New Zealand Autism Spectrum Disorder Guideline - Ministry of Health

Part 2: Support for individuals, families and carers
Part 2
occupational safety and so on. While no research
was found which assessed the effectiveness of
these campaigns for people with ASD, given
their communication, cognitive and social
characteristics, it is likely that effectiveness is
less than optimum. Adapting national health
campaigns in order to more effectively engage
people with ASD and their families (eg, through
use of visuals and web-based initiatives) and
developing ASD-specific campaigns on health
issues has been recommended internationally 39
136
(Recommendation 2.3.12).
2.3.f Issues especially relevant to
people who also have an intellectual
disability
The physical health of the population of people
with ASD who are also intellectually disabled
is a significant issue. Research into the physical
health of people with an intellectual disability
found that many have ongoing and complex
health needs (often unrecognised) combined
with difficulty accessing health care without
support and they were often dependent on
others to recognise their need for health
services 159 160 . Communication issues were linked
with impaired assessment, diagnosis, ongoing
care and the ability to fully inform patients 159
161
. Medical care of treatable, relievable or
curable conditions was substandard or
simply did not occur for some people with an
intellectual disability. They were often overmedicated,
treated with outdated medication
and unable to access specialist review. The use
of psychotropic medication in the absence of
psychiatric diagnosis was high and associated
with attempts to manage behaviour, without
attending to the cause of the behavioural
difficulties 136 159 .
Clearly, recommendations made on the health
of people with an intellectual disability are
of high relevance to people with ASD, many
of who also have an intellectual disability.
Recommendations from the National Advisory
Committee on Health and Disability state that:
The systemic neglect of the health of adults with an
intellectual disability [should] be urgently addressed
… directing the Ministry of Health to ensure that
primary health care providers are aware of the health
needs of adults with an intellectual disability and have:
• clearly developed policies for access to services
• comprehensive health assessment tools for people
with an intellectual disability
• appropriate staff education programmes,
including peer review processes
• health-promotion material is produced that is
directed towards and accessible by this population
• prescribing practices for this population are
consistent with current New Zealand best practice
guidelines
• directing the Ministry of Health to ensure that
service provider contracts include recognition,
and adequate funding and that the disability
support role includes assistance for people with an
intellectual disability to regularly access health care
• directing District Health Boards to examine access
to their secondary and tertiary services for people
with an intellectual disability, identify barriers
and take active steps to minimise or remove them,
and utilise their Disability Services Advisory
Committees to provide ongoing monitoring of
this’ 159 (Recommendation 2.3.13).
2.3.g Sensory processing
Evidence confirms the existence of sensory and
motor difficulties for many children with ASD 96
162
(see also section 3.2.c Sensori-motor development).
Most of the research evidence on sensory
processing difficulties is derived from studies
on children and young people with ASD but
may be relevant to older people with ASD as
well. Autopsy studies and magnetic resonance
imaging (MRI) studies support the notion that
people diagnosed with ASD have differences
in the parts of the mid-brain associated with
movement, the regulation of movement and
attention, the symptoms of which may have an
impact on a person’s ability to communicate and
relate to others 163 .
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New Zealand Autism Spectrum Disorder Guideline