Finding a Clinician using an evidence-based approach: Questions to Ask
As recently as 10 years ago it was nearly impossible for parents to find clinicians who approached treating patients with autism from a medical point of view, so ARI started keeping a clinician registry. We tried a number of measures to ensure that every clinician on our list provided high-quality care, but we are a small non-profit with limited resources and eventually determined that those seeking a talented clinician are best served by connecting with support groups—either locally or online—instead of choosing from a list that cannot be vetted.
The first step is to contact a local support group and ask for referrals. If there are none in your area, investigate ARI’s listservs. If you and your loved one with ASD are able to travel, you might not need to limit yourself to local clinicians—many will work with you primarily over the phone, though each State Medical Board has its own office-visit requirements.
Nutrition and supplementation are a very big part of addressing the needs of those on the spectrum. Dietary adjustment is one of the most effective treatments, though it’s often not as simple as gluten-free, casein-free, and soy-free. Some diets, such as the Specific Carbohydrate Diet, can provide impressive results when implemented correctly, but can actually be harmful when done wrong (kidney damage, ketosis). If your clinician doesn’t have extensive training in nutrition and/or dietetics, and also specific knowledge of dietary intervention in autism, you might need to add one of these professionals to your treatment team; some families are able to use diet, nutrition, and supplementation exclusively, guided by a knowledgeable professional, and some are not.
Not all nutrition-related degrees are equal—we recommend the following:
- Dietetic Technician
- Registered Certified Nutritionist
- Certified Clinical Nutritionist
- Registered Dietician
- Licensed Dietitian-Nutritionist
- Licensed Dietician
- Certified Nutrition Specialist (through the American College of Nutrition)
When seeking a new practitioner, beware of credentials from online diploma mills; be sure the program requires a large number of class hours and mentoring, and that the clinician is licensed or monitored by a supervisory board at the state or national level. Ask for an initial consult, and be prepared to ask questions, including:
- When was the last time he/she attended an ARI Practitioner Seminar? Which level? How many of these seminars has she/he attended in total?
- Is he/she board certified? If so, in what?
- Is there anyone on his/her staff who has been sanctioned, or received any licensing restrictions or revocation in the last five years?
- Is there anyone on his/her staff who has been or is currently under investigation by any regulatory agency?
You could also ask if he or she has pursued any advanced training, including:
- Has he/she been certified by the Institute for Functional Medicine?
- Has he/she completed an Integrative Health Fellowship?
- If you’re considering chelation, has he/she been certified by ACAM?
- Has he/she obtained certification in clinical nutrition through IAACN?
If a practitioner claims to “cure” autism, run in the other direction.
If someone claims to be “ARI-certified,” they’re overstating; neither ARI nor any of its progams by any name, has ever had a certification program.
A clinician can have many degrees from respected institutions and still provide poor care; educate yourself so you can recognize high-quality care.
Familiarize yourself with PubMed, the Federal Government’s online database of published research. The papers are generally not written in language that’s easily understood by people outside healthcare professions, but you’ll be able to get a sense of whether or not a particular treatment has good supporting research. You can also print research papers (often you have to pay about $25) and bring them to healthcare providers who might not be research-current (a good example is “Recommendations for evaluation and treatment of common gastrointestinal problems in children with ASDs.” In addition, you can subscribe to the Autism Research Institute’s quarterly science newsletter (this contains summaries written in plain English, for scientists and non-scientists alike).
Twice-yearly ARI Conferences keep professionals up-to-date and educate parents to be informed consumers of healthcare for their children on the autism spectrum. ARI’s website includes free videos of recent Conference presentations.
To help parents select a practitioner who best fits their needs and the needs of their child, several experienced parents formulated the following list of questions. (While interviewing a clinician, you might not need or want to ask all of them.)
- What led you to become a clinician using the ARI approach? How do you stay current with emerging treatments?
- Are your patients required to use special diets such as GF/CF, SCD, low-oxalate, etc.? Why, or why not?
- Approximately how many individuals with autism have you treated? What age range?
- How do you handle blood draws and other unique lab tests? My child is combative; do you have advice for violent patients?
- In the event we have a medical-related emergency, how will I contact you? Do you share an e-mail address, cell phone, etc., with your patients?
- Are you willing to offer phone consultation for distant patients? What are the costs?
- Can you collaborate with other specialists we will be dealing with (gastroenterologists, etc)? Are you willing to collaborate on treatment and testing with my child’s pediatrician if he/she is receptive?
- Will you provide a clear plan for supplements and where to purchase them? Do you sell proprietary nutritional supplements or have a sales agreement with supplement suppliers?
- Do you take insurance? If not, can you provide organized, coded insurance forms?
- Do you bill for laboratory tests done by commercial laboratories? How do you break down the fees?