Childhood autism presents a diagnostic dilemma for most GPs. Even specialists need formal help to diagnose borderline cases, mainly because crossover with other learning and behavioural problems is considerable. Community and professional resources available to parents struggling with a difficult child are already stretched. Government subsidies mean there are bureaucratic hoops for doctors and parents to jump through. What do WA GPs think? 196 responded to our E-poll.
What statement best describes your level of confidence in recognising autistic traits in a child with behavioural or social difficulties?
Parents can offer possible “autism” as a reason for their child’s developmental or behavioural problems. What statement best describes your overall view of this situation?
What is your experience of community support services for parents who have children with autism?
GP Comment on autism
Feeling inadequate. Six respondents spoke of their inadequacy in dealing with autism e.g. “There is a great deal of confusion and misinformation in both the medical and general community, which makes this a very emotive issue. I have been right and wrong in making both positive and negative diagnoses”.
Long delays getting help. Five GPs decried this fact, particularly in the public sector, with information relayed “by struggling parents”.
Factors affecting access.
“Depends on how well linked in people are with existing services and how functional the family is. Rural areas really struggle with these issues.
“Social stigma prevents many parents from seeking appropriate advice.
“Limited paediatricians willing to see patients with this problem.
“If support is available, not many know how to access it.
“Support is good when the ‘label’ is correct and appalling when there isn’t. So kids with the “not otherwise specified” label get no help without paying/EPC item and the others get the school assistance and the school psych and the whole shebang. The field has changed faster than the bureaucrats can keep up with.
“The difficulty lies with getting a diagnosis in the first place. There are waiting times of more than a year for the local community team, with costs of over $2000 for a recent patient in trying to get a diagnosis privately so they are able to access additional learning support at the local public primary school.
“Inadequate resources especially for families with financial difficulty – cannot afford private speech or OT services and government funded EPC plans are not adequate (only five per calendar year).
“Depends on locality – some areas have good support, others totally inadequate.
GP experiences of current services
“As a consumer I can talk from both sides. My experience with the ‘centre of excellence’, the State Child Development Centre, was particularly disappointing and grossly inadequate – the delay in diagnosis and the poor quality of therapies and therapists. As usual, the performance-driven private sector is where we have had most success. Fortunately, I was able to fund an intervention program suitable for my child by being able to go to work as a doctor. The cost has run into more than a good private school education and has been worth every cent.
“Compared with overseas the support offered here is very poor. The children need intensive work, starting as early as possible if they are to reach their potential.
“Limited school teacher aide funding is available; it is difficult to access speech pathologists with experience in autism.