- Initial Consultation
- Follow-up consultations
- Parent or adult sibling consultation and counseling
New patients are typically seen for an initial consultation appointment with the program director, Dr. Brodkin. This consultation will address the patient’s and family’s questions and provide recommendations about diagnosis, assessment, treatment, and/or day-to-day functioning. This in depth consultation typically lasts approximately 2 hours, and consists of a meeting of Dr. Brodkin with the patient, and, when indicated, with the family as well; a review of previous diagnostic or treatment reports; a detailed review of prior treatments and responses to the treatments; and administration of assessment questionnaires. Depending upon the patient and the situation, this initial consultation can focus on addressing one or more of a variety of questions, such as these:
- Is autism spectrum disorder or social communication disorder the right diagnosis? If so, how could this diagnosis explain challenges I’ve faced in interacting and communicating with others?
- How can I manage other symptoms that often go along with ASD, such as interfering behaviors, anxiety, or depression?
- How can I build up my skills and confidence in navigating the social world, communicating, and better understanding the complex social situations involved in relationships, school, work, and the community at large?
- Are there behavioral or psychological treatments that could be helpful? How do I choose among these treatments? Is a particular treatment useful in a particular situation? How can I find providers of those treatments?
- Are there medications that can be helpful? What could they help with? What are the risks and benefits of the medications? How can medication treatment be coordinated with behavioral or psychological treatment?
- Could current or previous treatment approaches be modified or changed to improve their effectiveness and to better target the most important issues?
Report Writing: Dr. Brodkin typically writes a report summarizing the findings from the consultation, and mails it to the patient. The report typically includes diagnosis and treatment recommendations.
Follow up visit: As part of the initial consultation, we typically offer a follow up visit several weeks after the initial visit, to discuss the information and recommendations in the report, and to answer any follow up questions.
Depending on the individual’s needs, the report may recommend additional psychological testing, functional behavior assessment (FBA), and/or medical tests. More detail on each of these types of assessments is provided below:
- Psychological tests:
In some circumstances, it can be helpful to conduct additional psychological testing to assess functioning in particular areas (e.g. IQ or other psychological tests) which can help to guide choices of treatments or services.
- Functional behavior assessment:
Based on the initial consultation, behavior analysis assessment may be recommended for particular patients. A behavior analytic approach often starts with an assessment called a functional behavior assessment (FBA) in which factors that contribute to specific behaviors can be identified.
- Medical workup or genetic tests:
In some circumstances, additional medical, imaging, or genetic tests can be helpful in understanding the factors contributing to symptoms and in tailoring treatment recommendations.
Recommendations following the initial consultation may also include individual behavioral or psychological treatment, social skills group treatment, medication treatment, educational or vocational supports, and/or referrals to providers for these treatments. More detail on each of these types of treatment recommendations is provided below:
- Behavior analysis treatment:
Goals of behavior analysis treatment include addressing interfering behaviors and building new social and communication skills. By collecting data on how frequently behaviors occur, and what happens before and after the behaviors, factors that affect or reinforce the behavior and response to the treatment can be determined. The treatment can be modified as needed to increase the effectiveness.
- Individual Psychological treatment:
Particular patients may benefit from psychological treatments, including cognitive behavioral, supportive, or social skills treatments, which may help to build adaptive, social, and communication skills. Family members under stress may also benefit from a variety of treatment or stress-reduction approaches.
- Social skills groups or seminars:
Participation in a social skills group can be helpful in developing skills useful in relationships, as well as in educational or work settings.
- Medication treatment:
Some patients may benefit from medication treatment. This can be helpful addressing symptoms of anxiety, depression, or interfering behaviors. Typically, medication alone is not sufficient to address issues of adults with ASD, and medication treatment is usually best conducted in coordination with behavioral and/or psychological treatment. Dr. Brodkin is experienced in consulting to help coordinate medication treatment with behavioral and psychological treatments.
- Vocational rehabilitation:
Some patients may benefit from programs designed to develop goals and skills for work and vocation.
We can provide consultation to individuals, families and providers on where to find these services listed above, and we can provide follow-up consultations, as described below.
Once a treatment and support plan has been implemented, its effectiveness should be monitored, and modifications to the plan may need to be made to optimize effectiveness. We can provide periodic follow-up consultations to patients, families, and other providers, to assist in assessing treatment response and to provide recommendations on modifying and optimizing treatment and support plans.
Adult family members of individuals with ASD (of any age) who have had a consult at Penn's AASP may have questions about ASD and how to best help their son, daughter, or sibling on the spectrum, and typically are under some degree of chronic stress. We can provide consultation and counseling for adult family members, and can provide appropriate referrals when necessary.
Currently, the focus of the Adult Autism Spectrum Program is in providing outpatient consultations and recommendations on diagnosis, treatment, and transition to adulthood issues to patients, families, and other providers, as described above. We can provide liaison to the patient’s primary psychiatric or other providers, referrals to providers, recommendations on implementing treatments, as well as periodic follow up consultations, if requested. At this time, the program typically does not provide primary psychiatric / psychological care or medication management.
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