The Open Door Care Network has a new name and logo but the same immediate approach to patient-centered care in Westchester County and the Hudson Valley. And that may be particularly key for parents concerned that their child may be on the autism spectrum but with no access to early testing.
It’s why pediatricians like Andrew Swiderski, M.D., who works at the Open Door Care Network — formerly Open Door Family Medical Center — in Ossining, offer preliminary diagnostic testing that can begin to answer parents’ questions.
Swiderski may hand his young patient a toy cell phone, encouraging the child to push the buttons that produce various sounds. Then he covers the keyboard with his fingers.
“Usually, a child will look up at me or his parent and say, ‘Why are you doing this?’ He’s made the connection that I interrupted his play,” Swiderski said. “A child with autism will instead get mad at my hand. He won’t look at me and doesn’t make the connection that a person is involved.”
This is one of the tools in Swiderski’s “bag of tricks” that he uses in making a diagnosis. Additionally, he encourages the parents of his patients to use an app (available in English and Spanish) produced by the U.S. Centers for Disease Control and Prevention (CDC) that provides a “milestone tracker” for monitoring their child’s development.
“Autism is a devastating diagnosis, and many providers are afraid to make it, fearing it labels the patient with a permanent condition that requires the involvement of many specialists and therapists,” Swiderski said. “Parents go into a panic. But the pediatrician should be the first to see this, as well as other delays in normal development. The big window is between six months and four years, a critical time to identify and look at this before school starts.”
An ever-increasing number of children are diagnosed with autism — 1 in 31 8 year olds have been given the diagnosis, according to the CDC — not because there is more autism than before, but because of increased awareness and more frequent testing, experts have said.
Pediatricians, Swiderski added, represent the “front line” in diagnosing these conditions. At Open Door, they work hand-in-hand with the health-care center’s Behavioral Health providers to refer these children to specialists so they don’t fall through the cracks.
Parents, he said, often ask for help if they notice their young child suffers from any one or more of a number of different symptoms, such as an inability to respond to social interactions or pick up on nonverbal cues, poor eye contact, lack of interest in others, little imaginative play, repetitive movements or ritualized behaviors. Contrary to some theories, he added, there is no evidence to indicate links to any environmental or lifestyle issues, such as vaccines, foods or toxins. Autism does, however, have a genetic link, so it is not uncommon to find two children with autism in the same family.
“I tell parents what features resemble autism and what don’t and through my testing come up with a preliminary conclusion and, if necessary, refer them to a specialist,” he said. “Parents are scared stiff and want to know.”
A 53-year-old nonprofit, Open Door is a Federally Qualified Health Center (FQHC) that seeks to deliver patient-centered care at locations in Westchester, Putnam, Dutchess and Ulster counties. It is certified as a Patient-Centered Medical Home (PCMH) by the National Committee for Quality Assurance (NCQA). For more, click here.
