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Background: Transition to adult care for adolescents with an intellectual disability and/or autism spectrum disorder with coexisting mental health disorders, often termed 'dual disability', is complex. It requires a family‐centred approach, with collaboration among health, disability and social services and early planning. Aim: To describe carer perspectives of transition to adult care and the outcomes of a transition support intervention, Fearless, Tearless Transition, for adolescents with dual disabilities piloted at a tertiary children's hospital. Methods: Carers of adolescents with a dual disability were invited to complete a survey at the commencement of their participation in the Fearless, Tearless Transition model, and again at the conclusion of the project. Within this intervention, carers and adolescents were encouraged to attend dedicated transition clinics and participate in a shared care general practitioner (GP) and paediatrician process. Results: One hundred and fifty‐one carers of adolescents with dual disabilities were included in Fearless, Tearless Transition. Of this cohort, 138 adolescents and their carers received support in a dedicated transition clinic with 99 carers completing the initial survey at the commencement of the model. Eighty‐two per cent of carers reported moderate to high levels of anxiety about transitioning from paediatric to adult care with 39% feeling 'unprepared' about transition. Eighty‐one per cent reported having inadequate access to respite care with 47% reporting a lack of access to services in the community and 56% expressing dissatisfaction with their GPs. One hundred and two families participated in the shared care process with 80 GPs and 33 paediatricians. Twenty‐two carers completed the second survey reporting a modest but significant improvement in preparedness for transition to adult care. Conclusion: This study highlights the potential to improve transition outcomes for adolescents with dual disabilities and their carers through early, centralized transition planning, consistent methods of assessing adolescent and carer needs and shared care. [ABSTRACT FROM AUTHOR]

Aim: First, to understand the barriers to achieving effective transition and the supports required from the perspective of parents and carers, adolescents with intellectual disability and/or autism spectrum disorder and co‐existing mental health disorders (often termed 'dual disability'), and those who provide services to this group. Second, to develop an informed model of shared care to improve the transition of adolescents with dual disabilities. Method: Carers and a young adult with a dual disability were surveyed about their experience of transition care. Other key stakeholders including paediatricians, general practitioners, and policy makers were also interviewed. These data informed the model of care. Results: Paediatricians and general practitioners reported difficulties establishing working relationships to foster smooth transitions, and carers reported lacking a regular general practitioner with adequate expertise to care for people with dual disabilities. A process of shared care between paediatricians and general practitioners was developed and initiated by a dedicated transition manager, who assisted with care coordination and service linkages. Standardized clinical assessment tools were also introduced to determine patient and carer support needs. Interpretation: This study highlights the potential to improve transition outcomes for adolescents with dual disabilities and their carers through early transition planning, consistent methods of assessing patient and carer needs, and shared care. What this paper adds: Adolescents with co‐occurring disabilities require a collaborative health and disability service interface.Fearless, Tearless Transition is a new approach to transitioning adolescents with dual disabilities from paediatric to adult care.Carers of adolescents with dual disabilities require support navigating and negotiating services.Engaging general practitioners and paediatricians in shared care early during the transition process is essential. What this paper adds: Adolescents with co‐occurring disabilities require a collaborative health and disability service interface.Fearless, Tearless Transition is a new approach to transitioning adolescents with dual disabilities from paediatric to adult care.Carers of adolescents with dual disabilities require support navigating and negotiating services.Engaging general practitioners and paediatricians in shared care early during the transition process is essential. This article is commented on by Pettit on page 497 of this issue [ABSTRACT FROM AUTHOR]

Autism Spectrum Disorder is a social communication disorder in someone displaying repetitive and restrictive interests. Diagnosed in early childhood, children struggle to develop social relationships required for further learning and independent living. This article discusses changes to the diagnosis, how the diagnosis is made, the prevalence, causes and interventions. Importantly, this review guides medical students towards an understanding of what to expect in individuals with autism spectrum disorder and how to interact with them. [ABSTRACT FROM AUTHOR]

Presents a study which determined the sources of nutrition information and services for children used by parents and child care staff in Melbourne, Victoria. Methodology; Results; Discussion.

Abstract This study aimed to identify sources of, and gaps in, nutrition information and services used by parents of children aged between six and eight years, their primary teachers and school nurses. This is the fourth part of a larger study of children from birth to eight years of age. Parents of 96 children aged between six and eight years completed a questionnaire. The children were randomly selected from 12 primary schools in Melbourne's western metropolitan region. The grade one primary teachers and the school nurses working in the area also completed a questionnaire and participated in in-depth follow-up interviews. The results indicated that school nurses generally viewed nutrition education as an integral part of their role and were interested in ongoing professional development on paediatric nutrition. Teachers saw themselves as having a role with the children through teaching nutrition as part of the standard curriculum, but most had not received any formal training in nutrition. Sources of nutrition information used by these nurses and teachers included brochures by food companies, newspapers and magazines, and television. Both teachers and nurses requested current, culturally specific nutrition information suitable for use with parents and children. Parents of the children identified family (67%) and own knowledge (65%) as main sources of nutrition information, followed by friends (44%), doctors (40%), television and radio (39%), books (35%) and magazines (31%). Some parents (34%) requested nutrition education to occur through the school system. Dietitians potentially have a role in resourcing the food industry, the popular media as well as health professionals. (Aust J Nutr Diet 2000;57:90-94) [ABSTRACT FROM AUTHOR]

Abstract The objective of this study was to identify sources of, and gaps in, nutrition information and services used by parents of children aged between four and six years and their kindergarten teachers. This is the third part of a larger study of children from birth to eight years of age. Parents of 133 children aged between four and six years attending 12 kindergarten groups in Melbourne's western metropolitan region completed a questionnaire. Kindergarten teachers (n = 26) working in the region completed a separate questionnaire. A sample of five teachers, participated in in-depth follow-up interviews. The results indicated that parents commonly accessed the family (74%), friends (48%), doctors (39%), television and radio (39%), magazines (31%) and own knowledge (30%) as sources of nutrition information. Maternal and child health nurses were used by 29% of these parents. Newspapers and magazines and brochures by food companies were cited by the teachers as their most consulted sources of nutrition information. Kindergarten teachers acknowledged that parents or carers viewed them as a source of nutrition information, though they did not see the provision of nutrition information to be a major part of their job. They indicated the need for a regional nutrition resource directory and nutrition information aimed at parents. Teachers requested information about food refusal, food additives, packaged snacks, allergies and drinks for distribution to parents as well as for their own professional use. Teachers also requested access to a dietitian for both referral and consultancy. (Aust J Nutr Diet 2000;57:40-45.) [ABSTRACT FROM AUTHOR]

Autism is associated with a wide and complex array of neurobehavioural symptoms. Examination of the motor system offers a particularly appealing method for studying autism by providing information about this syndrome that is relatively immune to experimental influence. In this article, we considered the relationship between possible movement disturbance and symptoms of autism and introduced an experimental model that may be useful for rehabilitation and diagnostic purposes: the reach-to-grasp movement. Research is reviewed that characterizes kinematically the reach-to-grasp movement in children with autism compared with age-matched 'controls'. Unlike the age-matched children, autistic children showed differences in movement planning and execution, supporting the view that movement disturbances may play a part in the phenomenon of autism.