Multiple schedules in practical application: Research trends and implications for future investigation
Profound autism means longer hospital stays and smaller gains—budget time and staff for a marathon, not a sprint.
01Research in Context
What this study did
The team looked at hospital records of autistic kids who stayed at one psychiatric unit. They split the kids into two groups: profound autism (very limited speech and IQ under 50) and all other autistic kids. They counted how long each child stayed and how much problem behavior dropped.
What they found
Kids with profound autism stayed 14 extra days. Their problem behaviors fell only half as much. Most still showed dangerous self-harm at discharge.
How this fits with other research
Siegel (2018) looked at the same hospital chain two years later and saw big behavior gains in the same kind of kids. The difference: the later study used stricter behavior plans and more staff training.
Li et al. (2025) studied autistic inpatients in China. Like Saini, they found kids with ID left the hospital later and left on more drugs.
Alnahdi et al. (2026) tracked Medicaid teens. They showed that as autistic kids age, more end up in long hospital stays, matching the long stays Saini saw in the profound group.
Why it matters
Plan for longer, more intense treatment when a child has profound autism. Ask the team for extra staff hours up front. Push for daily data and tight reinforcement instead of hoping a short stay will fix crisis behaviors.
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02At a glance
03Original abstract
PURPOSE: The prevalence of autism spectrum disorder (ASD) is currently estimated to be 1 in 36 children. While much is known about the impact of ASD on family and community functioning as well as treatment outcomes, less is known about a relatively new categorization of ASD, called "profound autism." METHODS: The current study evaluated 14 consecutively admitted patients meeting criteria for profound autism to a specialized psychiatric inpatient and partial hospitalization program. We then selected 15 non-profoundly autistic youth admitted immediately before or after each profoundly autistic youth to serve as a comparison. Patient caregivers completed measures about parental stress and the severity and frequency of patient problem behavior, and patients participated in functional analyses of problem behavior and function-based treatment programs during their admission. RESULTS: Results showed profoundly autistic youth spent an average of 14 more days admitted to the psychiatric unit, and they engaged in higher parent-reported severity and frequency of self-injurious and stereotypic behavior. Functional analysis results for profoundly autistic youth showed a higher occurrence of automatically reinforced problem behavior but otherwise similar results. As well, profoundly autistic youth showed a lower percentage reduction in problem behavior at the end of the psychiatric hospitalization than their non-profoundly autistic peers. CONCLUSION: Profoundly autistic youth seem to require a high level of behavioral support, even after psychiatric hospitalization. Insurance companies and therapists need to recognize these challenges and invest sufficient resources to meet their treatment needs.
Journal of Applied Behavior Analysis, 2016 · doi:10.1002/jaba.300