Autism Spectrum Disorder in Primary Care.

This review covers autism diagnosis and care in primary healthcare. About 1 in 31 children and 1 in 45 adults have autism in the US. Doctors should screen children at 18 and 24 months. Autistic people often have shorter lifespans and more health problems like diabetes, seizures, stomach issues, and mental health conditions. Treatment focuses on building independence and managing challenging behaviors. A framework called SPACE helps make healthcare more accessible for autistic patients.

This comprehensive review outlines autism spectrum disorder (ASD) prevalence, diagnosis, and management in primary care settings. ASD affects approximately 1 in 31 US children and 1 in 45 adults, presenting with diverse symptoms and abilities. Diagnosis requires deficits in communication/social interaction across settings plus restricted/repetitive behaviors causing functional impairment. The American Academy of Pediatrics recommends screening at 18 and 24 months.

Autistic individuals face significantly reduced life expectancy (20-30 years lower) and higher rates of chronic conditions including diabetes, epilepsy, GI issues, and mental health disorders. Treatment focuses on minimizing deficits, maximizing independence, and preventing problem behaviors. The SPACE framework (sensory, predictability, acceptance, communication, empathy) provides healthcare accessibility guidelines.

Primary care providers should implement routine autism screening at 18 and 24 months, adopt multidisciplinary diagnostic approaches, and address high rates of medical comorbidities. The SPACE framework can improve healthcare accessibility. Melatonin represents an evidence-based intervention for sleep issues, while comprehensive care addressing the significant mortality gap is essential.

As a narrative review without systematic methodology, this paper does not provide specific effect sizes, confidence intervals, or detailed quality assessments of cited evidence. The review nature limits ability to assess strength of individual recommendations.

Autism is a lifelong neurodevelopmental condition that affects approximately 1 in 31 US children and 1 in 45 US adults; autism spectrum disorder includes a wide range of neurologic diversity, symptoms, challenges, strengths, and abilities. The Diagnostic and Statistical Manual of Mental Disorders, 5th ed., text revision criteria for autism spectrum disorder require deficits in three areas of communication and social interaction across multiple settings, with at least two restricted or repetitive behaviors, not explained by another condition, and causing functional impairment. The American Academy of Pediatrics recommends screening for autism at ages 18 and 24 months in addition to routine developmental surveillance, whereas screening in adults is not recommended. Diagnosis should include a multidisciplinary team and a multidimensional assessment.

Autistic individuals have a 20- to 30-year lower life expectancy than nonautistic people and experience higher rates of many chronic conditions, such as diabetes, epilepsy, gastrointestinal concerns, feeding disorders, and mental health disorders (eg, attention-deficit/hyperactivity disorder, depression, anxiety, schizophrenia). Treatment of children with autism spectrum disorder focuses on minimizing core deficits, maximizing functional independence, and preventing problem behaviors. Pharmacologic therapy may be indicated for related conditions or symptoms, such as sleep disorders, seizures, mental health conditions, behavior problems, and gastrointestinal issues. Melatonin effectively reduces sleep symptoms and improves daytime behaviors with minimal adverse effects.

The SPACE (sensory, predictability, acceptance, communication, empathy) framework provides specific interventions that make health care more accessible and affirming to autistic patients.