Project: Providing ongoing training to community pediatricians in the medical management of children with Autism Spectrum Disorder (ASD) Phase II

Centre for Leadership in Child Development

Project: Providing ongoing training to community pediatricians in the medical management of children with Autism Spectrum Disorder (ASD) Phase II

Investigators:

What was this study about?

This study was a response to a request by community paediatricians to create and provide a comprehensive training program aimed at building capacity and increasing confidence in evidence based medical management, including the psychopharmacological management of children with Autism Spectrum Disorder (ASD). The training program was delivered through a one-day workshop, followed by an optional 1:1 mentoring program. The study aims to develop curriculum and evaluate its effectiveness in terms of the participants’ perception of how the workshop changed their practice and its influence on clinical referrals initiated by the participants. This is phase II of this program with the first workshop (Phase I) offered in March 2015.

What did we do?

  • Curriculum themes were determined by participants’ feedback from the March 2015 workshop Phase 1 study, and the advisory committee which comprised of a parent advocate, nurses, community physicians as well as specialists from Holland Bloorview, with guidance from the Pediatric Alliance of Ontario (PAO), the pediatric section of the Ontario Medical Association (OMA).
  • Curriculum content was developed based on evidenced based medicine and expert opinion.
  • The workshop was delivered through a dynamic 1-day course that used a combination of face- to-face teaching, case discussions, and multiple choice questions. Participants had the option of accessing ongoing mentorship and case discussion with the program lead.
  • To evaluate the effectiveness of the course curriculum participants of Phase I were surveyed at 6 months and 12 months post the first workshop (current funding cycle), and the same will be done in 2016-2017 for this workshop

Impact for clients, families and clinical practice

Currently there is limited capacity for both management of common pediatric issues such as sleep, gastrointestinal and puberty related difficulties, as well as for psychopharmacologyin the community for children with ASD and waiting lists for specialist service are long. This project will improve the community pediatricians’ capacity by increasing their skill set and therefore reducing the need for referral. It will also allow children to receive service close to home and within their communities.

What did we learn?

Phase I

  • The participants indicated that they are more confident in managing medical issues such as sleep and gastrointestinal difficulties associated with ASD, and more comfortable using psychotropic medications.
  • We identified areas of ongoing challenges for community paediatrician from the feedback questionnaires in phase I. This allowed the development of a more comprehensive workshop with new topics, including puberty difficulties, feeding and behavioral supports.
  • Participants formed new networks and a community of practice from this workshop and understood that other pediatricians were experiencing the same barriers and challenges.

Phase II

  • Many participants were not comfortable with providing pharmacological interventions for children with ASD prior to attending the workshop.
  • The participants felt that the learning objectives were achieved and indicated that they are now more comfortable using psychotropic medications and managing common pediatric problems.

Next steps

  • Continuing the ongoing mentorship program with the participants who attended the workshop.
  • Collecting and evaluating the 6 month and 1-year survey for program evaluation.
  • In addition, this project is now informing a submission to the government to turn this into a web-based large mentoring effort.