GP resources to support neurodiversity care

The assessment and management of neurodiverse conditions are becoming an increasing part of Australian GPs’ clinical practice.
 
In particular, greater awareness and diagnoses of attention deficit hyperactivity disorder (ADHD) are emerging, with the condition estimated to affect around one million people nationwide, occurring in approximately 6–10% of children and adolescents, and 2–6% of adults.
 
Additionally, more than three in four children diagnosed with ADHD continue to experience the symptoms into adulthood, and prescriptions for ADHD medications are rising.
 
A recent newsGP poll revealed that out of 1453 respondents, 94% have seen an increase in requests for ADHD referrals in the past 12 months, with almost four in five (78%) saying it has been a large increase, and 16% a small one. There were no reports of a decrease in referrals.
 
Diagnoses of autism spectrum disorder (ASD) are also rising, with an estimated one in 70 people on the autism spectrum.
 
In recognition of GPs’ role in diagnosis and management of these conditions, and to better support their provision of best practice care through research, education and training, the RACGP launched its Specific Interests ADHD, ASD and Neurodiversity group in October 2021.
 
Upskilling GPs in the diagnosis and management of ADHD and ASD and offering clearer guidelines to determine accurate diagnoses and referral pathways are key objectives of the group, as well as better recognition of neurodiverse conditions in general practice, which may often get overlooked.
 
To further place the spotlight on this complex area of health, Neurodiversity Celebration Week running from 13–19 March, is ‘a worldwide initiative that challenges stereotypes and misconceptions about neurological differences’.
 
Adjunct Associate Professor John Kramer, who is the inaugural Chair of RACGP Specific Interests ADHD, ASD and Neurodiversity, told newsGP it is an important event on the calendar to help raise awareness among GPs and the community.
 
‘Up to 10% of the population is neurodiverse, that makes it relatively common,’ he said.
 
‘ADHD is about as common as type 2 diabetes – all GPs need to know about it.’
 
In recent years, there has been a ‘much greater awareness’ of ADHD and related conditions, according to Associate Professor Kramer, who says this is due to multiple factors, including the September 2022 release of the NHMRC-approved, RACGP-endorsed evidence-based clinical practice ADHD guidelines – which he said were ‘long overdue’.
 
He also points to increased community awareness via social media, giving the example of comedian Em Rusciano who delivered a 2022 National Press Club address on her ADHD diagnosis as an adult.
 
Last year, Australia also launched a ‘world-first’ autism screening tool, which is estimated to identify 96% of children on the autism spectrum by preschool age.
 
The Social Attention and Communication Surveillance-Revised (SACS-R) tool is described by Chair of RACGP Specific Interests Child and Young Person’s Health, Dr James Best, as ‘ground-breaking’.
 
‘The [SACS-R tool’s] prediction of an ASD diagnosis is really high, and much better than anything else around the world,’ Dr Best previously told newsGP.
 
‘More broadly, it shows that autism can be picked up much earlier on if using the right techniques. This is extremely important because we know that early intervention makes a big difference. And this just reinforces the fact that we should be thinking about a child’s development, including social and communication development, at these very young ages.’
 
Experts welcome these advances in support for healthcare providers screening and managing neurodiverse conditions, highlighting that access to support and treatment is crucial, especially given extended wait times to see paediatricians. GPs are calling for improved referral pathways, support for diagnosing, and a review of rules around prescribing stimulants for children with ADHD.
 
To further support GPs in this space, the RACGP is presenting a March webinar series on identification and co-management of ADHD in general practice:
 
Webinar 1: Paediatric ADHD in general practice, Tuesday 21 March, 7.30 – 8.30 pm.
Hosted by Associate Professor Kramer, with guest presenter Royal Children’s Hospital Melbourne paediatrician, Associate Professor Daryl Efron.
 
Webinar 2: Adult ADHD in general practice, Wednesday 29 March, 7.30 – 8.30 pm.
Hosted by Dr Carmel O’Toole, co-founder of RACGP Specific Interests ADHD, ASD and Neurodiversity, with guest presenter, psychiatrist Dr Jörg Strobel.
 
Associate Professor Kramer says the first webinar will build on the ADHD evidence-based clinical guidelines to guide GPs to better identify screening, investigation, diagnosis, and management tools for treating paediatric ADHD and supporting patients and their families.
 
‘It will inform GPs about typical presentations, how to better assess such patients,’ he said.
 
‘[As well as provide] appropriate referral options and reliable patient information to share.’
 
RACGP members can join the ADHD, ASD and Neurodiversity Specific Interests group through the online membership form.
 
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ADHD ASD autism spectrum disorder children and young people neurodiversity