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Thursday, November 28, 2013

Autism and Health

At The Huffington Post, Dr. Arshya Vahabzadeh writes:
Medical practice and training has long focused on the treatment of medical illness -- the use of medicines and procedures to rectify what has gone wrong with a human body. Health, however, is far more than the absence of disease, it is also, according to the World Health Organization (WHO), a state of complete physical, mental, and social well-being. People with autism experience many barriers to achieving this definition of health.
Some people with autism find it difficult to engage in regular exercise, through a combination of a lack of suitable opportunities, their own social difficulties, and stigma against them. Let me jump now to my other truth: As medical professionals we often prescribe medications but "there is no pill that can replicate the health benefits of exercise." It is not limited to exercise either, what about diet? Many people with autism also find they are particularly picky about the food that they eat, often ending up on a "yellow diet" that includes starchy or fatty foods such as fries, cheese, burgers, and pizza. What are health care systems doing to address these issues? Unfortunately far less than they could be doing. [emphasis added]
Out in the community and close to patients are this group of [primary care] doctors that include pediatricians, family physicians, and internal medicine doctors. It can however be hard to find one, especially if you live in a rural area, or are on Medicaid -- like half of children with autism.
Providing early diagnosis, treatment, and referral for conditions such as autism are essential roles of these community physicians. Having an orthopedic surgeon, a psychiatrist, or a rheumatologist as the doctor at the helm of a person's total medical care just isn't going to cut it. If people with autism are struggling to find a primary care physician, it won't be long before people without autism find themselves in a similar situation.
So what happens if a family wants to see an autism specialist? Currently demand dramatically exceeds supply. People often resort to paying out of pocket, recognizing that early intervention is of utmost importance in autism. More autism specialists are not simply going to appear tomorrow, it takes at least five years of residency training after medical school to train a child and adolescent psychiatrist, pediatric neurologist, or developmental pediatrician. Let me give you an example of how dire the situation is, there are only 7,500 child psychiatrists in the country for 74 million children and adolescents.