Margot Savoy, MD, MPH, FAAFP, CPE, FABC Department of Family & Community Medicine, Jefferson Medical College, Philadelphia, Pa msavoy@christianacare.org
The author reported no potential conflict of interest relevant to this article.
Although every community may not have easy access to a pediatric subspecialist referral center, all 50 states and US territories are required by law to provide access to early intervention programs under Part C of the 2004 Individuals with Disabilities Education Act.31 (For a list of resources, see “Autism spectrum disorder: Where to learn more”.)
Help families prepare
Despite a lack of evidence connecting thimerosal to autism, the agent has been removed from most childhood vaccines as a precautionary measure.Advise families whom you refer for evaluation that they are unlikely to have a definitive answer after the first visit. Explain that the evaluation is quite thorough and generally takes several visits. Typically, a child suspected of developmental delay will undergo a comprehensive evaluation, including history and physical exam, blood work (including lead testing and, in some locations, genetic testing), hearing and vision screening, speech and language evaluation, and sensorimotor and cognitive evaluation. Additional information may be requested from daycare providers, preschool teachers, or others who spend significant amounts of time with the child.
Once a diagnosis is made, the team will work with the parents to develop an individualized care plan for the child, which often includes a mix of cognitive, physical, and speech development services in addition to nutrition and support services. The primary care physician, of course, will continue to oversee, monitor, and coordinate care.
CORRESPONDENCE Margot Savoy, MD, MPH, FAAF P, CPE, FA BC, Christiana Care Health System, Department of Family & Community Medicine, 1401 Foulk Road, Suite 100B, Wilmington, DE 19803; msavoy@christianacare.org
