Collaboration in Autism Care and Services

Oct 13, 2024

Department of Psychiatry and Behavioral Sciences Grand Rounds

Introduction

  • Speakers: Pat Osborne and Tiffany Otero
    • Pat Osborne: Speech and Language Pathologist, Associate Director of CDD, Director of Autism Programs and New Mexico START Program.
    • Tiffany Otero: Licensed Psychologist, Clinical Director of New Mexico START Program, specializes in diagnostic assessment and mental health interventions for developmental differences.

New Mexico START Program

  • Focus: Collaboration of services for individuals 6 and older with intellectual disabilities.
  • Objectives:
    • Identify types of presentations.
    • Discuss research on autism spectrum disorders and co-occurring conditions.
    • Support collaboration across disciplines.

Autism Spectrum Disorder (ASD)

  • Diagnostic Domains:
    • Deficits in social communication.
    • Restricted interests or repetitive behaviors.
  • Diagnostic Process:
    • Involves assessment of intellectual ability, language skills, adaptive functioning, and co-occurring conditions.
    • Evaluation team usually includes a psychologist and speech pathologist.

Prevalence and Presentation

  • 1 in 36 individuals identified with ASD.
  • Occurs across all racial and ethnic groups, more common in males.
  • 38% have intellectual disability; others in borderline or average range.
  • Girls likely to have intellectual disability with ASD.
  • 63% of children diagnosed exhibit language impairment.

Co-occurring Conditions

  • ADHD affects about 47% of adolescents with ASD.
  • Anxiety disorders present in 39% of adolescents, more common in those without intellectual disability.
  • Individuals with ASD more likely to experience traumatic events.

Intervention and Care

  • Early intervention and consistent treatment improve outcomes.
  • Focus on strengths and reducing maladaptive behaviors.

Systemic Therapeutic Assessment Resources and Treatment (START)

  • Developed over 30 years, focuses on crisis prevention and intervention.
  • Uses a biopsychosocial approach.
  • Positive psychology to focus on strengths to improve quality of life.

Challenges in Care

  • Barriers: Lack of satisfaction with care, increased risk of injury, missed medical diagnoses.
  • Behavioral Concerns: Aggression and self-injurious behavior common.
  • Medication Adherence: Challenges exist, especially with complex regimens.

START Model

  • Tertiary care model, systemic, focuses on individual and system support.
  • Uses positive psychology and the PERMA+ model for well-being.

Referral Criteria and Services

  • Criteria include ASD diagnosis, intellectual disabilities, and complex mental health needs.
  • Aims to increase quality of life and decrease maladaptive behaviors.

Resources and Support

  • National and UNM resources available for support.
  • Referral process for START provided, focuses on individuals within 2 hours of Albuquerque.

Q&A Highlights

  • Discussion on diagnosis capacity and barriers in providing care.
  • Importance of increasing provider ability to diagnose ASD.
  • Addressed systemic issues and capacity building for effective service delivery.

Conclusion

  • Strong interdepartmental collaboration enhances services for individuals with developmental differences.