GPs and Autism Spectrum Disorder
The general practitioner is usually the first port of call when a parent suspects that there is something unusual about with the development of their child. It is therefore very important that GPs have a good understanding of what an Autism Spectrum Disorder (ASD) is, what red flags to look for and what is the next step for parents to take.
As people are slowly becoming more aware of Autism Spectrum Disorder, diagnosis in pre-school children is increasing as the medical community is better able to recognise the signs.
However, there are still many individuals who do not receive a diagnosis until they are at school, at high school, or as adults. This may be the case where characteristics are not as severe or in the case of Asperger’s Syndrome, where speech delay is often not present.
Read about Autism Spectrum Disorder Assessment and Diagnosis
Assistance for Families – “Helping Children with Autism”
In 2006, the Australian Government committed $190 million to support families and their children with ASDs. Funding is provided through FaHCSIA, DOHA and DEEWR and support is available to children who have a DSM-IV diagnosis of Autistic Disorder, Asperger’s Disorder or, Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS). Although not ASDs, the funding also assists families of children with Rett’s Disorder and Childhood Disintegrative Disorder.
The information provided above will provide a basic understanding of ASDs and we strongly recommend that GPs attend training and read more about the disorder to ensure that they are equipped to assist patients.
Occupational Therapists and Autism Spectrum Disorder (ASD)
Individuals with an ASD often require the assistance of an occupational therapist (OT), depending on their level of disability. The Autism Spectrum is such that individuals may have advanced skills in one area, but very limited skills in another. It is not unusual for an individual, for example, to be able to play a musical instrument, but not to be able to put their shoes on and there are many other similar examples of skills developing at very different rates.
As with all learned skills, it is possible to teach individuals on the spectrum and to make many advances with the right supports.
Occupational therapists assist individuals with ASDs with the following:
- Sensory integration therapy – integrating sensory and motor skills to help individuals with spatial awareness, body awareness and motor planning
- Fine motor skills – such as using scissors, pre-handwriting skills
- Gross motor skills – to improve strength, balance and coordination in physical activities
- Self care skills – such as dressing
- Social skills – play skills and interacting with peers
In addition, OTs may assist with visual perception, cognition, equipment advice and prescription, life skills and recreational advice.
Speech Pathologists and Autism Spectrum Disorder (ASD)
A major characteristic of ASD is difficulty with communication.
Some individuals with ASD are non-verbal whilst others have good verbal skills but difficulties with the social aspects of language, or have good language but lack understanding and their ability to communicate is impaired. Some are able to use alternative communication methods and have good communication skills but struggle with speech.
Another main characteristic of ASDs is difficulty with social skills and this is closely allied with speech and communication difficulties.
While some individuals do not learn to speak, there are many stories of individuals making tremendous progress in this area with the right supports and therapies. Often using techniques such as signing and other communication methods, assist with speech development.
A speech pathologist is part of the multi-disciplinary team that makes a diagnosis of ASD.
Speech pathologists work with individuals with ASDs in the following areas:
- Receptive language – how the individual understands information given verbally or in written form
- Expressive language – how individuals express their needs and wants, thoughts and feelings. This can involve using picture symbols, signs, gestures or communication devices.
- Articulation – how the individual makes the sounds that make up words
- Social skills – understanding the unwritten social rules of conversation
- Cognitive skills – problem solving, making predictions and making inferences
Speech pathologists also assist with stuttering, eating and drinking, saliva control, voice and phonological awareness (such as rhyming skills).
To provide the best possible assistance to individuals with an ASD, we recommend that speech pathologists attend training and read more about the disorder.
Psychologists and Autism Spectrum Disorders (ASDs)
Psychologists assist in two main areas with individuals with ASDs:
- Diagnosis and assessment
- Treatment and intervention
Diagnosis and Assessment
Psychologists are part of the multi-disciplinary team that provides the assessment and diagnosis of ASD. They will be involved in assessing the individual’s overall level of mental/cognitive development, in assessing the individual’s patterns of strengths and weaknesses, observing behaviour and social interaction, and in interviewing family members about the development and behaviour of the individual.
Treatment and Intervention
Psychologists are able to provide a range of treatments to improve:
- Behaviour strategies – working with individuals and/or their parents, carers, teachers, to encourage appropriate behaviours and reduce or eliminate inappropriate behaviours
- Social skills – working with individuals and/or parents/family members to encourage social skills
- Help with anxiety and mood – working with individuals and/or parents/family members to help with relaxation and mood improvement
- Planning and monitoring – developing a plan that other therapists, teachers and family members implement with the individual
- Support – assistance for other family members including parents and siblings to cope with the demands that living with an individual with ASD places on the whole family
To provide the best possible assistance to individuals with an ASD, we recommend that psychologist attend training and read more about the disorder.
Psychiatrists and Autism Spectrum Disorders
A psychiatrist assesses an individual’s physical and mental health and development and looks for any medical conditions that may be associated with ASDs.
The psychiatrist may order further tests, such as blood tests, to help diagnose certain conditions. Psychiatrists will also ask the individual or their family members questions about their development and the family history to help them to make a diagnosis of an ASD.
Psychiatrists may also diagnose mental illnesses such as depression or anxiety, which individuals with ASD may also display. It is important that psychiatrists making a diagnosis have a good understanding of ASDs and other developmental disorders.
After the diagnosis Psychiatrists will continue to monitor their patients’ progress and development. They may make referrals to other professionals, such as psychologists or speech pathologists.
In some case Psychiatrists may prescribe medications for their patients. There are no medications to treat ASDs themselves, but medications may help with associated problems, such as anxiety, depression, inattention and sleep problems.
Training and Events Information
AdviceLine – advice for professionals
Paediatricians and Autism Spectrum Disorders
Paediatricians who specialise in Autism Spectrum Disorders are part of the multi-disciplinary team that makes a diagnosis of ASDs in children and adolescents up to 17 years old.
Paediatricians assess children’s health and development and look for any medical conditions that may be associated with ASDs. They may order further tests, such as blood tests, to help diagnose these conditions. Paediatricians will also ask parents questions about their children’s development and the family history, to help them to make the diagnosis.
It is important that paediatricians making a diagnosis have a good understanding of ASDs and other developmental disorders.
After the diagnosis paediatricians will continue to monitor their patients’ progress and development. They may make referrals to other professionals, such as psychologists or speech pathologists. In some case they may prescribe medications for their patients.
There are no medications to treat ASDs themselves, but medications may help with associated problems, such as anxiety, depression, inattention and sleep problems.
Neurologists and Autism Spectrum Disorders
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder and it may be the case that individuals with certain characteristics of ASD are referred to neurologists for assistance.
Neurologists may also be asked to conduct tests such as EEGs and MRIs ion individuals with ASDs to assess for the presence of any underlying or associated brain abnormalities or to make a differential diagnosis between ASDs and other conditions that may have similar symptoms.
While there are no specific neurological tests for ASDs, neurological conditions such as epilepsy and tuberous sclerosis can be present in individuals with ASDs. Neurologists need to be aware of the characteristics of individuals with ASDs that may make it more difficult for them to cope with or cooperate with neurological testing
Read more online or contact our AdviceLine for assistance.
Maternal and Child Health Nurses, Practice Nurses, School Nurses and Autism Spectrum Disorders
As with GPs, nurses are well placed to notice developmental and behavioural differences in children, especially those who have the time to observe children regularly, as is the case in schools, local practices and child health centres.
It is therefore important to have a good understanding of Autism Spectrum Disorders and to be able to identify characteristics that may signal the presence of an ASD, and to refer parents to their GP or to a paediatrician for further assistance.
Contact our AdviceLine if you have specific questions or need further advice.
Dentists and Autism Spectrum Disorders
One of the characteristics often present in individuals with an ASD is a difference in their responses to sensory stimuli – individuals may be hypersensitive or hyposensitive. This can make a visit to the dentist a lot more of an issue than it is for the general population.
If you are notified that your patient has an ASD, you can familiarise yourself with the disorder so that you know how to help them.
Find out more about Autism Spectrum Disorders
You may not be notified that your patient has an ASD or you may be told that they have sensory issues. If so, read more online or contact our AdviceLine for assistance.