HJAR Mar/Apr 2025

HEALTHCARE JOURNAL OF ARKANSAS I  MAR / APR 2025 17 start interventions, such as developmental therapies, early on. Conclusion When there are concerns about autism, it’s crucial to consider and rule out other conditions with overlapping features. Early intervention, thorough assessments, and connection to the right specialists are essential in ensuring children receive the appropriate support. n 9. Accessing Autism Assessments in Arkansas Due to a nationwide shortage of devel- opmental-behavioral pediatric specialists, comprehensive autism evaluations can be difficult to access. In Arkansas, the UAMS Dennis Developmental Center and Schmied- ing Developmental Center offer multidisci- plinary evaluations. In the meantime, pri- mary care providers should consider other conditions with overlapping features and Many children with autism spectrum disorder have co-occurring medical con- ditions. Children with autism have medi- cal conditions that are common in other children their age and are at increased risk for other conditions. It is important for the child’s PCP to recognize these medi- cal conditions so that they can be treated and appropriate referrals made if needed. However, it is sometimes difficult for phy- sicians to identify specific medical condi- tions if the child has limited communication skills, atypical response to pain, etc. There is not a single medical workup appropriate for every child with autism, and the medi- cal evaluation and treatments should be tai- lored to the individual child’s specific symp- toms. This article summarizes some of the more common medical conditions seen in children and adolescents with autism. You can find more in-depth information and recommendations in the American Acad- emy of Pediatrics Clinical Report, “Identi- fication, Evaluation, and Management of ChildrenWithAutism SpectrumDisorder.” 1 Genetic disorders associated with autism spectrum disorder are discussed in a sepa- rate article in this series. Sensory Assessment (Hearing and Vision) Children with autism spectrum dis- order should have routine hearing and vision screens that are recommended for From Seizures to Sleep: Understanding Co-Occurring Medical Conditions in Autism — What Every Provider Should Know By KimberlyMacferran, MD all children. Additional evaluations should be considered if parents express concern about their child’s hearing or vision. In addi- tion, children with speech or language delay should have a hearing evaluation included as part of their initial evaluation, even if the newborn hearing screen was passed. 1 Children with autism may closely visu- ally inspect objects, look at objects from an unusual angle, have poor eye contact, or poke at their eyes. These behaviors can also be seen in children with vision impair- ments, so referral for a vision exam should be considered. 1 Motor Delays Communication difficulties or differences are part of the diagnostic criteria for autism spectrum disorder. 2 Children with autism also frequently have mild delays with motor skills and coordination. 1 They may have low muscle tone, and some children will meet criteria for developmental coordination disorder. 1,2 Children with autism should be evaluated for motor delays and referred for occupational and/or physical therapy if indicated. 1 Feeding Problems Up to 75% of children with autism spec- trum disorder have problems related to eat- ing. A dietary history should be obtained at health supervision visits. Referral to a registered dietician for consultation may be beneficial if nutritional deficiencies are suspected. 1 Please refer to the article in this series on management of feeding difficul- ties for recommendations regarding feed- ing issues. Pica is the persistent eating of nonnutri- tive, nonfood substances over a period of at least one month. 2 Many young children with autism have pica, and it may persist in older children and adolescents, espe- cially if they also have intellectual disabil- ity. Children with pica are at risk for toxic ingestions, lead intoxication, potential for infection, and possible mechanical inges- tions, such as batteries. Lab monitoring for blood lead level and iron deficiency should be considered in children with pica. Bowel obstruction should be considered in a child with pica and acute abdominal symptoms. 1 Children and adolescents with autism have an increased risk of being overweight and obese. 1 It is important to remember that a child may have nutritional deficien- cies even if they are overweight or obese if they have a restricted diet. GI Issues GI issues — including abdominal pain, constipation, diarrhea, and gastroesopha- geal reflux — are common in children with autism spectrum disorder. Sensory differ- ences, limited diet, resistance to change, and anxiety can all contribute to GI issues. 1 Abdominal pain can contribute to increased