Neurologist Gary Stobbe has been working with patients with autism since his residency in the early 1990's. Listen in to hear how this compassionate physician has been learning from his patients, their families and advocates. Dr Stobbe's perspective has evolved from the medical approach within which he was trained to now recognize the spectrum of stable neurodivergence to profoundly symptomatic patients who desperately need extensive support for living their daily lives. 
We start with the DSM-V diagnostic criteria of impaired social communication + repetitive behaviors or interests, recognizing that the social communication network of the brain touches multiple structures and centers. This does not necessitate any intellectual disability, and in fact, many autistic people have both specialized skills and brilliance that initially can be lost in the communication difficulty (for example, the poetry that can come from a non-verbal patient only after they are able to access a device to type out their creative expression). 
Dr Stobbe then reviews some of the more profound struggles that can co-exist with autism including expressive language impairment (aka non-verbal), co-occurring intellectual disability, required assistance for daily living and the presence of crises. 
As we touch on the 'causes' of autism, he recognizes they are likely 'multifactorial, so many complex conditions, and end up being the total sum of genetics + environment'. He also emphasizes that the diagnosis of autism is based on development and behavior versus any biological function or cause. 
The management approach for autism has evolved to be 'person-centered and strength-based' and there is no singular treatment. Dr Stobbe honors the collaborative team that can support the person with autism, including the patient themselves, thier family, patient advocates, state/ national organizations, in addition to their medical team. 
Autism can be tricky to understand because it flies in the face of our conventional assumptions about one singular disease with one singular treatment. Join in & share widely as Dr Stobbe exemplifies the curiosity and thoughtfulness to support this amazing population of patients.

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#78 MD Gary Stobbe: Complex Basics of Autism

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