M Health Fairview Psychologist Amy Esler, PhD, LP, will help lead autism spectrum disorder (ASD) research and treatment efforts at Masonic Institute for the Developing Brain (MIDB).

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Q&A: New MIDB team will be a lifeline for children and families facing autism spectrum disorder (ASD)

M Health Fairview Psychologist Amy Esler, PhD, LP, will oversee care for patients with autism spectrum disorder (ASD) at the new Masonic Institute for the Developing Brain, a joint clinic and research facility opening this fall.

  • July 19, 2021
  • By Staff Writer

Autism spectrum disorder (ASD) diagnoses are rising nationwide, and Minnesota has one of the highest rates in the country. As the number of people with ASD grows, so too does the need for informed, compassionate, and comprehensive healthcare.

The Masonic Institute for the Developing Brain (MIDB) – which opens to patients Nov. 1 – is dedicated to research and treatment of brain development and mental health disorders in childhood and adolescence. The first-of-its-kind in Minnesota institute will also fulfill a critical statewide advocacy role, ensuring new discoveries are shared with patients and community leaders. 

Though MIDB experts will focus on a wide range of childhood health conditions, ASD quickly emerged as a focal point. M Health Fairview Psychologist Amy Esler, PhD, LP, is helping lead ASD research and treatment efforts at MIDB. Esler also serves as an associate professor in the Department of Pediatrics at University of Minnesota Medical School.

We asked her what healthcare gaps the new institute will fill in Minnesota, and how MIDB will help advance our understanding and treatment of ASD for families across the state.

What is your current role at M Health Fairview? What will be your role at MIDB?

I currently oversee two programs within the M Health Fairview Pediatric Specialty Clinic – Voyager. I lead the Autism and Neurodevelopment Clinic, as well as the Fragile X Clinic. Fragile X syndrome is a genetic disorder that causes intellectual disability and is a leading cause of autism. We’re moving the Voyager clinic into MIDB, so my role will be largely the same when the new institute opens.

At MIDB, our team will get to work side-by-side with experts from other medical areas. It’ll be easier for us to collaborate, and it will be easier for our patients to get access to psychiatric care and other services. We see that need often in patients with ASD or fragile X. They may also struggle with anxiety, hyperactivity, aggression, and self-injury. We all benefit from a multidisciplinary approach.

I’ll spend about half of my time in the clinic and the other half conducting research at the institute. I always want my research to fill an unmet clinical need, so it’s important to me to be involved with both components at MIDB.

Can you tell us more about your research on ASD?

I co-lead a study on ASD prevalence in Minnesota, along with Jennifer Hall-Lande, PhD. We’re focused on improving access to care, including early diagnosis and intervention. We’re also looking into health disparities. For the first time in 2016, we didn’t see any disparities in ASD prevalence rates for Black and white children nationally, but we’re seeing discrepancies in other areas. We see fewer Latinx children getting diagnosed, and children of color are getting diagnosed later than their white peers. This research informs our clinical set-up and practice. 

Our ASD prevalence study is done through the Institute on Community Integration (ICI), which is also moving to MIDB. ICI works with employers, community leaders, and others to advocate for people with disabilities or educational support needs. We want our research to improve people’s quality of life, which is why we meet frequently with a group of advisers from the ASD community. Our findings are used to support further research, legislation, and more. Being in one location with other researchers and clinicians at MIDB will further this collaboration. 

We’ve been seeing an increase in ASD diagnoses nationwide over the past couple decades. Minnesota has one of the highest rates in the country. Why do you think that is?

In Minnesota and nationally, we’re identifying far more people with ASD who don’t have an intellectual disability. In the past, about half of those diagnosed with ASD also had some form of intellectual disability – now we’re seeing that rate drop to about a third. With increased awareness and access to services, it’s been easier to identify children and adults who have ASD but may not have as much difficulty communicating.

Autism rates are determined from reviewing records from educational and health sources. If you look at national rates of ASD, those have been increasing steadily over the last two decades. Minnesota has the second-highest prevalence nationwide, but we also do a good job of funding services for ASD. More people are identified and access services in Minnesota, so we have more records to review as part of our ASD prevalence study. We’re not only identifying more children earlier, we’re also identifying teens and adults later in life. More awareness and diagnoses also means a larger known need for services, which is why now is a critical time for a facility like MIDB.

How does MIDB meet the increased need for ASD-related care? What unique services will it provide?

There needs to be a long-term investment in providing new services and supports for families with an ASD diagnosis. There’s been a sharp increase in demand nationwide for ASD-related care, and health systems are trying to find ways to adjust. One thing we’re working on at MIDB is expanding our telehealth capabilities as an added support before and between in-person visits. We have children who could start engaging in parent-led early interventions through telehealth services, even before they come in for a diagnosis. In partnership with researchers at ICI, who have developed telehealth interventions for ASD, our providers can support families virtually and share ways to help their child at home.  After a diagnosis, we know many families face waitlists for intervention services. Virtual visits can be a bridge between diagnosis and when in-person interventions can begin.

Our multidisciplinary approach can also benefit the many children with ASD who come in with multiple diagnoses. For example, being able to easily partner with psychiatrists is great. We can do team evaluations and consolidate those consultations into one or two days. People on the more profound end of the autism spectrum often struggle with aggression and self-injury. A lot of times, medication will be one part of the treatment, but we will be able to combine it with behavioral therapy. We know both kinds of therapy work better together than alone. We can now provide those options in one place – along with offering families access to leading-edge research and studies they can choose to participate in.