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Announcer: Medical news and research from University Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Lisa: Hello. This is Lisa.

Interviewer: Hi, Lisa. How are you doing? This is Scott from The Scope.

Lisa: Hi, Scot.

Interviewer: So today I thought we could talk about supporting adults on the spectrum. So when it comes to supporting adults on the spectrum, what is the latest information that has you really excited right now?

Lisa: I think the increased attention on autism on adults is the most exciting thing. There's a lot of focus now at looking at transition age kids and adults as the number of kids with autism increases. They're all growing up and becoming adults. There's been a call to action to look into what's happening with adults with autism and how we can do best by them, provide services for them.

Interviewer: What's some of the latest information as far as what can we do? And how can we provide for them better? Did we have any new breakthroughs or new thoughts on that?

Lisa: Well, the area that I've been looking at is healthcare and health status. We completed the study that's just been published that really documents the very increased rates of many different medical and psychiatric conditions among adults with autism. We don't really know why many of those conditions are occurring at such a high rate compared to the non-autistic's counterparts. So we have to understand that better and then figure out ways to treat and provide health care in a better way.

Interviewer: Sounds like we're very much at the beginning of this journey.

Lisa: I think that's true. It's just been the last couple of years really that there's been a lot of talk about adults in transition-age youth and adults. So I think that's just going to increase and it's nice to see all the attention being put in that direction.

Interviewer: So a lot of talk, a lot of attention. What do we need to do to start making progress at this point? Is that going to be a hard transition to make or is it going to naturally occur? What are your thoughts on that?

Lisa: I think it's going to naturally occur because there are increasing numbers of adults with autism out there in every sector of society. The education system, all these kids who are identified with autism in K through 12 education, they're aging out and then there's a huge need for continued services for them. Yet there's not much organized for them. So in the education realm, in the employment realm, in the health care realm and the social service realm, all those areas are being increasingly tapped because, there are all these individuals looking for those services.

Interviewer: You had mentioned earlier that for adults that have autism we're starting to identify other medical issues that face them? What are some of the more common ones that we're starting to discover?

Lisa: All of the medical issues that we've seen occur more frequently in children with autism, we also see them occurring in adults with autism. These are things like GI problems, sleep problems, mental health issues like anxiety and depression. Some immune conditions. All of those things have been identified as perhaps occurring more commonly in children with autism compared to non-autistic kids.

Then we see that happening in adults as well. But, in addition to those conditions, we found almost every diagnostic increased at a higher rate in the adults with autism. So these are things that commonly you don't identify in children because they occur later in life. So things like hypertension, obesity, some heart disease, metabolic disorders. The list goes on and on.

There are only a few conditions for which the adults with autism were no different than their non-autistic counterparts. And that was cancer was one thing that stood out. They didn't have increased rates of cancer compared to the non-autistic adults.

The research I'm doing on adults is looking at the health status ad health service utilization. And, also looking at the health care providers, what they know and what researches they need with regards to caring for adults with autism.

Interviewer: What types of resources are they missing that you are finding that they do need? And what could we do about that?

Lisa: We did a survey of over 900 health care providers who provide care for adults in the Kaiser Permanente system here in northern California. They reported that their knowledge is very poor. Their knowledge about autism is very poor. And they require better training, like training on how to communicate effectively with patients with autism, resources that are available that they can direct their patients to, the need for resources, the need for better ways for providing care for them. They're really unsophisticated when it comes to dealing with patients with autism because they just haven't seen that many or they're not even aware that they have patients with autism.

Interviewer: Oh, yeah.

Lisa: So there's difficulty communicating with them and difficulty doing assessments on them because of what the autism is. So they're really sort of facing this big wave of children who are going to be entering their practices as they become adults and they have very little training, background knowledge, comfort level, resources available, strategies to communicate, all of those things they're saying they really need help.

Interviewer: That sounds like a lot. That sounds like whole sections. And maybe medical school education is going to have to change to help physicians be more up to speed on this thing. Or, do you see specialties arising where you're going to have specialty doctors that deal just exclusively with adults with autism?

Lisa: I think there really is a need for general training in medical schools so every medical student is taught about autism spectrum disorders and what it is and that they persist throughout their lifespan. It's not just a pediatric condition. These kids grow up to be adults and they still have these impairments. Or maybe there's a need for a specialty in adult medicine that's going to deal with adults with neurodevelopmental disorders. People with autism have health issues, as I've mentioned, all different kinds of health issues just like people without autism do. And they're being cared for by their primary provider. And so there's really a need for training of those primary health care providers on this segment of the population.

Interviewer: What's next? What is it that you want to look at next? What piques your curiosity?

Lisa: We're going to be starting a project very soon looking at this transition in healthcare from pediatric to adult medicine. Really trying to identify what are the health issues facing that transition-age youth population? And what are the barriers and facilitators to care for that population? We're going to be talking to patients and their caregivers and providers. And then we want to try, based on what we learn about what works and what doesn't work, try to develop and test some strategies, things that will improve that transition. So that's our next focus.

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