Perth GP Andrew Leech on why doctors should play greater role in diagnosing autism in children

A Perth GP selected by the State Government to diagnose and treat attention deficit hyperactivity disorder in children believes doctors should also play a bigger role in diagnosing autism. Dr Andrew Leech has also questioned why the new initiative to train 65 WA GPs in the diagnosis and management of ADHD will only benefit patients aged 10 and over. “From my perspective, there’s no reason we shouldn’t be able to offer the same service for children aged six and up,” Dr Leech told The West Australian. “Many primary school aged children remain stuck on long waitlists with the Child Development Service (CDS) when they could be managed effectively within primary care.” As revealed in The West Australian on Saturday, almost 12,000 primary school aged children are on the waitlist for a public developmental paediatrician appointment. While the median wait time is 18.7 months, some families are waiting more than four years for a paediatrician assessment, which is currently the only pathway for children to receive an ADHD diagnosis and medication. A paediatrician diagnosis also allows children with autism spectrum disorder to access the National Disability Insurance Scheme and receive extra support at school. Dr Leech, who owns the Garden Medical Centre, was among the first cohort of 17 GPs who started the training program on Friday. He said while the initiative would not provide immediate relief, it was a positive step towards improving the system. “We know how important early intervention is, and the risk that delays can have on a child’s mental health, learning and development, not to mention the impact on their parents and siblings,” he said. He said GPs with the right skills could also play a role, as part of a multidisciplinary team, in the diagnosis and management of autism. “At our clinic, we’re already moving toward this model and have completed a number of diagnoses,” he said. “Looking ahead, I’d like to see further structured training programs for autism like this one in ADHD to support GPs, build confidence, and ensure adequate funding for primary care clinics to run these models sustainably.” He said the current situation was devastating for families, many of whom were met with “radio silence” while they waited years to be assessed, while often also grappling with school refusal or family dysfunction and stress. “It is really quite heartbreaking, and it’s stressful for those of us in primary care who do spend a lot of time reviewing and supporting these families,” he said. “Sometimes, two or three years go by and they don’t hear anything other than an initial letter. That in between time is really important, there are things they can do, but they need to have guidance and regular check ins.” More than 400 GPs expressed interest in the program, which Health Minister Meredith Hammat said underscored the strong demand for enhanced ADHD care across WA. The first group includes GPs working in rural, remote and outer metropolitan communities and areas of low socio-economic advantage. Ms Hammat said wait times for paediatricians were too long, which was why the government was delivering a reform program to the CDS. “The reform program is focused on reducing wait times and improving access to timely and appropriate assessment, diagnosis, treatment and support for children and families across WA. She said the ADHD program, which is in addition to the forms, would be closely monitored and “opportunities to improve will be regularly considered”.