Childhood is a crucial time for promoting healthy social and emotional development. Healthcare for children rests on a foundation of monitoring a child’s overall health and developmental progress while also identifying any problems or delays and intervening before they become too serious. For children with autism, perils can lie even before intervention. Early identification of autism is important. Diagnostic evaluation performed by trained professionals, usually psychologists, psychiatrists and developmental pediatricians, is essential. However, family accessibility to these professionals is often limited based on their community and income. Because effective intervention with this population strongly relies on “the sooner the better” approach, these limitations carry significant weight for children on the autism spectrum. As a mental health professional working in a community where families encounter barriers to treatment on a daily basis, I see the potential for integrated health and primary care settings, like those found at Valley Health, to help families overcome obstacles.
Autism is a complex developmental disability that typically appears during the first three years of life. It is the result of a neurological disorder that affects the normal functioning of the brain. It is characterized by delays and impairment in social skills, language and behavior. The diagnosis of autism denotes that there are neurological differences within the individual that affect how the individual thinks, feels and reacts. However, it affects each person differently. This is why autism is labeled a spectrum disorder. One child may have a particular symptom while another may not. Symptoms can be identified by a number of professionals. An evaluation is a critical step in accounting for these different variations in symptoms to provide an accurate diagnosis. While there is no known cure for autism, there are treatment and educational approaches that can address the challenges associated with the condition. Behavior and communication approaches, such as individual and group psychotherapy, applied behavior analysis, speech therapy and occupational therapy can all help to lessen disruptive behaviors, improve social skills, develop functional speech and address sensory sensitivities. Educational approaches can teach self-help skills for greater independence, as well as new methods of learning that fit these children’s unique set of skills and personality. Medication can also be a treatment option; however, it is important to know that medication alone is not a treatment for autism but an aid to better functioning.
Receiving a diagnosis of autism can be overwhelming for some families and a relief to others. These emotions can range from grief to panic, to even relief for finally having an explanation for a child’s behaviors. Whatever the strong emotions may be, they often serve as motivation for parents to find the effective help their children need. I believe continuing to integrate healthcare services with mental health professionals captures the motivation and turns it into a positive outcome for these children and their families. The most important point I make to all my patients and their families, is that children with autism have the potential to grow and develop into healthy, happy adults. Diagnosis is not necessarily an indicator of prognosis. Even delayed treatment can still result in positive impacts on quality of life.
So what happens when a family seeks services for their child? The obstacle that many face is gaining awareness of and finding effective services that can provide the assistance these children need. According to the 2018 Center for Disease Control’s Autism and Developmental Disabilities Monitoring Network, the last estimate is now one in 59 children have been identified with having autism. Therefore, barriers to services could only potentially grow as we move into the future. However, primary care can play a key role in furthering access to mental health treatment. Families in communities where access to multiple professionals and specialized services is limited often first seek help for mental health or other specific issues with their primary care physician.
We know children with autism often benefit greatly from having a range of services. With primary care centers incorporating other disciplines such as mental health, the answer to finding these services is apparent. Primary care providers are now more aware of mental health issues, screeners and follow-up care. Patients often find it less stigmatizing and more comforting to follow up with other professionals who are at the same site or in direct contact with their primary care provider. These facilities also provide reduced costs, increased identification and holistic care of mental health issues, and improved outcomes. Therefore, as autism awareness continues to grow, this form of healthcare becomes more and more crucial, in my opinion, in helping all families have the opportunity to take all steps necessary for their children to grow and improve.
About the Author
Dr. David Oxley, Psy.D., is a graduate of Marshall University’s Doctorate of Clinical Psychology Program. He is a licensed psychologist in the States of West Virginia and Maryland. He received his post-doctoral training in Baltimore, Maryland, through Mt. Washington Pediatric Hospital’s Autism Clinic. Dr. Oxley is currently employed by Valley Health Systems and sees patients at their Hurricane and Huntington locations. For further information about autism and how Dr. Oxley can support and coordinate diagnostic and treatment needs, please call (304) 760-6040.