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J Autism Dev Disord (2012) 42:11561164 DOI 10.1007/s10803-012-1474-3
ORIGINAL PAPER
Autism and Pediatric Practice: Toward a Medical Home
Susan L. Hyman Jara K. Johnson
Published online: 13 March 2012 Springer Science+Business Media, LLC 2012
Abstract The pediatrician sees a child for 11 well child visits by their third birthday. The provision of continuous primary care supports development of trust with parents, provides opportunity for screening and surveillance of autism spectrum disorders (ASD), allows monitoring the progress of children requiring therapy, and a framework to support and educate families. Families of children with ASD are less likely to report that they receive care in a Medical Home, a practice providing coordinated, accessible, continuous, culturally competent care. They report less access to specialty and family focused care compared to other children with special health care needs. It is a major challenge to identify and effect the solutions necessary to bring Medical Home care to all children with ASD.
Keywords Medical Home Screening
Pediatric practice Autism spectrum disorders
The primary health care provider plays a critical though often underappreciated role in the identication and ongoing care coordination of children and youth with autism spectrum disorders (ASDs). Consistent and accessible care is important for initial identication of children at risk for ASD, but also for ongoing management and identication of the medical and nonmedical needs of the
child and family. Integration of care across medical, educational and social service systems is challenging to both families and health care providers due to the time required, cost of staff time and services, knowledge, training, availability of services, and lack of support for the collaborative effort itself (Swiezy et al. 2008). Effective communication and collaboration between families and health care providers helps to facilitate the implementation of interventions. The Maternal Child Health Bureau and the American Academy of Pediatrics promote the Medical Home model of primary care practice. The Medical Home provides care that is accessible, continuous, comprehensive, family centered, compassionate, culturally effective, and coordinated with special services for children with special health care needs (CSHCN) (Medical Home Initiative 2002). This review addresses the enhanced responsibilities that children and youth with ASD present to the primary health care provider and the real barriers that need to be addressed by research and...