421 - Screening for Adolescent Risk Behaviors and Sexual Orientation in Youth with Developmental Disabilities

High risk behaviors threaten the overall youth health and adolescent health screening is crucial. Little is known about the lifestyle and high-risk behaviors of adolescents with developmental disabilities (DD) and information on sexual orientation is limited.

Objective:

To examine screening practices of adolescent risk behaviors and sexual orientation in a university-affiliated urban developmental center that serves children with DD and to compare adolescent high risk behaviors and sexual orientation by developmental diagnoses.

Design/Methods:

Review of medical records and health screening forms embedded in EMR of all adolescents who were referred for initial multidisciplinary evaluation to determine if the child had DDs. Patients were evaluated from 1/2019 to 12/2020. Data included demographics, DD diagnoses, risk behaviors from adolescent history and whether interviewed alone or not, smoking, alcohol and drug use, being sexually active, and sexual orientation. Patients who were nonverbal were excluded. Statistics included chi-square, t-test, and non-parametric test.

Results:

Of all children evaluated in that period (n=345), 120(35%) were adolescents (verbal and ≥12), mean age 14±2; 70%boys, 48% from English/Spanish households. DD’s: Language Impairment 87%, Learning Disabilities(LD) 52%, ADHD 45%, Autism 20%, Intellectual Disabilities(ID)13%. Adolescent form was completed in 65 patients(55%), 59(88%) with patient alone; youth with ID were less likely to be screened (31% vs 59% p=.03), and adolescents with Autism were less likely to be interviewed alone (54% vs. 95% p=.002), no other differences in demographics or other DD. Of the 65 who were screened, 3(5%) reported smoking and alcohol use and 10(16%) were sexually active; 59 patients answered the sexual orientation question: 38(64%) identified as heterosexual, 16(27%)identified as bisexual, 5(7%) were homosexual and 1 neither. Youth with Autism were more likely to identify themselves as bisexuals (75% vs. 20% p=.006), and adolescents with LD were more likely to identify themselves as heterosexuals (82% vs. 46% p< .001) compared to the rest. No other differences by DD diagnoses.

Conclusion(s): In this ethnically diverse, urban group of adolescents with DD, more than half were screened for risky behaviors. Youth with ID were less likely to be screened. Adolescents with Autism reported more sexual diversity than youth with other DD. Provider screening and education for sexual health and high-risk behaviors should be included in the care of adolescents with DD to improve health care practices.