Article Download article Download Citations. Discussion The incorporation of specific knowledge and adaptations in the areas of communication, awareness of physical health comorbidities, management of challenging behaviour, impact of the environment, role of carers and an approach that values neurodiversity has the potential to positively influence mental health outcomes of adults with ASD. Downloads Help with downloads. November Focus Foley pdf KB. Opening or saving files Files on the website can be opened or downloaded and saved to your computer or device.
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Health Care and the Autism Spectrum: A Guide for Health Professionals, Parents and Carers
I declare the following competing interests:. Yes No. Confirm E-mail:. Add Another Author. Competing Interests:. Body dysmorphic disorder in men. Chronic schizophrenia and the role of the general practitioner. Letters to the editor. Nailfold dermatoscopy in general practice. Non-resolving eye injury. Vaccination and the law. Clinical Challenge. Ask the patient or carer to bring their personal health record Determine any specific requirements mobility or sensory Arrange for a longer appointment time where appropriate.
Improves clinical assessment Optimises experience in further medical appointments. Simplifying language Leave pauses and wait Communicate one idea at a time Speak in a normal tone Avoid ambiguous language Consider most appropriate communication style eg written, verbal Consider using multiple techniques eg message supported by written materials. Improved communication will improve accuracy and quality of assessment Changes in communication may reflect changes in mental health.
Perform a hierarchical assessment, which considers the contribution from medical and psychiatric disorders Refer to appropriate specialist behaviour support or specialist psychiatrist. Untreated medical and psychiatric disorders commonly exacerbate challenging behaviour Poorly managed challenging behaviour leads to exclusion from participation, which may have a negative impact on mental health. Carers can assist GPs with valuable personal information about the adult on the spectrum eg changes in behaviour, communication, nutritional uptake and previous medical history Refer carers to support services where appropriate.
Carer stress and poor mental health can influence the mental health of individuals on the autism spectrum. People on the autism spectrum experience similar physical health problems to the general population Screen for common comorbidities Annual general health checkups and routine preventive screening measures are recommended.
Strong interaction of both physical and medical health Chronic conditions such as pain, epilepsy and gastrointestinal disorders may increase likelihood of mental ill health and challenging behaviours. Sensory sensitivities may complicate assessment and management of mental disorders Overwhelming sensory environments can increase stress and anxiety. Psychological therapies are recommended as first-line management Selective serotonin reuptake inhibitors SSRIs are first-line medication.
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Commence on a low dose and increase slower than in the general population Unless advised differently by a specialist, benzodiazepines should only be used as a short-term medication. Benzodiazepines may, paradoxically, heighten agitation, impulsivity or disinhibition. There is some evidence of the effectiveness of cognitive behavioural therapy CBT in treating children and adolescents with autism and anxiety 33,34 Mindfulness-based therapy may be useful Follow treatment recommendations for the general population Psychological therapies are the recommended first-line management for mild depression SSRIs can be used to treat depression and aggression Lithium may be useful, particularly if underlying bipolar disorder is suspected, or in situations where there are high levels of impulsivity and aggression.
A structured form of psychotherapy, including CBT, is often suggested in the literature; however, there is little evidence of the effectiveness of such interventions. Follow treatment recommendations for the general population Lithium 36 may be useful along with other standard mood stabilisers such as sodium valproate and carbamazepine Atypical antipsychotics such as quetiapine and olanzapine may be useful adjunctive medication. No clear evidence base but psycho-education, cognitive and mindfulness-based therapies may be of benefit.
Follow treatment recommendations for the general population Consider potential heightened sensitivity to side effects and the impact on medical comorbidities Avoid depot medication administration greater vulnerability to side effects such as tardive dyskinesia Clozapine may be considered for confirmed cases of treatment-resistant psychosis Extra precautions include: Ability to cooperate with blood test and other monitoring is necessary Consider medical comorbidities such as epilepsy or elevated baseline cardiometabolic risk profile.
No clear evidence base but adapted cognitive and rehabilitative approaches may be of benefit. Follow treatment recommendations for the general population Treat with caution if comorbidities such as tic disorders and anxiety are present.
Follow treatment recommendations for the general population. National developmental team for inclusion — includes publications such as the Green light toolkit Amaze previously known as Autism Victoria — Fact sheets Autism CRC — Health hub Medical comorbidities in autism spectrum disorders: A primer for health care professionals and policy makers. Reasonable adjustments that should be made to mental health services to enable people with ASD to have equal access and effective treatment A variety of fact sheets are available, including Modifying your message: Communicating effectively with individuals with ASD Up-to-date health and wellbeing resources relevant to ASD Summary report of medical comorbidities in ASD.
Accessible mental health services for people with an intellectual disability: A guide for providers Intellectual disability mental health e-Learning modules Convention on the rights of people with disabilities Comprehensive Health Assessment Program CHAP. Alison Morton-Cooper.
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Consultation and Health Assessment. Attending hospital clinics. Admission to hospital for investigations or. Admission to hospital as an inpatient for surgery. In Tools for the primary care of people with developmental disabilities.
Talking to patients on the autism spectrum
Burke, L. Volkmar, B. NY: Springer Publishing. National Autistic Society.
Patients with autism spectrum disorders: Guidance for health professionals. Her primary clinical activity is assessment of adults who have ASD. She has a special interest in assessment of and support for women with Asperger Syndrome and other developmental disorders, as well as parents with Asperger Syndrome. As psychotherapist, psychiatrist, teacher and researcher, she has worked with persons with intellectual disabilities and ASD over the past 30 years both in Canada and the United Kingdom. Morton-Cooper A.
Health care and the autistic spectrum: a guide for health professionals, parents and carers. Jessica Kingsley Publishers. New York. Stoddart, K.
Autism and mental health: Meeting the needs of young people in crisis | Autism Speaks
Disclaimer: This document reflects the views of the author. Every situation is unique and while we hope this information is useful, it should be used in the context of broader considerations for each person. Please contact Autism Ontario at info autismontario.