By Dr Simon Moore MD CCFP
"I think my child has autism.”
What are your next steps if you hear this on a SOO exam or in clinic?
A free e-course from UBC helps you prepare for exactly this scenario – and it’s completely free of charge. Here are 4 takeaway points that this course covers:
1. DO: Recognize early Be familiar with the common symptoms that should make you think “Autism Spectrum Disorder” (ASD) - and recognize that they are different across age ranges, for example:
A young child may prefer to play alone and have unusual eating / sleeping patterns
A school-aged child may present with rigid adherence to routines or difficulty following instructions
An adult may go undiagnosed for years if signs go unnoticed, such as exaggerated sensitivity to environmental distractions, or social or employment challenges
A complete list of indicators to know is available for download on the course website.
2. DON’T: Delay or say “Let’s wait and see”
Early intervention has been shown to improve patient outcomes.
3. DO: Refer early – to more than just pediatrics When a patient shows indicators of ASD, refer for specialty assessment immediately (e.g. pediatrics). However, there are many other multidisciplinary supports you can arrange for your patient:
Early Childhood Intervention / Infant Development services – see list of examples
Support services for people with disabilities – see list of examples
Speech-language pathology
Vision and hearing assessment
Psychology
4. DON’T: Miss another diagnosis
Another diagnosis might explain ASD symptoms, or co-exist with ASD. Rule out other causes such as:
Neurodevelopmental disorders (e.g. ADHD, developmental delay)
Mental / Behavioural disorders (e.g. Anxiety, depression, obsessive-compulsive disorder)
Genetic disorders (e.g. Fragile X syndrome)
Investigations to consider include height, weight, head circumference, EEG if seizures, MRI if abnormal neurologic exam, and labs such as TSH, CBC (but don’t ever write "CBC" or "MRI" as an answer on the CCFP exam! Find out why at The Review Course), ferritin, serum lead, metabolic screen.
Comments