On Friday, January 12th, the third annual Autism Summit took place at the Alberta Children’s Hospital with over 120 professionals and service providers from the healthcare and autism communities in attendance.  The focus of the summit was on mental health and autism, and the transition to adulthood.  Dr. Kristin Evashuk, a Community Pediatrician in Calgary, started Autism Summit in 2016, with sponsorship from the Section of Community Paediatricians Calgary (SCP). For the past two years, The Sinneave Family Foundation (Sinneave) has joined SCP to co-sponsor and support coordination of the event.  The planning committee for Autism Summit 3 included:

  • Kristin Evashuk, Community Pediatrician
  • Dan Ross, Community Pediatrician
  • Katelyn Lowe, Chief Strategy Officer, Sinneave
  • Teunisje Gruber, Reg.OT, CCC, Launch Clinical Associate, Sinneave
  • Nicki Wilson, Associate Executive Director, Psychologist, Renfrew Educational Services
  • Arlene Klooster, Executive Director, SLP, Lead Foundation
  • Avneet Sangha, PaceKids
  • Sara Baker, Reg.OT, Launch Clinical Associate, Sinneave
  • Sinneave’s Resource Centre Ambassadors put together promotional materials for networking at the event.

The Summit began with three consecutive presentations made on mental health concerns in children and youth with autism. The first presenter was Dr. Jennifer Hibbard, a psychiatrist at the Arnika Centre, who presented on “Mental Health & ASD: Risk and Resiliency.”  She discussed the concepts of mental health and wellness.  Individuals with Autism Spectrum Disorder (ASD) are at higher risk for emotional problems and behaviour disorders than the general population: their core diagnostic feature, resistance to change and insistence on sameness, makes it more difficult for them to be resilient to life’s stressors.  Dr. Hibbard discussed Jonathan Weiss’ (2005) research on autism and the concept of “thriving.” This relates to the Six C’s in the context of the youth’s family, school, and community: competence, confidence, character, caring or compassion, connection, and contribution.  Her take home message was that thriving and mental health are good outcomes in ASD.

Dr. Hibbard also discussed mental health conditions that commonly co-exist with autism such as specific phobias, obsessive-compulsive disorders, Attention Deficit Hyperactivity Disorder (ADHD), anxiety, depression, and oppositional defiant disorders.  She provided a more in-depth discussion of the co-existence of ASD with ADHD and self-injurious behaviour (SIB).  Thirty to fifty percent of children with ASD also have ADHD and there is a genetic basis for this co-occurrence.  Twenty-five to fifty percent of individuals with ASD will engage in some type of SIB ranging in severity from skin picking to head banging.  The reasons for SIB are complex and require an assessment of the biological, psychological, and social factors and a treatment approach that targets all those areas.  Dr. Hibbard outlined two key targets for intervention: support the parents, and identify and treat behavioural and mental health disorders in their children with ASD.

Dr. Allan Donsky, a child and adolescent psychiatrist and university professor, presented on “Understanding and Responding More Effectively to Anxiety in the ASD population: Getting closer to the life we want.”  Anxiety is based on anticipated future danger.  Anxiety can be normal; however, it is the degree of distress or suffering that makes it a disorder.  Anxiety has multiple sources: psychological, social, spiritual, and biological.  Anxiety sets off the fight, flight, or fight response of the sympathetic nervous system.  In youth with ASD, anxiety can present as follows (credit to K. Lowe): fight behaviours include aggression, SIB, tantrums, etc.; flight behaviours include avoiding, procrastinating, lacking motivation, etc.; and freeze behaviours include being indecisive, withdrawing, perfectionism, avoiding eye contact, etc.  In helping youth with ASD, Dr. Donsky emphasized the “4 Rs”: rapport, respect, receptivity, and responding.  A mindfulness approach to intervention helps not only the clients but also the professional.  Mindfulness is purposefully paying attention to the present moment.  In addition, Dr. Donsky helps youth with ASD improve symptoms by educating them on anxiety and the relationship between thoughts, feelings, and actions.  By being mindful, one can make “wiser” or more helpful choices.  He also helps youth develop an emotional vocabulary and coping strategies.

Dr. Jennifer Fisher is a professor and a psychiatrist at the Developmental Psychiatry Consultation and Complex Patient Management Clinic.  In her practice, Dr. Fisher sees children with ASD and intellectual disabilities (ID).  She discussed the many causes of aggression in children with ASD: medical factors, bullying, different sensory thresholds, communication frustration, environmental factors (e.g. exhausted parents), anxiety, arousal, sleep issues, the need for sameness, etc.  Her team does a comprehensive history and assesses all the various factors that can be causing a child’s problematic behaviours.  Electronic Medical Recording (EMR) also known as Netcare is critical in caring for complex patients that see multiple specialists and professionals.  Dr. Fisher provided case examples where individuals with ASD received help in the form of interventions in their environment or with medical issues, and psychiatric medications were not necessary.  In addition, she discussed the various genetic causes of autism and the possibility that, in the future, the diagnosis of autism will not be necessary as the underlying causes are identified.  She discussed several barriers to management, and popular treatments not supported by evidence.  Dr. Fisher described that we are in a “post truth era” meaning objective facts are less influential on public opinion than appeals to emotion and personal belief.  She concluded by saying that complex clients need to be cared for by a specialist who is also a generalist (one who provides multi-domain assessment and treatment) and efficient patient care coordination is critical.

The theme of the afternoon was the transition of youth with ASD to adulthood.  Dr. Katelyn Lowe of The Sinneave Family Foundation provided an update on Launch – a suite of programs, services and tools designed to help adolescents and young adults with autism, parents and professionals with transition planning.  Two new Launch programs, Launch On-line and Launch + Skills, are in development and will be available soon.  Stay tuned in the coming weeks for more details!

Following Dr. Lowe, Ms. Karen Beekhuizen, a Social Worker and parent, shared the story of her daughter’s transition to adulthood.  Her daughter was able to grow her special talents of reading and typing into successful employment.  Ms. Beekhuizen emphasized the importance of educating employers on not only the talents of the prospective employee who has ASD, but also their challenges (e.g. decreased eye contact, needing extra processing time, problems with relational skills, etc.).  This helps the employer know what to expect and to make accommodations.

The event concluded with a question and answer period with a Provocative Panel: Ms. Beekhuizen; Amanda Richardson, Supervisor Specialized Mental Health Services, Emerging Adult Treatment Clinic; Lorna Selig, Transition Consultant, The Children’s Link; Clayton Bothwell, Persons with Developmental Disabilities, Disability Services; and Kimberley Nerbas Hartley, Team Leader, Disability Services, PDD and FSCD.  Overall, the event was a huge success and many thanks go out to all those who organized, presented, and participated in it!

Written by Teunisje Gruber

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