Autism spectrum disorder in primary care

Weill, Victoria A.; Zavodny, Stefanie; Souders, Margaret C.

doi:10.1097/01.npr.0000529670.62188.1a

Cited by 10 publications

(6 citation statements)

References 40 publications

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“…Although the added value of these interventions has been widely discussed and contemplated in the literature, it must be noted that few psychology-based interventions were identified through this systematic review. For instance, applied behaviour analysis (ABA) and reinforcement learning using certified behaviour analysts have been widely recommended ( Weill et al, 2018 ). However, ABA is largely condemned by the autistic community as ‘cruel’ and ‘trying to bend the autistic person’ to fit neurotypical stereotypes, stealing away their unique autistic identity ( Devita-Raeburn, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

A systematic review of person-centred adjustments to facilitate magnetic resonance imaging for autistic patients without the use of sedation or anaesthesia

Stogiannos

Carlier

Brammer

et al. 2021

Autism

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Magnetic resonance imaging is widely used for different diagnostic examinations involving autistic patients. The noisy, narrow, isolating magnetic resonance imaging environment and long scan times may not be suitable for autistic individuals, given their communication challenges, sensory sensitivities and often heightened anxiety. This systematic review aims to reveal any reasonable and feasible radiography-based adjustments to facilitate magnetic resonance imaging scanning without the use of sedation or general anaesthesia. Nine electronic databases were systematically searched. Out of 4442 articles screened, 53 were deemed directly relevant; when assessed against eligibility criteria, only 21 were finally included in this systematic review. Customising communication was found to be a key adjustment, as well as scan-based optimisation and environmental adaptations. The importance of distraction techniques and use of technology for familiarisation with the processes was also highlighted. The results of this study can inform recommendations to improve magnetic resonance imaging practice and patient experience, without the use of sedation or anaesthesia, where feasible. They can also inform the basis of dedicated training for magnetic resonance imaging radiographers. Lay abstract Autistic patients often undergo magnetic resonance imaging examinations. Within this environment, it is usual to feel anxious and overwhelmed by noises, lights or other people. The narrow scanners, the loud noises and the long examination time can easily cause panic attacks. This review aims to identify any adaptations for autistic individuals to have a magnetic resonance imaging scan without sedation or anaesthesia. Out of 4442 articles screened, 53 more relevant were evaluated and 21 were finally included in this study. Customising communication, different techniques to improve the environment, using technology for familiarisation and distraction have been used in previous studies. The results of this study can be used to make suggestions on how to improve magnetic resonance imaging practice and the autistic patient experience. They can also be used to create training for the healthcare professionals using the magnetic resonance imaging scanners.

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Section: Discussionmentioning

confidence: 99%

A systematic review of person-centred adjustments to facilitate magnetic resonance imaging for autistic patients without the use of sedation or anaesthesia

Stogiannos

Carlier

Brammer

et al. 2021

Autism

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“…gastrointestinal (GI), sleep, and seizure (Earles & Currie, 2011). For children with ASD the combination of altered muscle tone, motor difficulties, sensory challenges, hyposensitivity to rectal sensations, and food selectivity commonly result in GI disturbances (Weill et al, 2018). Constipation can be a cumulative factor in changes to behaviour, toilet training, pain, and food intake, therefore it warrants early management.…”

Section: Asd Medical Managementmentioning

confidence: 99%

“…from public health nurse with suspected ASD, requires the PCP to be adept in a range of skills. The PCP needs to be competent in completing scheduled and timely developmental check-ups, reviewing antenatal and family history, eliciting, listening to, and appreciating parental concerns, and visually assessing the child in the clinic setting (Weill et al, 2018).…”

Section: The Health Impact Of Asd On the Familymentioning

confidence: 99%

“…The PCP must be able to access and apply ASD-specific screening tools with skills, capacity, and confidence. There are numerous ASD screening tools; for example, the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) (see Appendix A) is an efficient and evidence-based tool, commonly used in Canada that can be completed by both parent and PCP (Weill et al, 2018). Examining the sensitivity and specificity of such tools and knowing when to most effectively apply these in primary care practice is outside the scope of this paper.…”

Section: The Health Impact Of Asd On the Familymentioning

confidence: 99%

“…Current literature, including clinical practice standards and pathways, support the importance of establishing and maintaining strong parent-PCP relationships via establishing good communication, partnership, and ongoing involvement to address ASD management (Dua, 2003; National Institute for Health and Care Excellence [NICE], 2017). However, ASD studies with younger children often focus on assessment, with little investigation in to focused evidenceinformed strategies that promote relationships, establish, sustain, and reconcile communication in the partnership to foster ongoing engagement (Fewster & Gurayah, 2018;van Tongerloo et al, 2015;Weill, Zavodny & Souders, 2018). Of note, over the last few decades numerous models have been adopted that can help to foster professional-parent partnerships; for example, the expert model, the transplant model, the consumer model (Cunningham & Davis, 1985), the social systems model (Appleton & Minchom, 1991) and patient and family centred care (PFCC) model (Bellin et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

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Primary care strategies for supporting parents of children with suspected autism spectrum disorder

Salih¹

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ASD is a complex neurobiological disorder requiring early childhood intervention to mitigate effects on overall quality of life. Without early intervention, individuals and families are impacted socially, emotionally and economically. In BC, wait lists for a formal assessment and diagnosis are longer than a year. Parents of children with suspected ASD are often left in an anticipatory waiting phase once ASD is suspected. They require guidance on learning what ASD is, developing knowledge about treatment approaches, and determining what resources and supportive measures are available to them. The mainstay approach to assessment is initially via a primary care provider. As such, the primary care provider (PCP) is the first source of guidance when concerns about a child are raised, and is responsible for referring the child for diagnosis, and providing parents direction on where to obtain interventional therapies. However, there is limited guidance on how to support parents during the anticipatory period of time between suspicion of symptoms and diagnosis. The aim of this project is to explore strategies that enable PCPs when caring for parents of children with suspected ASD. An integrative literature review was conducted, which included ten carefully selected articles. Two major themes were identified, which focused on concepts of knowledge and communication. Knowledge linked to the PCP included the need for up-to-date developmental, clinical, communication understanding and tacit knowledge. Communication is essential during waiting and early diagnosis, and in aspects of PCP availability, multidisciplinary collaboration and supportive decision-making. These key aspects help to prepare families to flourish in their recreation of family life. Attention to parent health and wellbeing is critical, as is the need to discuss difficult topics such as emotional stress and service limitations. Patient and family centred care (PFCC) is reported as a health care model that illuminates the importance of respect, rapport and trust, while affording accord, equity and collaboration. Using the PFCC model as a polestar, the PCP can navigate care focusing on cocreating longer term relationships between primary care, parents, interventions teams and early education partners.

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Factors for Assisting Adolescents with Autism Develop Health Self-Management

Rock¹,

Becker²

2021

The Journal for Nurse Practitioners

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Autism spectrum disorder in primary care

Cited by 10 publications

References 40 publications

A systematic review of person-centred adjustments to facilitate magnetic resonance imaging for autistic patients without the use of sedation or anaesthesia

A systematic review of person-centred adjustments to facilitate magnetic resonance imaging for autistic patients without the use of sedation or anaesthesia

Primary care strategies for supporting parents of children with suspected autism spectrum disorder

Factors for Assisting Adolescents with Autism Develop Health Self-Management

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