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Caring for Children With Autism Spectrum Disorders:
A Resource Toolkit for Clinicians
This toolkit was developed to support health care professionals in
the identification and ongoing management of children with autism spectrum
disorders (ASDs) in the medical home. The toolkit is divided in to
the following sections listed below. Please choose a section for specific
information and tools that can be found in the toolkit. Some sample
tools are provided on this page.
Introduction
This
section contains the 2 ASD clinical reports and developmental screening policy
statement. It also contains other AAP ASD publications and helpful Web sites.
Identification
This section contains freestanding algorithms for ASD and general developmental
screening that can serve as quick references for the clinician. It also
includes surveillance and screening tools that are sensitive to ASD for
3 different age groups. No tool is perfect and inclusion of these tools
does not imply AAP endorsement; they were chosen because of their easy
accessibility and reliability based on current available research.
Referrals
This
section provides sample referral forms and letters that can assist the clinician
in gaining access to insurance payment for early intervention, educational,
and therapeutic services for patients with ASDs.
Physician
Fact Sheets
This section provides the clinician with additional informational
fact sheets that complement and further explain selected
topics addressed in the 2 ASD clinical reports: seizures,
sleep, nutrition, gastrointestinal disorders, behavior, education,
complementary and alternative medicine, and more. It also
contains a form that can be inserted into the child?s
clinical record as an age-specific flowchart to guide the
clinician through the maze of tests and interventions appropriate
for the diagnosis and management of children with ASDs.
Family
Handouts
This section contains the greatest number of tools and is especially
formatted to help the clinician provide focused information
to families when they identify a specific concern or need that
emerges throughout the life span. Handouts address early intervention,
school interventions, behavioral techniques, vaccines, strategies
to prepare children for medical appointments, a form for local
emergency medical services, coexisting health conditions, and
more (these serve as companions to the Physician Fact Sheets).
Introduction
- Autism
A.L.A.R.M. -PDF
The A.L.A.R.M. bullets were developed to raise physician
awareness, promote surveillance and screening, and ensure that all
children receive appropriate and timely interventions. The flipside
includes the new algorithm developed as part of the AAP clinical
report, ?Identification and Evaluation of Children With Autism Spectrum
Disorders? (2007).
- American
Academy of Pediatrics clinical report, ?Identification and Evaluation
of Children With Autism Spectrum Disorders?-Link
This clinical report supports health care professionals in identifying
children with ASDs as early as possible.
- American
Academy of Pediatrics clinical report, ?Management of Children
With Autism Spectrum Disorders?
-Link
This clinical report supports health care professionals in the management
of children with ASDs in the medical home.
- American
Academy of Pediatrics policy statement, ?Identifying Infants
and Young Children With Developmental Disorders in the Medical
Home: An Algorithm for Developmental Surveillance and Screening?- Link
This policy statement supports health care professionals in developing
a pattern and practice for addressing developmental concerns in children
from birth through 3 years of age.
- Policy
Statements and Clinical Reports Authored by the American Academy
of Pediatrics Council on Children with Disabilities and Additional
Resources and Web Links-
This document
provides additional resources for pediatricians and parents
addressing the identification and management of children with
ASDs, including select policy statements and clinical reports
authored by the Council on Children with Disabilities.
Identification
Surveillance
and Screening Tools -
This section provides information about
screening tools in general, including the difference between Level 1 and
Level 2 screening tools.
- Surveillance
and Screening Algorithm: Autism Spectrum Disorders -
This tool was designed as part of the AAP clinical report, ?Identification and
Evaluation of Children With Autism Spectrum Disorders.? It guides the surveillance
and screening process for identifying children with autism.
- Developmental
Surveillance and Screening Algorithm Within a Pediatric Preventive Care Visit- Link
This tool was designed as part of the AAP policy statement, ?Identifying
Infants and Young Children With Developmental Disorders in the Medical Home:
An Algorithm for Developmental Surveillance and Screening,? to guide the
surveillance and screening process for identifying children with general
developmental problems.
Surveillance
Tools
- Examples
of DSM-IV-TR Criteria for Autism/Examples of DSM-IV-TR Criteria for
Asperger Syndrome-
These tools help primary care professionals recognize
several of the criteria required as part of the Diagnostic and Statistical
Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) requirements
for diagnosis of autism or Asperger syndrome.
- Is Your One-Year-Old
Communicating With You?- See excerpt
This AAP patient education brochure is designed to help
encourage parents to share concerns they have about
their baby?s language development as early
as possible. A printed copy is provided with this toolkit. The brochure can
be ordered from the AAP online Bookstore (www.aap.org/bookstore) and should
be handed out to parents at their child?s 1-year well-child
visit.
- CDC/AAP Developmental
Growth Chart-
This chart was developed jointly by the AAP and CDC for primary care professionals
to hang in their waiting or examination rooms. It lists developmental milestones,
important AAP screening recommendations, and physical growth markers. A printed
copy is provided with this toolkit.
- Web-based ASD
Video Glossary Flyer
This flyer contains information about a new Web site with more than 150 video
clips designed to help pediatricians and parents recognize early signs of
autism.
Screening
Tools
- Selected
Level 1 and Level 2 ASD Screening Measures -
This table lists several
screening tools available, psychometric properties, and information about
how to obtain the tools.
- CSBS DP
Infant-Toddler Checklist/CSBS DP Scoring Instructions -
This checklist
is designed to identify different aspects of social-communication development
in infants and toddlers. A caregiver should complete this checklist when
the child is between 6 and 24 months of age. It does not provide a diagnosis,
but rather identifies children needing further evaluation. A scoring
handout is also included.
- M-CHAT/M-CHAT
Scoring Instructions -
This screening tool was designed to help primary
care professionals with early identification of children with autism.
The M-CHAT does not provide a diagnosis but can indicate if a child is
at risk and should receive further evaluation. A scoring handout is also
included.
- The
Childhood Asperger Syndrome Test (CAST)/Social & Communication
Development Questionnaire-Key -
This
screening tool helps primary care professionals
with early identification of children
with Asperger syndrome. The CAST does
not provide a diagnosis but can indicate
if a child is at risk and should receive
further evaluation. A scoring handout is
also included. The AAP does not recommend
universal screening for Asperger syndrome
for all children.
Other
Resources
- Screening
and Testing for Autism: Coding Fact Sheet for Primary Care Pediatricians
-
This handout was developed to guide pediatricians in coding for services
related to autism.
- The
Medical Laboratory Evaluation of
a Child Diagnosed With Autism Spectrum
Disorder -
This resource discusses
the pediatrician?s role in the
medical evaluation of the child
diagnosed with an autism spectrum
disorder.
Referral
- The Medical
Home and Early Intervention Programs -
This brochure is designed to educate
pediatric clinicians about early intervention programs funded under Part
C of the Individuals With Disabilities Education Act, educate early intervention
programs about the role of the medical home, and provide strategies for
effective collaboration and communication.
- Early Intervention
Program Referral Form - Word Doc
This editable form is designed to simplify the
referral process to early intervention programs and allows primary care
professionals to indicate the types of information they would like to
receive from the early intervention program.
- Tips for
Writing Letters for Insurance Coverage of Recommended Therapies/Sample
Letters -
This document was developed to assist primary care professionals
in obtaining payment for recommended therapies. Sample letters are also
included as editable files.
- Local List
of Possible Community Resources for Pediatric Practices -
This editable
form is designed for primary care professionals to insert names and contact
information of local referral sources and family groups so that the information
is readily available when needed.
Physician
Fact Sheets
-
Autism Checklist
for Health Care Professionals-
This
checklist was developed
to assist health
care professionals
in ensuring that
important steps are
taken in the identification,
diagnosis, intervention,
and management of
children with ASDs
and their families
and can be placed
in the child?s chart
to track when these
steps have been completed.
-
Meeting
the Needs of Children With Autism Spectrum Disorder During Medical Visits,
Dental Visits, and Other Challenging Procedures: Advice for Health
Care Professionals-
This
document is designed to provide guidance to health care professionals on
how to make visits go as smoothly as possible for patients with ASDs. It
includes steps an office can take to better prepare for these visits.
-
The
following resources are fact sheets that provide primary care professionals
with background information about a variety of topics. They can be used
to prepare for questions parents may ask during a visit.
- Adolescence and
Transition to Adulthood
- Asperger Syndrome
- Behavioral Principles
- Complementary
and
- Alternative Medicine
- Therapies
- Dietary Treatments
- Used for Behavioral
- Management
- Eating and Nutrition
- Gastrointestinal
- Problems
- How to Decide
on
- Treatments When
Parents Are Seeking
- Complementary
and Alternative Medicine
- Psychopharmacology
- Seizures and Epilepsy
- Sleep Disorders
- Toilet Training
Family
Handouts
- Understanding
Autism Spectrum Disorders (ASDs)- See
excerpt
This
booklet, written for parents, provides critical information about ASDs and
answers the most common questions asked by parents about ASD. A printed copy
is provided with this toolkit.
- Emergency
Information Form for Children With Autism
This
editable form is used to record health information for children with ASDs.
It should be kept in multiple locations for easy access by physicians and
emergency medical personnel. A parent should fill this out with the help
of the primary care professional and provide it to the local emergency medical
services professionals.
- The
following handouts are in question-and-answer format for parents on a variety
of topics. They can be given to parents to enhance discussions you have about
these issues.
- Behavioral Challenges
- Diet
- The Early Intervention
Program
- Gastrointestinal Problems
- Growing Up: Moving
From Childhood to Adolescence
- Guardianship*
- Lab Tests
- Medications
- Medicines and Your
Child
- Nutrition and Eating
Problems
- School-based Services
- Seizures and Epilepsy
- Sibling Issues
- Sleep Problems
- Support Programs for
Families
- Toilet Training
- Transition to Adulthood:
The Ultimate Outcome
- Vaccines
- Visiting
the Doctor *The Doctor?s Form Letter
included in this handout is also provided
as a Word document to allow for modification.
If
you are interested in purchasing
Autism-Caring for Children
with Autism Spectrum Disorders: A Toolkit for Clinicians,
please
visit the AAP
Bookstore.
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