Shahidullah Jeffrey D, Azad Gazi, Mezher Katherine R, McClain Maryellen Brunson, McIntyre Laura Lee
1 Rutgers University, New Brunswick, NJ, USA and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
2 Johns Hopkins University, Baltimore, MD, USA and Kennedy Krieger Institute, Baltimore, MD, USA.
Clin Pediatr (Phila). 2018 Nov;57(13):1496-1505. doi: 10.1177/0009922818774344. Epub 2018 May 3.
Children with autism spectrum disorder (ASD) present with complex medical problems that are often exacerbated by a range of other intellectual and psychiatric comorbidities. These children receive care for their physical and mental health from a range of providers within numerous child-serving systems, including their primary care clinic, school, and the home and community. Given the longitudinal nature in which care is provided for this chronic disorder, it is particularly necessary for services and providers to coordinate their care to ensure optimal efficiency and effectiveness. There are 2 primary venues that serve as a "home" for coordination of service provision for children with ASD and their families-the "medical home" and the "educational home." Unfortunately, these venues often function independently from the other. Furthermore, there are limited guidelines demonstrating methods through which pediatricians and other primary care providers (PCPs) can coordinate care with schools and school-based providers. The purpose of this article is 2-fold: (1) we highlight the provision of evidence-based care within the medical home and educational home and (2) we offer practice recommendations for PCPs in integrating these systems to optimally address the complex medical, intellectual, and psychiatric symptomology affected by autism.
患有自闭症谱系障碍（ASD）的儿童存在复杂的医疗问题，这些问题常常因一系列其他智力和精神共病而加剧。这些儿童在众多儿童服务系统中的一系列提供者那里接受身心健康护理，包括他们的初级保健诊所、学校以及家庭和社区。鉴于对这种慢性疾病的护理具有纵向性质，服务和提供者协调他们的护理以确保最佳效率和效果尤为必要。有两个主要场所作为为患有ASD的儿童及其家庭提供服务协调的“家园”——“医疗之家”和“教育之家”。不幸的是，这些场所往往相互独立运作。此外，关于儿科医生和其他初级保健提供者（PCP）可以通过哪些方法与学校及校内提供者协调护理的指导方针有限。本文的目的有两个：（1）我们强调在医疗之家和教育之家中提供循证护理；（2）我们为初级保健提供者提供实践建议，以整合这些系统，从而最佳地解决受自闭症影响的复杂医疗、智力和精神症状。
