Dr. Mary Doherty:

First, by way of providing some hope, while the data on healthcare are absolutely shocking, I have seen massive change in the past couple of years, particularly in the UK. Over the last five years the change has really been phenomenal and we are in a perfect position here in Ireland to replicate that very quickly. It need not take very long at all.

There is a huge need for training among all medical professionals because autism is not on the radar for most people. If it is in the curriculum at all, it is included as part of training in paediatrics and learning disabilities and there is no real recognition of autistic adults.

To answer the question about increasing prevalence, I do not think that is the case. The increasing rates of diagnosis are related to increased recognition. If we think back to when we were children, we can all think of people in school that we would now recognise as autistic. How did I get to this point in my life without it ever being recognised? I do not think there is an increase in incidence at all.

Healthcare is such an enormous issue because so many autistic people are completely excluded from the healthcare system. That is something that we discovered when we piloted our first study. We just assumed, as most healthcare providers do, that people are in the system and will present for care when unwell but we discovered that is not necessarily the case for autistic people. So many people responded by saying that they did not have a doctor, did not go to a doctor or could not access one at all. They are completely excluded from the healthcare system. What is known is that prior negative experiences in healthcare are an independent barrier to future care. So much of that relates to a lack of understanding as well as sensory issues in healthcare environments and predictability issues. There is so much need for training. While so much of the work we do focuses on children, identifying children early and providing supports, we need to think about the adult outcomes for those children. We need to think about mental health in particular because poor mental health, while incredibly common for autistic people, is not inevitable. The way that we identify and support autistic children can have a profound effect on outcome.