The Politics of Autism discusses health care, and explains that autism services can be complicated, creating difficulties for autistic people and their families. Sometimes medical professionals lack sufficient training in ASD.
Autism spectrum disorder and intellectual disability are associated with psychiatric comorbidities, yet a 2009 study of US child and adolescent psychiatry program directors indicated that psychiatry residents receive insufficient training in autism spectrum disorder/intellectual disability. This follow-up study surveyed child and adolescent psychiatry and general psychiatry program directors to assess (1) the current extent of residency training in autism spectrum disorder/ intellectual disability, (2) program director perceptions of educational topics and resident competency in autism spectrum disorder/intellectual disability, and (3) preferred resources to strengthen autism spectrum disorder/intellectual disability training. As in 2009, many child and adolescent psychiatry program directors reported few lecture hours, although current child and adolescent psychiatry residents saw slightly more patients with autism spectrum disorder but not intellectual disability. General psychiatry program directors reported fewer lecture hours in autism spectrum disorder/ intellectual disability and fewer patients with autism spectrum disorder than child and adolescent psychiatry program directors. Both child and adolescent psychiatry and general psychiatry program directors recognized the importance of a range of educational topics in autism spectrum disorder/intellectual disability. Child and adolescent psychiatry program directors reported higher resident competency, and lecture hours and patients seen moderately correlated with resident competency. Program directors indicated that online videos and other resources would help improve autism spectrum disorder/intellectual disability training in their programs. Collectively, these findings suggest minimal improvements in autism spectrum disorder/intellectual disability training over the past decade and highlight the urgent need to advance psychiatry training in this field through dissemination of resources.
From the article:
Notably, literature from other countries demonstrates that insufficient training of psychiatrists in the care of patients with ASD/ID is a global concern, particularly given a pervasive shortage of psychiatrists, with many low-income and middle-income countries having one psychiatrist for every 200,000 people (World Health Organization [WHO], 2013). Recent reviews of training standards in ID for psychiatrists in the European Union (Dias et al., 2020) and overall psychiatry training in Asia (Isaac et al., 2018) have identified multiple training deficits, including wide variance in the rigor and availability of training, with no required ID training in some countries, a lack of unified minimum training standards, a mismatch between the prevalence of a condition and the amount of training, and limited trainee supervision. These disparities were noted to compromise the quality of psychiatric care by contributing to inconsistent and fragmentary treatment across the lifespan. In countries throughout North America, Europe, and Asia, as well as Australia, training deficits have been corroborated by psychiatrists themselves (Edwards et al., 2007; Kaushal et al., 2018; Lunsky et al., 2007; Sajith et al., 2019; Werner et al., 2013), and systemlevel challenges entailing early identification of these patients and the availability of educational resources have also been reported in Brazil and South Africa (Adnams, 2010; Bordini et al., 2015).
