A known problem is developing where parents of children with autism are unable to talk to their doctors about their child’s autism due to their physician’s lack of knowledge about treatments and community resources.
A recent study reported in Academic Pediatrics reports that pediatricians did not discuss the choice of any treatment options with parents of children with ASD and also that physicians had only general recommendations or referrals. It didn’t help that many of the parens also had a relative ambiguity on treatment options and the kinds of questions they could have been asking about ASD treatments, community resources, the pediatrician’s role in ASD care, and the difference between complementary and alternative medicine treatments.
Researchers from this study suggest that since increasing amounts of children with ASD will be scheduling doctors visits, pediatricians would benefit from the Autism Toolkit and clinical practice guidelines which are available through the American Academy of Pediatrics. These measures will not be kept on the backburner for much longer as more and more children are being diagnosed with ASD and parents are seeking answers from their health care professionals.
One pediatrician stated, “we in general are not so much an expert on it so it is harder to just prescribe things, and it turns out we really can’t do it anyway.” This is unacceptable. A health care professional is not meant to just prescribe things; their goal should be to keep their patients healthy and strong and there are a lot of options for families who have children on the spectrum. Pediatricians are often not comfortable in discussing the unproven possibilities of alternative and complementary treatments such as specialized diets, supplements or vitamin shots, and outside therapies and yet, all of these treatments are information for the parents and options that come with potential benefits and risks that need to be discussed.
Autism is unique in its ability to provide a higher possibility for shared decision making between the provider and the patient, especially as there are so many different treatments that can be done either at home or in centers or in a combination of the two. Due to all of these options and the nature of research on autism so far, pediatricians just have to be aware and prepared to discuss what is currently available to make a treatment plan. This is made possible through care coordinators, ASD care plans, creating summaries of outside resources, and by providing families with logs to monitor progress.
The conclusion seems to be that decision aids and practice guidelines may be useful tools to help foster better communication and establish treatment plans between families and pediatricians. And furthermore, pediatricians need to really get on with using them and be universally more prepared to discuss autism with families. Working together with shared decision making, pediatricians can help find care for children with ASD that will be within their families’ best interest.