Addressing medical needs of adolescents and adults with autism spectrum disorders in a primary care setting.
Youssra Saqr, Erika Braun, Kyle Porter and 2 others
PMID 28750547WHAT IT FOUND
17 of 74 patients needed changes to the visit format after phone screening, and all 74 were successfully seen.
Waiting rooms, touch, noise, light, and communication were barriers.
Key findings
01In 126 charts, 74 had usable pre-visit intervention data; 17 of 74 (23%) needed changes to the standard visit format, and all 74 were successfully roomed and evaluated.
02Mean medication regimen complexity was 14.7, with higher scores in patients with intellectual disability (20.4), seizures (21.7), or history of aggressive behavior (25.8).
0310 adults with ASD described communicating with the physician, the physical exam, and the waiting room as the most stressful parts of care.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
Most data came from retrospective chart review, and 38 of 112 pre-visit assessments lacked usable intervention data. Intellectual disability was based on patient or caregiver report, not verified testing. The focus group included only 10 adults who could attend independently, communicate verbally, and had no intellectual disability. The chart review did not compare these visits with usual care, so success cannot be attributed to the pre-visit assessment alone. The clinic may have attracted patients with higher medical needs than the general autism population. Multiple comparisons were not adjusted.
Declared interests
The work was supported in part by an OSU College of Medicine Bennett research scholarship, and the CAST program was supported by donations from the White Castle Foundation and Bill and Marci Ingram.
The easy way to misread this
Do not conclude that the phone assessment caused all 74 patients to be successfully seen. This was a chart review and focus group, not a controlled trial, and the clinic already had care coordination and a transition coordinator.