Make the Connection
by Molly Crossan Harty
Research aims to facilitate the flow of information between physicians and the autism community.
On any schoolyard in America, an unfortunate scene plays out: One young boy stands alone as his classmates race by, teasing him about being overweight. In frustration, he lashes out, banging his fists and crumbling to the ground.
What isn’t clear in this scenario is that the lone boy has autism spectrum disorder (ASD) and the weight gain is caused by medicine prescribed to alleviate the symptoms of his disorder. Is the remedy worth the risks associated with its side effects? His concerned parents must decide.
Many pediatricians and psychiatrists prescribe some sort of medication, usually powerful psychotropic drugs such as Risperdal or Aripiprazole, for children and adolescents on the autism spectrum. It’s understandable that parents would want to discuss with a professional how these drugs might affect their child, but with one in 68 children diagnosed with ASD in the United States (Center for Disease Control and Prevention, 2014), and the number of cases accelerating, there aren’t enough specialists in the field.
“There’s a missing link,” says Reecha Sharma, M.D., ’08 (M.S.), assistant professor of health services. “The parents need to talk to health care practitioners about their concerns, but the practitioners don’t have enough time.”
Sharma wanted to find out more about the communication gap between parents and doctors. She enlisted Olivia Correll ’16 and Emily Moore ’16, undergraduate student SCHOLARS from SJU’s Kinney Center for Autism Education and Support, to conduct a national study supported by the SJU Summer Scholars' program surveying physicians about their perceptions and knowledge of the use and side effects of psychotropic medications on children with autism.
The research results, now being submitted for publication, indicated that while doctors believe these drugs are a safe and an effective way to treat symptoms in children with ASD, such as deficits in social communication and interaction and repetitive patterns of behavior, the medication’s side effects — like weight gain, behavior deterioration and suicidal tendencies — are poorly tracked.
Sharma believes physicians should record the medicine’s side effects at every visit, not just the annual checkup.
“The side effects may have other health-related consequences that the system must find a way to monitor,” she says. “It’s complicated. The study opened a new set of questions.”
Sharma is in the right place to further her investigation. She moved to the United States after receiving her medical degree at Maharashtra University in Mumbai, India, “because the opportunities for research were better here, and I wanted to be a part of those advances,” she says.
With acceptances to many prestigious graduate schools, she chose to pursue a master’s degree in health administration at SJU — the same program she teaches in now — because it was the area’s only broad-based program focusing on the U.S. health system overall. She joined the SJU faculty in 2013.
Last year, Sharma followed her 2014 physician survey with a study of parents of children and adolescents with ASD, conducting in-depth interviews regarding the accessibility of care, information and services.
“Essentially, all parents were unhappy with how information was given to them,” she says.
As the number of autism diagnoses grows, Sharma says parents often have to wait up to two years to meet with a specialist. The extended wait for a diagnosis creates a delay for children to receive the services and health care they need.
To address this challenge, Sharma is coordinating a third study this summer. She plans to reach out to physicians’ offices to create a checklist of topics for caregivers related to the various side effects of medications and other medical, behavioral and emotional aspects of ASD that their children and adolescents may experience.
Her ultimate goal is to create a network in which everyone involved in the management of a child with ASD — including teachers and principals — communicate with each other to make the best decision for the child’s care.