All Grown Up: The Many Faces of Autism

A Developmental Approach to Behavioral Health Care for the Transitional Age Youth diagnosed with Autism Spectrum Disorder (and Intellectual Disabilities)


Lisa R. Fortuna, MD, MPH (Psychiatry/Child and Adolescent Psychiatry)

Marilyn Augustyn, MD (Developmental Behavioral Pediatrics)

Curriculum Director:

Dana Rubin, MD, MSW (Psychiatry/Child Psychiatry/Pediatrics)

ASD is a common neurodevelopmental disability in the population. Current data suggests it occurs in 1/45 individuals. While parents, pediatric clinicians and schools often identify and diagnose ASD in early childhood, there are teens and young adults for whom the diagnosis was missed. Likewise, those who were fortunate enough to have early intervention and appropriate support, are still at higher risk for developing new problems that include depression, anxiety, OCD and psychotic disorders. Pediatric clinicians, particularly the specialties of Developmental and Behavioral Pediatrics (DBP) and Neurology diagnose and will follow children and teens over time.

Psychiatry, has a less well established ‘track record’ for caring for these youth over time but are called upon to diagnose and treat psychiatric disorders that commonly co-occur with ASD including anxiety, OCD, agitation and depression. Mental health services for young adult, and transitional age youth in particular, are limited and difficult to access. Our population at Boston Medical Center also face additional challenges that include language and cultural barriers as well as poverty. The focus of this educational series is to provide residents, medical students and other behavioral health professions a better understanding of the treatment needs and complexities of teens and young adults, ages 16-22 (aka Transitional Age Youth or TAY) with Autism Spectrum Disorder and/or Intellectual Disability.

One way to help address these shortages and disparities in behavioral health care is to increase clinical education and awareness of this population to psychiatry residents in training as well as medical students learning about psychiatry. Psychiatrists are taught to understand the whole person, from a bio-psychosocial perspective. This is a perfect springboard from which to teach about the recognition and treatment of ASD comorbid psychiatric conditions that frequently effect this population.

Acknowledgements: Funding for this curriculum was provided by the Massachusetts Department of Developmental Services and Massachusetts Department of Mental Health through their educational grants program.

Contributing Faculty:

Lauren Bartolotti, MA (Pediatrics, Autism Program)

Mandy Coles, MD, MPH (Pediatrics/Adolescent Medicine)

Eileen Costello, MD (Pediatrics)

Laurie Douglass, MD (Pediatrics)

Simone Dufresne, MA (Pediatrics, Autism Program)

Ivys Fernandez-Pastrana, JD (Pediatrics, Lead Family Navigator)

Jodi Hoffman, MD (Pediatrics)

Shari King, MA (Pediatrics, Autism Program)

John (Jack) Maypole, MD (Pediatrics)

Lucia Morales, LCSW (In Home Behavioral Specialist)

Claudio Morera, MD (Pediatrics)

Andrea Spencer, MD (Psychiatry/Child and Adolescent Psychiatry)

Naomi Steiner, MD (Pediatrics)

Sarah Valentine, PhD (Psychiatry)

Jodi Wenger, MD (Pediatrics)

Videography, Website Development, and Contributing Faculty:

Michelle V. Porche, EdD (BU Wheelock College of Education & Human Development)

Robert Diehl, MA (BU Wheelock College of Education & Human Development)