New Zealand Autism Spectrum Disorder Guideline - Ministry of Health

Part 2: Support for individuals, families and carers
• some individuals with ASD experience
unusual sensory and perceptual sensitivities
(both hypo- and hyper-responsivity) to a
range of experiences including light, sound,
taste, touch and pain
• there may be unpredictable reactions to
medication, sleep disturbances, issues with
diet and, for some people, engagement in
behaviours that can be harmful to themselves.
In New Zealand, public sector health services
focus on the provision of care in primary health
settings. Everyone is encouraged to enrol with
a general practitioner (GP). The health care of
children known to have ASD is often monitored
by a paediatrician in addition to the service
provided by the general practitioner. However,
specialist input usually ceases when the person
reaches adulthood. As a result, it is possible that
many adults with ASD access only GP care and
do not access specialist services. Accounts by
people with ASD suggest that there are barriers to
good health care which include lack of attention
to health issues, anxiety, poor communication
and confusion and avoidance of contact caused
by dissatisfaction with previous contact 25 135 .
Clearly, some people with ASD need support to
manage their physical well-being appropriately,
and medical and health care practitioners
require knowledge of ASD and how it affects
their clients to be able to provide optimum
health care services (Recommendation 2.3.1).
Strategies to improve the current situation could
include:
• comprehensive medical assessments of
people with ASD 11
– dietary and exercise guidelines to prevent
secondary health issues, especially for
those on medication
– screening for motor, sensory and
perceptual difficulties
• education in ASD should occur both in initial
and in post-qualification training of GPs,
nurses and other health care practitioners 136-138
• educating families, whänau and carers how
to, first, support the person with ASD to
attend to their own health care, and second,
how to recognise health care issues and get
assistance accordingly (Recommendations 2.3.2,
2.3.3, 2.3.4, 2.3.5 and 6.8, Professional learning
and development).
Health care providers have also been advised to:
• work with the person and their family/
supporters to ensure that their needs are
understood
• work within the interests and strengths of the
person with ASD
• alter agency procedures to take the ASD
needs into account (ie, have several short
appointments rather than one long one, use
the same room each time, fit into their daily
routines and use language they understand)
• communicate clearly
• use photographs or pictures to explain
procedures
• provide visual and written information
• remove stimuli that may distress the person
25 39 135 138-141
• give feedback and encouragement
(Recommendation 2.3.6).
Part 2
• routine health care screening 136
• the development of a health-assessment
profile covering:
– close surveillance for the development of
mental health problems and epilepsy
– age-related prompts for screening for
hearing loss, eyesight changes/glaucoma,
hypertension and metabolic syndrome
2.3.b Specific health care issues
Acute and emergency care
Acute and emergency medical care presents
special problems for people with ASD and their
parents, carers and families. The very nature of
acute illness and the need for urgent medical
care means that the child or adult cannot be
New Zealand Autism Spectrum Disorder Guideline 75