, 1.03, 1.00-1.05, respectively).Conclusion: Analysis of the association between disability characteristics and school refusal in school-aged children with ASD suggests that sensory processing deficits are associated with school refusal.

Objective: This study aims to statistically clarify the association between disability characteristics and school refusal in school-aged children with Autism Spectrum Disorder (ASD).Methods: The subjects were 158 school-aged children with ASD who were prescribed rehabilitation at Narita Hospital of International University of Health and Welfare. The following information was collected from medical records: presence or absence of school refusal, age, gender, the Autism Screening Questionnaire (ASQ) scores, result of the Wechsler Intelligence Test 4th version, the Sensory Profile (SP) scores, the Liebowitz Social Anxiety Scale for Children and Adolescents scores, decline in family functions, bullying, and enrolled class. Poisson regression analysis was conducted using both crude and adjusted models. School refusal was the dependent variable, while ASQ and SP subcategories were the independent variables. Age and other factors were used as covariates in the adjusted model.Results: The “sensory avoidance” of the SP subcategory was significantly associated with school refusal in both the crude and adjusted models (odds ratio, 95% confidence interval: 1.03, 1.01-1.05, 1.03, 1.00-1.05, respectively).Conclusion: Analysis of the association between disability characteristics and school refusal in school-aged children with ASD suggests that sensory processing deficits are associated with school refusal.

In Japan, because the most common site of drowning among patients with epilepsy is the bathtub, showering is generally recommended as an alternative to bathing. We herein report a case involving a female patient with epilepsy who drowned while showering. She had been diagnosed with epilepsy approximately 25 years previously, and her condition had progressed to refractory epilepsy. Carbamazepine, levetiracetam, lamotrigine, clobazam, and perampanel were prescribed daily. One day while showering, the patient was found lying with her face immersed in water that had accumulated on the floor of the bathtub. A forensic autopsy revealed water in the stomach, trachea, and proximal regions of both lung bronchi as well as white and red foam on the pharynx and larynx. A total of 1.9 μg/mL of lamotrigine, 0.14 μg/mL of carbamazepine, and 0.069 μg/mL of perampanel were detected in the patient's blood. The patient's cause of death was determined to be drowning due to an epileptic seizure. Although the patient was prescribed five types of antiepileptic medication, only three were detected in her blood. The current case demonstrates that drowning can occur while showering, suggesting that it is unsafe for patients with medication nonadherence. To prevent unintentional deaths in the bathroom, we recommend that patients with epilepsy maintain high adherence to all prescriptions and are supervised by a family member, even when showering. The current case is the first autopsy report of a patient with epilepsy who drowned while showering.
Adult ; Anticonvulsants ; blood ; therapeutic use ; Autopsy ; Drowning ; etiology ; pathology ; Drug Resistant Epilepsy ; drug therapy ; pathology ; Female ; Humans ; Japan ; Medication Adherence