journal
https://read.qxmd.com/read/38423727/pediatric-management-of-autism
#1
EDITORIAL
Paul H Lipkin, Joshua B Ewen
No abstract text is available yet for this article.
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423726/autism-today
#2
EDITORIAL
Tina L Cheng
No abstract text is available yet for this article.
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423725/mortality-and-autism-suicide-and-elopement
#3
REVIEW
Suzanne Rybczynski
Autistic children and youth are at risk for premature mortality. Two preventable causes of that increased risk are elopement and suicide. Pediatricians should educate themselves and caregivers about strategies that could prevent tragic situations involving autistic youth.
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423724/the-autism-constellation-and-neurodiversity-long-term-and-adult-outcomes-in-autism-spectrum-disorder
#4
REVIEW
Inge-Marie Eigsti
Research on autistic adults suggests significant heterogeneity in outcomes. A significant proportion of individuals struggle with intellectual disability and limited communication skills. Of the 67% who have age-appropriate cognitive skills, around half are expected to attain a college education, and 25% are likely to hold a full-time job. Outcomes have been improving over time, in part because of earlier diagnosis and earlier intervention. Indeed, an estimated 10% to 20% are expected to lose all symptoms of autism by adolescence...
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423723/a-pediatrician-s-practical-guide-for-navigating-transition-to-adulthood-with-autistic-youth-and-their-caregivers
#5
REVIEW
Kristin Sohl, Crystalena Oberweiser, Elly Ranum, Charles Oberweiser, Wendy Cornell
When pediatricians, autistic people, and their families carefully consider and plan for the transition from pediatric care to adult care, there are better outcomes for patients. Pediatricians see their patients over time and are uniquely positioned to help prepare for the changes that come with the transition through adolescents to adulthood. Although programs such as Got Transition offer some guidance on how to navigate the transition from pediatric care to adult care, there is less information on how to help those on the autism spectrum and their families transition to adulthood in other ways...
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423722/profound-autism-an-imperative-diagnosis
#6
REVIEW
Lee Elizabeth Wachtel, Jill Escher, Alycia Halladay, Amy Lutz, Gloria M Satriale, Arthur Westover, Carmen Lopez-Arvizu
Profound autism refers to a subset of individuals with autism spectrum disorder who have an intellectual disability with an intelligence quotient less than 50 and minimal-to-no language and require 24-hour supervision and assistance with activities of daily living. The general pediatrician will invariably work with autistic children across the spectrum and will likely encounter youth with profound autism. Awareness of profound autism as a real entity describing autistic children with concomitant intellectual disability and language impairment who require 24-hour care is the first step in developing a solid pediatric home for these youth...
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423721/psychopharmacology-management-in-autism-spectrum-disorder
#7
REVIEW
Jay A Salpekar, Lawrence Scahill
Persons with autism spectrum disorder (ASD) may have other psychiatric conditions that warrant treatment. Symptoms may not be easy to discern from rigidity or irritability that are sometimes considered to be constituent parts of ASD. Pathophysiology that involves hyperexcitable neurons and anomalous connectivity may provide justification for using psychopharmacologic agents, although nonmedical strategies may also be effective. Hyperactivity, irritability, and tantrums with or without aggression may be rational targets for psychopharmacological intervention...
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423720/mental-health-crises-in-autistic-children-a-framework-for-prevention-and-intervention-in-primary-care
#8
REVIEW
Roma A Vasa, Kate Neamsapaya, Elizabeth A Cross, Luther Kalb
Children with autism are at high risk for experiencing a mental health crisis, which occurs when psychiatric and behavioral symptoms become a danger and caregivers do not have the resources to safely manage the event. Our current mental health systems of care are not fully prepared to manage crisis in autistic individuals, due to the shortage of available mental health providers and programs that are tailored for autistic children. However, new strategies to address crisis are gradually emerging. This article provides a framework to define crisis and implement prevention and intervention approaches that could potentially mitigate risk for crisis...
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423719/sleep-problems-in-autism-spectrum-disorder
#9
REVIEW
Navjot Sidhu, Zoe Wong, Amanda E Bennett, Margaret C Souders
Sleep problems are common in children with autism spectrum disorder (ASD), with 40% to 80% prevalence. Common disorders include insomnia, parasomnias, and circadian rhythm sleep-wake disorders. These problems have a multifactorial etiology and can both exacerbate and be exacerbated by core ASD symptoms. Sleep problems also impact the health and quality of life of both patients and their caregivers. All children with autism should be regularly screened for sleep problems and evaluated for co-occurring medical contributors...
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423718/autism-and-epilepsy
#10
REVIEW
Jamie K Capal, Shafali S Jeste
Epilepsy is one of the most common comorbidities in individuals with autism spectrum disorders (ASDs). Risk factors include the presence of developmental delay/intellectual disability, female sex, age, and an underlying genetic condition. Due to higher prevalence of epilepsy in ASD, it is important to have a high index of suspicion for seizures and refer to a neurologist if there are concerns. Genetic testing is recommended for all children with ASD but it becomes more high yield in children with epilepsy and ASD...
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423717/autism-spectrum-disorder-at-home-and-in-school
#11
REVIEW
Megan E Bone, Mary L O'Connor Leppert
The diagnosis of autism spectrum disorder (ASD) brings a lifetime of considerations for individuals and their families. The core symptoms of ASD vary in severity and influence behavior and function across all environments. Co-occurring medical, mental health, cognitive, language, learning, and behavioral differences add challenges to those associated with core symptoms. Navigating the preschool, school, and transition ages in the educational setting requires continual reassessment of the strengths, weaknesses, and needs of the student to provide appropriate placement and services...
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423716/evidence-based-interventions-in-autism
#12
REVIEW
Julia S Anixt, Jennifer Ehrhardt, Amie Duncan
Pediatricians have a critically important role in the care of children with autism, including conducting developmental screening to support early diagnosis and intervention, advising families about evidence-based treatments for autism spectrum disorder, and supporting families' emotional health as they care for a child with a developmental disability. The purpose of this article is to provide pediatricians with information about evidence-based autism treatments and how to determine which interventions are appropriate for children across the autism spectrum at different ages and developmental stages...
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423715/etiologic-evaluation-of-children-with-autism-spectrum-disorder
#13
REVIEW
Steven M Lazar, Thomas D Challman, Scott M Myers
Autism spectrum disorder (ASD) is clinically and etiologically heterogeneous. A causal genetic variant can be identified in approximately 20% to 25% of affected individuals with current clinical genetic testing, and all patients with an ASD diagnosis should be offered genetic etiologic evaluation. We suggest that exome sequencing with copy number variant coverage should be the first-line etiologic evaluation for ASD. Neuroimaging, neurophysiologic, metabolic, and other biochemical evaluations can provide insight into the pathophysiology of ASD but should be recommended in the appropriate clinical circumstances...
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423714/differential-diagnosis-of-autism-and-other-neurodevelopmental-disorders
#14
REVIEW
Lindsay Olson, Somer Bishop, Audrey Thurm
This article discusses the diagnostic criteria for autism spectrum disorder (ASD), as well as other neurodevelopmental disorders that may be confused with or co-occur with ASD. Practitioners involved in diagnostic assessment of ASD must be well versed in the features that differentiate ASD from other conditions and be familiar with how co-occurring conditions may manifest in the context of ASD. ASD symptoms present differently across development, underscoring the need for training about typical developmental expectations for youth...
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423713/screening-for-autism-a-review-of-the-current-state-ongoing-challenges-and-novel-approaches-on-the-horizon
#15
REVIEW
Kate E Wallis, Whitney Guthrie
Screening for autism is recommended in pediatric primary care. However, the median age of autism spectrum disorder (ASD) diagnosis is substantially higher than the age at which autism can reliably be identified, suggesting room for improvements in autism recognition at young ages, especially for children from minoritized racial and ethnic groups, low-income families, and families who prefer a language other than English. Novel approaches are being developed to utilize new technologies in aiding in autism recognition...
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/38423712/health-care-for-autistic-children-a-public-health-perspective
#16
REVIEW
Jennifer L Ames, Meghan N Davignon, Elizabeth A Hayes, Lisa A Croen
Autism has been the subject of large-scale public health investment. These investments are increasingly shifting toward mitigating the lifelong disability and impairment associated with autism. Key efforts include bolstering screening schedules, accelerating the path to diagnosis and early entry into evidence-based therapies, and providing preventive management of common co-occurring conditions. Enhancing their implementation will necessitate addressing neurodiversity and health equity. Pediatric primary care teams continue to be important stewards in population-level initiatives to promote autistic health...
April 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/37973313/everyday-ethics-in-the-clinical-practice-of-pediatrics
#17
EDITORIAL
Margaret R Moon
No abstract text is available yet for this article.
February 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/37973312/everyday-ethics-in-a-changing-world
#18
EDITORIAL
Tina L Cheng
No abstract text is available yet for this article.
February 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/37973311/management-of-uncertainty-in-everyday-pediatric-care
#19
REVIEW
Nicholas A Jabre, Margaret R Moon
Medicine is filled with uncertainty. Clinicians may experience uncertainty due to limitations in their own or existing medical knowledge. Uncertainty can be scientific, practical, or personal, and may involve issues related to probability, ambiguity, and complexity. Pediatricians face additional uncertainties related to the role of families in decision-making and limited ability to know the preferences of children. Clinicians may approach uncertainty in different ways: some choosing to embrace its presence and others attempting to avoid it...
February 2024: Pediatric Clinics of North America
https://read.qxmd.com/read/37973310/how-to-do-ethics-in-pediatrics-practice-a-framework-for-addressing-everyday-ethics-issues
#20
REVIEW
Mark T Hughes
Pediatricians have a fiduciary responsibility to advocate for the best interests of their patients. They accomplish this through the therapeutic alliance with the patient and their parent. In everyday clinical medicine, the pediatrician may be faced with challenging situations. When a case raises concerns, the pediatrician needs to determine if the issues relate to ethical obligations and whether they are in conflict. To resolve the concerns, a systematic process for gathering, organizing, and analyzing the facts of a case is needed to discern morally permissible options...
February 2024: Pediatric Clinics of North America
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