Recognising, supporting and understanding Autistic adults in general practice settings

Bradshaw, Pia; Pickett, Claire; Driel, Mieke van; Brooker, Katie; Urbanowicz, Anna

doi:10.31128/ajgp-11-20-5722

Cited by 10 publications

(8 citation statements)

References 24 publications

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“…The APA (2013, p. 52) notes a characteristic of autism is: ‘Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day)’, which relates to executive functioning. According to Bradshaw et al executive function ‘is the term used for the brain's ability to manage life’, noting that contemporary living ‘demands timely replies to emails, the keeping of appointments, adhering to schedules and commitments’ (2021, p. 128). Differences in executive functioning mean some autistic individuals find daily tasks such as work or accessing public transport extremely difficult, demanding, or exhausting (Bradshaw et al, 2021).…”

Section: Neurodiversity and The City: Emerging Urban Responsesmentioning

confidence: 99%

“…According to Bradshaw et al executive function ‘is the term used for the brain's ability to manage life’, noting that contemporary living ‘demands timely replies to emails, the keeping of appointments, adhering to schedules and commitments’ (2021, p. 128). Differences in executive functioning mean some autistic individuals find daily tasks such as work or accessing public transport extremely difficult, demanding, or exhausting (Bradshaw et al, 2021). On the other hand, some autistic individuals may be very organised and ‘use this as a coping strategy to manage unforeseen circumstances or anxiety’ (2021, p. 128).…”

Section: Neurodiversity and The City: Emerging Urban Responsesmentioning

confidence: 99%

“…Differences in executive functioning mean some autistic individuals find daily tasks such as work or accessing public transport extremely difficult, demanding, or exhausting (Bradshaw et al, 2021). On the other hand, some autistic individuals may be very organised and ‘use this as a coping strategy to manage unforeseen circumstances or anxiety’ (2021, p. 128). The lack of predictability of urban life, together with daily demands of urban living, can create considerable challenges for those who are neurodiverse and such experiences need to be better understood.…”

Section: Neurodiversity and The City: Emerging Urban Responsesmentioning

confidence: 99%

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Cities of neurodiversity: New directions for an urban geography of neurodiversity

Kenna

2022

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The concepts of difference and diversity are now central to understanding cities and urban societies (Valentine, 2008). Differences such as age, gender, sexuality, disability, and their intersections have gathered considerable research attention over the last three decades. Much has already been written on how socio-spatial context affects experiences of those in marginalised groups (in terms of gender, class, disability, etc.) and the socio-spatial exclusions that result. Other aspects of difference and diversity, such as neurodiversity, have received significantly less attention. However, the neurodiversity movement has sought to have neurological differences (such as autism) recognised and respected in similar ways to other aspects of difference, such as gender or sexuality, for example, paving the way for research on cities of neurodiversity.In proposing new directions for geographical research, this paper makes four key arguments. First, that research needs to recognise the multiplicity of neurodiversity. That is, while we are witnessing a burgeoning interest in autism, there are various neurodivergent conditions that also need research attention and consideration, including ADHD, Sensory Processing Disorder (SPD), and dyspraxia, among others (see Singer, 1999). Some individuals may be diagnosed

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Section: Neurodiversity and The City: Emerging Urban Responsesmentioning

confidence: 99%

Section: Neurodiversity and The City: Emerging Urban Responsesmentioning

confidence: 99%

Section: Neurodiversity and The City: Emerging Urban Responsesmentioning

confidence: 99%

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Cities of neurodiversity: New directions for an urban geography of neurodiversity

Kenna

2022

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“…16 It is known that autistic patients face significant health disparities and autistic doctors have a unique perspective on the contributory factors and possible solutions. 17,18 Autistic GPs and scholars contributed to the March 2021 issue of the Australian Journal of General Practitioners, which focused on neurodiversity. 17 Their open representation in this publication highlights the heterogeneity of autism and directly challenges the tragedy narrative of autism pervasive in health care.…”

Section: Implications For Autistic Patientsmentioning

confidence: 99%

Supporting autistic doctors in primary care: challenging the myths and misconceptions

2021

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From 2014 to 2017 autism was championed by the Royal College of General Practitioners (RCGP). A suite of resources were developed to support GPs in their care of autistic patients. 1 Engagement on this topic allowed the RCGP and GPs to be represented in national policy and guideline development.The RCGP continues to promote proper care of autistic patients, their families, and carers. In its position statement on the subject in June 2016 2 it recognised the essential role general practice plays in caring for this community, their families, and carers. It committed to promoting evidence-based training on autism, and to sign-posting resources that enable equitable access by this group to primary health care.The Core Capabilities Framework for Supporting Autistic People 3 and Reasonable Adjustments 'flag' on patient records mark out some of the significant progress that has been made. Much remains to be done, and although sensitivities to the needs of autistic patients have improved, the experience and needs of autistic doctors have gone, largely, unrecognised. AUTISM PREVALENCE IN HEALTHCARE PRACTITIONERSRecent prevalence data indicates 1.1% of the UK population is autistic, 4 although this is widely held to be an underestimate. While we do not yet have prevalence rates for autistic doctors, 1% of GP responders surveyed on this topic by the RCGP clinical priority group 5 indicated that they were themselves autistic, so informing their care of autistic patients.Public awareness campaigns, 6 medical literature, 7 or the diagnosis of a family member are prompting a 'lost generation' of autistic healthcare professionals to recognise their autistic traits, 8 but it is

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“…[20] Title two of The Americans with Disabilities Act prohibits discrimination against disabled people in both public and private hospitals and health facilities [21] and requires modified policies and procedures, such as the use of auxiliary aids, to improve communication and remove barriers to accessing care. In North America, the Autism Healthcare Accommodations Tool (AHAT) was developed as part of the AASPIRE Healthcare toolkit [22] and has been referenced within the Australian Journal of General Practice, [23] alongside the NAS My Health Passport as examples of resources to aid in the provision of care for Autistic people. In addition, the My Autism Passport App has been introduced to Canada.…”

Section: Introductionmentioning

confidence: 99%

A hostile context, very limited intervention theory and almost no change in outcomes: findings from a systematic realist review of health passports for Autistic adults

Ellis

Williams

Brown

et al. 2022

Preprint

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Background: Autism is a normal part of cognitive diversity, resulting in communication and sensory processing differences, which can become disabling in a neurotypical world. Autistic people have an increased likelihood of physical and mental co-occurring conditions and die earlier than neurotypical peers. Inaccessible healthcare may contribute to this. Autism Health Passports (AHPs) are paper-based or digital tools which can be used to describe healthcare accessibility needs; they are recommended in UK clinical guidance. However, questions remained as to the theoretical underpinnings and effectiveness of AHPs. Methods: We undertook a systematic literature search identifying studies focused on AHPs for adults (aged over 16 years) from five databases. Included literature was subjected to realist evaluation. Data were extracted using a standardised form, developed by the research team, which considered research design, study quality for realist review and the Context, Mechanisms and Outcomes (CMOs) associated with each AHP tool. Findings: 162 unique records were identified, and 13 items were included in the review. Only one item was considered high quality. Contextual factors focused on the inaccessibility of healthcare to Autistic patients and staff lack of confidence and training in supporting Autistic needs. Interventions were heterogeneous, with most sources reporting few details as to how they had been developed. The most frequently included contents were communication preferences. Mechanisms were often not stated or were inferred by the reviewers and lacked specificity. Outcomes were included in four studies and were primarily focused on AHP uptake, rather than Outcomes which measured impact. Conclusion: There is insufficient evidence to conclude that AHPs reduce the health inequalities experienced by Autistic people. Using an AHP tool alone, without the inclusion of the local Autistic community developing the tool, and a wider intervention, such as training for staff or the use of local champions, may mean that AHPs do not trigger any Mechanisms, and thus cannot affect Outcomes.

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Recognising, supporting and understanding Autistic adults in general practice settings

Cited by 10 publications

References 24 publications

Cities of neurodiversity: New directions for an urban geography of neurodiversity

Cities of neurodiversity: New directions for an urban geography of neurodiversity

Supporting autistic doctors in primary care: challenging the myths and misconceptions

A hostile context, very limited intervention theory and almost no change in outcomes: findings from a systematic realist review of health passports for Autistic adults

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