Pain can express itself as self-harm and be missed because of diagnostic overshadowing in people with autism and a learning disability, according to new research.
Diagnostic overshadowing happens when medics automatically attribute a person’s symptoms to their autism or learning disability without assessing for other health problems.
Specialist dentist Mona Yekezare says many dentists are turning to the Oliver McGowan training to help them tackle diagnostic overshadowing
The new research suggests educating dentists to make reasonable adjustments to mitigate diagnostic overshadowing.
No ‘clear information’
Dental specialist Mona Yekezare, based at the Royal London Hospital, led the research team.
She said dentistry degrees should include awareness of diagnostic overshadowing so new medics have the right “knowledge and mindset”.
She said there is no “clear information” on the prevalence of the problem in dentistry and medicine.
Oliver McGowan training
The Health and Care Act 2022 required that medics undergo training in autism and learning disabilities appropriate to their roles.
Yekezare said many dental services are adopting the Oliver McGowan training to help them tackle diagnostic overshadowing.
Oliver McGowan training was introduced in the wake of the death in NHS care of 18-year-old Oliver in 2016. He had a learning disability, autism, cerebral palsy and epilepsy.
The teenager was given antipsychotic medication against his wishes and those of his family.
More medical treatment needed
Anita Kungelstadt chairs biomedical charity Thinking Autism, which has long campaigned against diagnostic overshadowing.
Kungelstadt said the charity issued guidance on all the other medical conditions to which people with autism are vulnerable more than 10 years ago.
She added that even then there was “overwhelming evidence that people with autism need far more medical investigations and treatment than the general population”.
Yekezare and her colleagues published their new research in the British Dental Journal.
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Published: 9 July 2024
