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Advancing Autism Knowledge and Care in the C-L Setting: Skills for the C-L Psychiatrist: A Pediatrics SIG-sponsored Skills Course
Autism spectrum disorder (ASD) is a common diagnosis and prevalence rates continue to rise; recent studies show that one in 40 children in the US carry this diagnosis. (1) Patients with ASD often have significant challenges in medical settings due to limited communication abilities, sensory processing difficulties, resistance to change in routine, and difficulty regulating behavior when stressed, which can worsen autism related behaviors and aggression, delay diagnosis and treatment, and limit their participation in their care. This patient population additionally has significant medical comorbidities, more symptoms of chronic medical problems and mortality rates that are 2.4 times higher than the general population; these rates are even higher in patients with severe intellectual disabilities. (1, 2) Providers may be unfamiliar with how to effectively complete a diagnostic assessment, manage their behaviors and provide treatment, leading to poorer patient outcomes and increased distress in both providers and patients.
Consultation-liaison (CL) psychiatrists can improve the care of patients with ASD through staff education, patient and family involvement, and coordinated care using best practices.
This skills course will help attendees gain a better understanding of unique challenges in the care of patients with autism and provide skills and strategies to better support these patients and improve their medical care experience.
- Dr. Laura Markley will begin by discussing the diagnosis of autism and providing an overview of common symptoms (24 minutes).
- Dr. Alex Israel will discuss common medical comorbidities associated with autism and give tips on how to best treat these (24 minutes).
- Dr. Serena Fernandes will describe the process and benefits of standardizing autism specific care and identify systemic interventions and tools to improve the hospital experience (24 minutes).
- Dr. Julie Jacobson will discuss best practices in management of agitation and aggression in patients with ASD (24 minutes).
- Dr. Shelly Kucherer will talk about how to manage sexuality in patients with ASD including menstruation, sexual health, contraception, and the treatment of hypersexual behaviors (24 minutes).
We will use a case-based approach when teaching and will plan to use the live session to allow participants to practice the skills and will answer questions on how to apply these skills at their home institutions.
References:
- Thom, R. P., McDougle, C. J., & Hazen, E. P. (2019). Challenges in the medical care of patients with autism spectrum disorder: the role of the consultation-liaison psychiatrist. Psychosomatics, 60(5), 435-443.
- Volkmar, F. R., Reichow, B., & McPartland, J. C. (2014). Adolescents and adults with autism spectrum disorders. New York: Springer.
Speakers
Shelly Kucherer
Assistant Professor of Psychiatry | University of Pittsburgh School of Medicine, Western Psychiatric Hospital
Dr. Shelly Kucherer is an assistant professor of psychiatry at the University of Pittsburgh School of Medicine, Western Psychiatric Hospital. She completed her general adult psychiatry residency and her consultation-liaison psychiatry fellowship at the University of Pittsburgh Medical Center and is thrilled to continue at UPMC as a faculty member. She recently also became the associate medical director of UPMC's Adult Center for Autism and Developmental Disorders. Her interests include autism spectrum disorder, intellectual disabilities, consultation-liaison psychiatry, and women's mental health.
Alex Israel
Assistant Professor of Psychiatry | UPMC Western Psychiatric Hospital
Alex Israel, MD received his medical training from University of Rochester School of Medicine and Dentistry. He graduated from adult psychiatry resident and Consult-Liaison fellowship at Western Psychiatric Hospital at University of Pittsburgh Medical Center. He currently works as an inpatient consultant at University of Pittsburgh Medical Center and as an integrated psychiatrist in the Headache and Epilepsy Centers at UPMC. His interests include neuropsychiatry, medical education, and integrated models of psychiatric care.
Serena Fernandes
Child and Adolescent Psychiatrist | Boston Children's Hospital
Serena Fernandes, M.D. is an child and adolescent psychiatrist on the Psychiatry Consultation Service in the Department of Psychiatry and Behavioral Health at Boston Children’s Hospital. Her research interests focus on neuropsychiatric disorders in children and adolescents. She also serves as an Instructor in Child Psychiatry at Harvard Medical School and Director of the Advanced Clinical Child and Adolescent Psychiatry Elective at Boston Children's Hospital.
Laura A Markley
Medical Director of C-L Psychiatry | Akron Children's Hospital
Dr. Markley is Board-Certified in General Psychiatry, Child & Adolescent Psychiatry, Pediatrics, and Addiction Medicine, and is a Fellow of the Academy of Consultation-Liaison Psychiatry, American Academy of Pediatrics, and the American Psychiatric Association. She is the Medical Director of Consultation-Liaison Psychiatry and Community Pediatrics Liaison at Akron Children's Hospital. She also practices pediatric medicine in the Adolescent Medicine Clinic at Akron Children’s. She has been a member of ACLP since 2010 and co-leads the Pediatric C/L SIG with Dr. Susan Turkel.
Dr. Markley is an Associate Professor of Psychiatry and Associate Clinical Professor of Pediatrics at the Northeast Ohio Medical University. She graduated from the Triple Board Residency at the University of Utah Medical Center in 2009, then moved back to Ohio to practice. She recently achieved an additional Board Certification in Addiction Medicine. Dr. Markley’s interests are varied and include substance abuse (particularly the novel designer drugs of abuse), psychopharmacology of the medically ill, and collaborative care. Teaching is a passion of hers, and she is involved in teaching activities in several settings.
Dr. Markley is an Associate Professor of Psychiatry and Associate Clinical Professor of Pediatrics at the Northeast Ohio Medical University. She graduated from the Triple Board Residency at the University of Utah Medical Center in 2009, then moved back to Ohio to practice. She recently achieved an additional Board Certification in Addiction Medicine. Dr. Markley’s interests are varied and include substance abuse (particularly the novel designer drugs of abuse), psychopharmacology of the medically ill, and collaborative care. Teaching is a passion of hers, and she is involved in teaching activities in several settings.
Julienne Jacobson
Clinical Associate Professor Keck School of Medicine of USC | Direct C/L Psychiatry, Children's Hospital Los Angeles
Dr. Jacobson is the director of the C/L Psychiatry Service at Children's Hospital Los Angeles, and an associate professor of psychiatry and pediatrics at the Keck School of Medicine of USC. She is board certified in general psychiatry, child and adolescent psychiatry and consultation and liason psychiatry. Dr. Jacobson completed medical school, residency and fellowship training in Southern California at University of Southern California and Loma Linda University. Clinical interests include pediatric psychiatric syndromes such as delirium and catatonia, professional interests include teaching and mentorship of medical students and trainees.
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