Understand

AUTISM SPECTRUM DISORDER

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Autism spectrum disorder is a developmental disability that can cause significant social, communication and behavioral challenges. 

Autism spectrum disorder (ASD) is a construct that describes a constellation of social communication difficulties and restricted, repetitive patterns of behaviors or interests that have strong genetic underpinnings and appear early in life. 

 

People on the autism spectrum often have difficulties with social, emotional, and communication skills. They might also repeat certain behaviors or have a hard time changing routines or daily activities. Signs of ASD emerge during early childhood and typically last throughout a person’s life (American Psychiatric Association, 2013).

 

Diagnosing ASD can be challenging since there is no medical test, only clinical observation and informant-report tools. Signs and symptoms of ASD can sometimes be seen in someone experiencing ASD as early as 18 months and sometimes even younger. An initial diagnosis by a specially trained clinician can be ascertained as early as two years old or younger. Unfortunately, many children do not receive their first ASD diagnosis until much older, especially children who are Latinx or African American (Mandell, et al., 2002; Constantino, et al., 2020) This delay means that autistic children might not get the early intervention services they need.

 

Co-occurring mental health conditions are highly prevalent and require a lifespan, transdisciplinary and community participatory care approach (Gotham, et al., 2020). Attention-deficit hyperactivity disorder, anxiety disorders, sleep-wake disorders, disruptive behavior disorders, and depressive disorders have the highest co-occurring prevalence in the autism population. Examining co-occurring mental health conditions, service needs, and evidence-based treatment approaches is an important research priority of stakeholders including autistic people, family members, providers, and researchers (Frazier et al., 2018; Pellicano et al. 2014). 

 

To address the documented disparities in access and receipt of evidence-based care for autistic individuals, service models are increasingly focused on ways to promote equity in access and reach. Primary care is well-positioned to reach those who may be at most risk of facing health disparities. Examples in primary care include the Extension for Community Healthcare Outcomes (ECHO) program and the Access to Tailored Autism Integrated Care model, both which are accumulating evidence for feasibility, acceptability, and adoption (Stadnick et al., 2019; Stadnick et al., 2021). 

Dr. Nicole Stadnick Interview

Dr. Nicole Stadnick is a Psychologist, Assistant Professor in the Department of Psychiatry at the University of California San Diego, Director of Dissemination and Evaluation of the Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center and investigator in the Child and Adolescent Services Research Center. A primary area of Dr. Stadnick’s research aims to promote equitable access to evidence-based practices and mental health services for children with Autism Spectrum Disorder and co-occurring mental health needs through tailored service delivery models. She currently leads several implementation projects supported by the National Institutes of Health focused on community-engaged, cross-system health services and implementation research for individuals with complex clinical presentations including publicly funded mental health services and HIV AIDS care programs.

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