PCPs must be flexible in treating adults with autism

Alice Kuo

NEW ORLEANS — The broad range of autism spectrum disorder in adults necessitates a variable approach with each patient, according to a presenter here at the American College of Physicians Internal Medicine Meeting.

There are approximately 60,000 people with autism who turn 18 each year, and not all of them display the same characteristics, according to Alice A. Kuo, MD, professor of internal medicine and pediatrics at the David Geffen School of Medicine at University of California Los Angeles.

“Autism is particularly heterogenic. I wish I could tell you 1, 2, 3, these are the things you need to know,” she told attendees.

In light of this medical ambiguity, Kuo offered some suggestions on how to help make the office visits with adult patients who have autism go as smoothly as possible.

Always address the patient, even if non-verbally. “The parent will really appreciate this, and it will help make the clinical encounter more successful,” she said. “Even if all you do is a simple, ‘How you are doing?’, even if the child has no capacity to understand what you are saying to them, it means so much to the family members that you treated the child with respect.”
Support the family and look for signs of caregiver burnout. “Encourage parents to be OK with trying to help them find someone to take care of their child for a few hours,” Kuo said.
Work with parents/family to decrease the anxiety of the visit. “Sometimes I get requests from parents asking them to send pictures of my office before the visit so they can show it to the child and be prepared,” she said.
Be creative in performing procedures. “This can entail doing something like taking blood and giving shots while the patient is already under anesthesia for a dental procedure,” Kuo said.
Other tips include being patient, not judging any decision the parent or child makes, putting the patient in an exam room quickly while he or she awaits your arrival if the waiting room is too overstimulating, not forcing medical procedures such as BP readings, vaccines and blood draws and helping patients and parents plan for the future.

“Primary care providers [should] want to be protective factors. We want to help our adults patients to achieve the highest outcomes they possibly can ... we should also be helping our patients realize their full potential and also help their families as well,” she said. – by Janel Miller

Reference:

Kuo AA. Autism in adults: an update. Presented at: American College of Physicians Internal Medicine Meeting; April 17-21, 2018; New Orleans.

Disclosure: Kuo reports no relevant financial disclosures.