1 00:00:00,235 --> 00:00:02,205 - Prepare to dive into the forefront 2 00:00:02,225 --> 00:00:05,525 of healthcare innovation at our 14th annual meeting coming 3 00:00:05,545 --> 00:00:06,645 up on April 8th 4 00:00:06,645 --> 00:00:10,765 through 11th at the Hyatt Regency in Chicago, with thousands 5 00:00:10,765 --> 00:00:13,965 of industry leaders converging over four dynamic days 6 00:00:13,985 --> 00:00:16,805 of discussions on crucial topics from health IT 7 00:00:17,185 --> 00:00:18,685 to executive leadership. 8 00:00:18,995 --> 00:00:21,325 It's where the future of healthcare takes shape. 9 00:00:21,865 --> 00:00:24,085 We can't wait to connect with you in person 10 00:00:24,305 --> 00:00:26,725 and engage in these important conversations. 11 00:00:27,755 --> 00:00:30,125 - This is Laura Dedo with the Becker's Healthcare Podcast. 12 00:00:30,705 --> 00:00:33,005 I'm thrilled today to be joined by Dr. Thomas peo, 13 00:00:33,005 --> 00:00:36,285 medical director of UPMC community osteopathic in 14 00:00:36,285 --> 00:00:37,405 Harrisburg, Pennsylvania. 15 00:00:37,705 --> 00:00:39,965 Dr. PEOs, a pleasure to have you on the podcast today. 16 00:00:40,965 --> 00:00:43,305 - Oh, thank you so much. It's a pleasure to be here. 17 00:00:44,635 --> 00:00:46,295 - Now I'm looking forward to our discussion. 18 00:00:46,475 --> 00:00:48,895 Um, and before we dive in though, 19 00:00:48,955 --> 00:00:50,095 can you tell me a little bit more 20 00:00:50,095 --> 00:00:51,295 about yourself and your background? 21 00:00:52,255 --> 00:00:54,345 - Sure. I am a physician. 22 00:00:54,615 --> 00:00:57,505 I've been practicing as a physician 23 00:00:57,725 --> 00:00:59,945 for about 24 years now. 24 00:01:00,625 --> 00:01:03,025 I started out my career as a family practitioner, 25 00:01:03,765 --> 00:01:06,665 and about halfway through that time, I, uh, 26 00:01:06,665 --> 00:01:07,865 became a hospitalist, 27 00:01:08,605 --> 00:01:10,665 and I've been working for the last eight years 28 00:01:10,805 --> 00:01:13,225 as the medical director at community osteopathic 29 00:01:13,885 --> 00:01:16,305 and worked closely with my hospitalist team 30 00:01:16,365 --> 00:01:19,625 and remain engaged in clinical care on a daily basis. 31 00:01:21,405 --> 00:01:22,975 - Well, that's great to hear. And Dr. 32 00:01:23,165 --> 00:01:25,135 Peno, you're part of the lost generation 33 00:01:25,135 --> 00:01:26,575 of autistic US adults. 34 00:01:26,995 --> 00:01:30,135 Can you tell us more about your journey to a diagnosis 35 00:01:30,135 --> 00:01:32,255 and why so many adults have fallen through the cracks? 36 00:01:33,295 --> 00:01:34,705 - Sure. Yeah. 37 00:01:34,765 --> 00:01:39,745 So as your question, um, presupposes I was diagnosed 38 00:01:39,745 --> 00:01:42,865 with autism and I was diagnosed later in life. 39 00:01:43,185 --> 00:01:45,385 I was in my early fifties when I was diagnosed, 40 00:01:46,285 --> 00:01:50,025 and my story is very similar to 41 00:01:50,825 --> 00:01:55,785 a story told by many other late diagnosed autistic adults. 42 00:01:56,545 --> 00:01:59,725 Um, in that I came to my diagnosis through my children, 43 00:02:00,885 --> 00:02:02,785 um, when I was young. 44 00:02:03,405 --> 00:02:05,745 Uh, the diagnostic criteria were different 45 00:02:05,895 --> 00:02:07,105 than they are today. 46 00:02:07,885 --> 00:02:11,505 So a person like me would not have qualified 47 00:02:11,605 --> 00:02:13,185 for a diagnosis of autism. 48 00:02:13,965 --> 00:02:15,545 Um, it wasn't 49 00:02:15,635 --> 00:02:19,945 until 2013 when the DSM diagnostic criteria folded, 50 00:02:20,485 --> 00:02:23,425 uh, diagnoses like Asperger's and autism 51 00:02:23,565 --> 00:02:26,665 and pervasive developmental disorder all into one, uh, 52 00:02:26,715 --> 00:02:31,345 broad category that, uh, people from my generation, 53 00:02:31,885 --> 00:02:34,665 um, what is referred to in the autism literature 54 00:02:34,665 --> 00:02:36,505 as the lost generation, um, 55 00:02:36,685 --> 00:02:38,505 had an opportunity to be diagnosed. 56 00:02:39,485 --> 00:02:44,025 And I think as we, as a society, uh, talk more about autism, 57 00:02:44,605 --> 00:02:47,265 uh, we become more familiar with the traits 58 00:02:47,645 --> 00:02:49,265 and the diagnostic criteria. 59 00:02:50,285 --> 00:02:52,785 Um, we start to see it, uh, more and more. 60 00:02:52,785 --> 00:02:55,265 And I can, I can, I can assure you that 61 00:02:55,265 --> 00:02:57,465 that has been the case for me in my clinical life. 62 00:02:58,675 --> 00:03:03,325 My diagnosis actually came as my oldest daughter was, 63 00:03:04,025 --> 00:03:08,445 um, working her way through her own, um, struggles 64 00:03:08,505 --> 00:03:12,845 and was diagnosed with OCD for a number of years. 65 00:03:13,585 --> 00:03:17,805 And, uh, she was, uh, very intelligent, um, 66 00:03:18,655 --> 00:03:23,005 young woman who, um, at some point began 67 00:03:23,005 --> 00:03:24,605 to question her own diagnosis 68 00:03:25,345 --> 00:03:27,805 and said to her counselor one day says, look, I 69 00:03:28,325 --> 00:03:30,445 I just don't feel like this is me. 70 00:03:30,605 --> 00:03:34,805 I don't think it describes me well, and I mentioned that 71 00:03:34,805 --> 00:03:39,585 because of the, um, psychiatric 72 00:03:40,665 --> 00:03:45,105 diagnoses that people tend to have on their way 73 00:03:45,125 --> 00:03:48,985 to an autism diagnosis, OCD is is one 74 00:03:48,985 --> 00:03:50,065 of the more common ones. 75 00:03:50,645 --> 00:03:53,505 Um, she had been working hard doing everything 76 00:03:53,505 --> 00:03:55,185 that the counselor was telling her to do. 77 00:03:55,325 --> 00:03:58,825 And, and, and then finally the counselors came back to her 78 00:03:58,825 --> 00:04:01,185 and said, gee, I wonder if we're dealing with autism here. 79 00:04:02,245 --> 00:04:04,785 And I can tell you that she came home from that meeting 80 00:04:05,285 --> 00:04:08,625 and started her own deep dive in the world of autism 81 00:04:09,285 --> 00:04:10,785 and our lives, 82 00:04:11,005 --> 00:04:13,265 our collective lives have never been the same since. 83 00:04:14,045 --> 00:04:18,605 Um, it was just a year later that her sister was diagnosed. 84 00:04:18,745 --> 00:04:21,365 And, and then the two of them were armed 85 00:04:21,395 --> 00:04:23,245 with all this diagnostic information, 86 00:04:23,825 --> 00:04:25,845 and they turned their attention towards me. 87 00:04:26,705 --> 00:04:31,125 Um, I think like a lot of adults who have not been 88 00:04:31,125 --> 00:04:32,205 around autism 89 00:04:32,465 --> 00:04:36,405 and certainly didn't understand it deeply, I, you know, 90 00:04:36,845 --> 00:04:38,565 offended them off or, you know, kind 91 00:04:38,565 --> 00:04:40,965 of denied, uh, for months. 92 00:04:41,225 --> 00:04:45,425 But they persisted. And I finally swallowed my pride 93 00:04:45,605 --> 00:04:48,385 and carefully reviewed the diagnostic criteria, 94 00:04:48,485 --> 00:04:50,905 and I said, you know, I think they're onto something. 95 00:04:51,905 --> 00:04:55,225 I, um, sought, you know, a professional 96 00:04:56,465 --> 00:04:59,975 evaluation, and indeed the diagnosis was concern, 97 00:05:00,075 --> 00:05:01,295 uh, was confirmed. 98 00:05:02,145 --> 00:05:06,245 Um, and it's really been a, 99 00:05:06,845 --> 00:05:08,245 a fantastic journey. 100 00:05:08,475 --> 00:05:11,255 I've learned so many things, um, 101 00:05:11,515 --> 00:05:16,095 and so many ways that not only does this diagnosis, uh, 102 00:05:16,325 --> 00:05:19,655 help me to bring clarity to me and to my life, 103 00:05:19,715 --> 00:05:22,175 but also to help me be a better doctor and to, 104 00:05:22,675 --> 00:05:26,095 and to see autistic traits in my patients and, uh, 105 00:05:26,095 --> 00:05:27,095 and colleagues alike. 106 00:05:29,465 --> 00:05:31,355 - Well, that's a fascinating, uh, 107 00:05:31,385 --> 00:05:32,995 perspective that you have now. 108 00:05:33,175 --> 00:05:35,155 And just so interesting to hear, um, 109 00:05:35,215 --> 00:05:37,715 the way in which you came to your diagnosis 110 00:05:37,715 --> 00:05:38,715 through your children, 111 00:05:38,895 --> 00:05:42,075 and as you said, um, I can imagine others have had 112 00:05:42,075 --> 00:05:43,595 that same experience as well, or, 113 00:05:43,615 --> 00:05:46,795 or really, you know, could be transformative to understand 114 00:05:46,865 --> 00:05:47,995 that about themselves. 115 00:05:48,535 --> 00:05:50,915 How has your diagnosis changed your understanding 116 00:05:50,915 --> 00:05:53,715 of yourself as well as your professional and personal life? 117 00:05:54,855 --> 00:05:57,495 - Yeah. One of the things that is 118 00:05:58,235 --> 00:06:01,415 unique about autistic people is this concept 119 00:06:01,515 --> 00:06:02,775 of a spiky profile. 120 00:06:03,565 --> 00:06:06,465 Um, if you think of just very generally speaking, 121 00:06:07,065 --> 00:06:10,155 a non-autistic person being like a circle 122 00:06:10,895 --> 00:06:14,555 and the profile of an autistic person being spiky, 123 00:06:15,205 --> 00:06:19,155 those spikes are the special interests they represent, um, 124 00:06:20,385 --> 00:06:21,675 deep and, and, 125 00:06:22,255 --> 00:06:26,475 and recurring, uh, uh, topics that, that they, 126 00:06:27,135 --> 00:06:28,875 um, Brent that brings joy 127 00:06:29,575 --> 00:06:32,835 and, um, motivates them to learn more and to do more. 128 00:06:34,415 --> 00:06:37,395 Um, which means that autistic people tend 129 00:06:37,395 --> 00:06:39,395 to be exceptionally good at certain things. 130 00:06:40,345 --> 00:06:43,805 Um, and then there are other areas where we tend 131 00:06:43,805 --> 00:06:44,885 to need some support. 132 00:06:45,705 --> 00:06:49,365 And the degree of that, of those, you know, 133 00:06:49,365 --> 00:06:50,485 exceptional traits 134 00:06:50,625 --> 00:06:54,125 and the degree of those areas of support is so variable. 135 00:06:54,345 --> 00:06:57,785 It really is such a vast, uh, world, uh, 136 00:06:57,785 --> 00:06:59,505 that autism represents. 137 00:07:00,285 --> 00:07:04,585 But fortunately, I have 138 00:07:05,445 --> 00:07:07,665 had a support structure in my life that I, 139 00:07:08,105 --> 00:07:11,105 I really didn't appreciate until you know, much later. 140 00:07:11,165 --> 00:07:14,145 And I think that support structure has been my wife 141 00:07:14,245 --> 00:07:15,945 and my family and the people around me. 142 00:07:16,795 --> 00:07:19,895 As I've learned more about autism, I've noticed that 143 00:07:20,125 --> 00:07:22,015 that part of the reason I didn't realize, uh, 144 00:07:22,155 --> 00:07:23,855 didn't appreciate it in myself is 145 00:07:23,855 --> 00:07:24,855 because probably many 146 00:07:24,855 --> 00:07:26,535 of my family members are also autistic. 147 00:07:26,535 --> 00:07:30,225 And I, I just had a sense of normal, um, 148 00:07:31,055 --> 00:07:34,105 that was probably more autistic than non-autistic. 149 00:07:35,045 --> 00:07:39,865 So yeah, I've been able to be immersed in my profession, 150 00:07:40,485 --> 00:07:43,145 you know, very young in life that I developed, you know, 151 00:07:43,145 --> 00:07:45,785 passions for math and science and education. 152 00:07:47,015 --> 00:07:50,275 And, you know, that led me off to medical school, 153 00:07:50,415 --> 00:07:52,475 and I was very fortunate to have a chance 154 00:07:52,495 --> 00:07:55,635 to become a physician and care for patients. 155 00:07:56,335 --> 00:08:00,395 But seeing that spiky profile in myself has helped me to see 156 00:08:00,395 --> 00:08:02,955 that same kind of spiky profile in my patients. 157 00:08:03,615 --> 00:08:08,595 So, for example, you know, aren't they able to, uh, 158 00:08:08,735 --> 00:08:12,275 pay their bills, um, executive functioning? 159 00:08:12,375 --> 00:08:14,435 Can they schedule their own appointments? 160 00:08:15,095 --> 00:08:16,115 Is it reasonable 161 00:08:16,295 --> 00:08:20,435 or even fair for me to expect my patient to be able to 162 00:08:21,025 --> 00:08:24,115 take on the, this level of independence in the future? 163 00:08:25,105 --> 00:08:27,995 Just like we counsel patients 164 00:08:28,055 --> 00:08:31,915 and their families of all sorts of neurologic issues, 165 00:08:32,655 --> 00:08:36,925 autism is one of those areas where we can dig deep, 166 00:08:37,585 --> 00:08:40,085 ask questions and find out about 167 00:08:40,085 --> 00:08:43,925 what areas they may have support needs, uh, what areas, uh, 168 00:08:43,925 --> 00:08:45,165 can they be independent? 169 00:08:45,825 --> 00:08:49,715 Um, does this person need a social worker in their life? 170 00:08:50,495 --> 00:08:52,595 Is there a family member who can be engaged? 171 00:08:53,215 --> 00:08:56,355 And we can have a conversation about autistic traits 172 00:08:56,455 --> 00:08:58,595 and how this, how this all works. 173 00:08:59,635 --> 00:09:02,855 Um, or is, is this an individual 174 00:09:02,955 --> 00:09:04,775 who really can be quite independent, 175 00:09:04,795 --> 00:09:09,255 but just needs to have, um, some appreciation of their, 176 00:09:09,635 --> 00:09:11,775 you know, enjoyment of, of, you know, 177 00:09:12,835 --> 00:09:15,775 having a relatively small social circle and, 178 00:09:16,475 --> 00:09:19,655 and, um, you know, managing their own day-to-day life. 179 00:09:21,025 --> 00:09:22,445 - Uh, that's really interesting to hear, 180 00:09:22,465 --> 00:09:24,925 and certainly such important points to think about 181 00:09:25,065 --> 00:09:26,485 as you're caring for patients 182 00:09:26,585 --> 00:09:27,805 and really for any doctor 183 00:09:27,825 --> 00:09:30,685 to understand is they're looking at their patient's profile 184 00:09:30,745 --> 00:09:33,085 and, and trying to create expectations 185 00:09:33,205 --> 00:09:34,285 and a plan for the future. 186 00:09:35,085 --> 00:09:37,405 I know you recently authored a paper on caring 187 00:09:37,425 --> 00:09:39,525 for autistic adults in the inpatient setting. 188 00:09:39,955 --> 00:09:42,085 What are some tips that you can share with our listeners? 189 00:09:42,545 --> 00:09:43,565 How has your own journey 190 00:09:43,675 --> 00:09:46,485 with autism helped shape your awareness of these strategies? 191 00:09:47,555 --> 00:09:50,885 - Yeah, thank you. So the first point 192 00:09:51,805 --> 00:09:55,485 that is so important for our listeners to appreciate is just 193 00:09:55,485 --> 00:09:56,765 how common autism is. 194 00:09:57,425 --> 00:10:01,725 Um, as of 2023, the CDC and the Autism 195 00:10:01,785 --> 00:10:04,685 and Developmental Disabilities Monitoring Network reported 196 00:10:05,495 --> 00:10:08,865 that the incidence is 2.7800000000000002% 197 00:10:09,525 --> 00:10:13,505 of the population, or about one in 36 people. 198 00:10:15,485 --> 00:10:19,075 There was another study done by Kaiser some years ago 199 00:10:19,565 --> 00:10:22,715 where they looked at a sample of 1.6 million adults 200 00:10:22,735 --> 00:10:24,195 who were diagnosed with autism, 201 00:10:24,575 --> 00:10:28,835 and they found that only 0.095% of 202 00:10:28,955 --> 00:10:30,915 that sample had been diagnosed. 203 00:10:31,835 --> 00:10:33,485 What that means is 204 00:10:33,485 --> 00:10:36,565 that autistic adults are 30 times less likely 205 00:10:36,625 --> 00:10:40,295 to have a diagnosis than children, meaning 206 00:10:40,685 --> 00:10:43,815 that there are over 7 million undiagnosed adults 207 00:10:44,435 --> 00:10:46,775 in the United States who are autistic. 208 00:10:47,925 --> 00:10:50,235 These numbers are staggering. 209 00:10:50,895 --> 00:10:54,995 And the healthcare community, society at large, we need 210 00:10:54,995 --> 00:10:57,835 to get better at recognizing autistic traits, 211 00:10:58,555 --> 00:11:00,875 offering diagnostic clarity to autistic people 212 00:11:01,415 --> 00:11:03,475 and matching up the support needs 213 00:11:03,945 --> 00:11:06,515 that this vulnerable population has. 214 00:11:08,365 --> 00:11:12,825 The second point that I would make is that being autistic is 215 00:11:13,345 --> 00:11:14,905 a social determinant of health. 216 00:11:16,165 --> 00:11:18,545 We know that autistic people have higher 217 00:11:18,555 --> 00:11:19,785 rates of unemployment. 218 00:11:20,135 --> 00:11:22,105 They're more likely to live with family members 219 00:11:22,205 --> 00:11:25,665 or relatives, and they may have very 220 00:11:25,665 --> 00:11:27,065 limited social connections. 221 00:11:27,765 --> 00:11:31,425 We know that there's higher rates of diabetes, hypertension, 222 00:11:32,035 --> 00:11:35,425 heart disease, and just generally speaking, 223 00:11:35,425 --> 00:11:37,705 they're less likely to have their health needs met. 224 00:11:38,775 --> 00:11:40,955 We know that there are higher rates of hearing loss, 225 00:11:41,725 --> 00:11:44,675 autoimmune disease, sleep problems. 226 00:11:44,845 --> 00:11:47,995 Sleep problems are, uh, extremely common. 227 00:11:48,535 --> 00:11:51,555 Uh, so folks who are complaining of insomnia, could 228 00:11:51,555 --> 00:11:53,035 that be an autistic trait. 229 00:11:53,945 --> 00:11:57,405 Um, and we also see higher rates of mental illness 230 00:11:58,025 --> 00:11:59,045 and substance use. 231 00:11:59,985 --> 00:12:03,405 And in the end, the average life expectancy 232 00:12:03,405 --> 00:12:07,165 of an autistic person is 16 years shorter than that 233 00:12:07,165 --> 00:12:08,565 of the non-autistic population. 234 00:12:09,935 --> 00:12:14,715 So we in the healthcare community have to first recognize 235 00:12:14,715 --> 00:12:18,515 that this is more common than I think that we've, uh, 236 00:12:18,545 --> 00:12:20,075 that we've appreciated in the past 237 00:12:20,865 --> 00:12:23,635 that the implications are quite severe, 238 00:12:24,555 --> 00:12:28,335 and that there is really a massive population 239 00:12:28,715 --> 00:12:31,135 of people out there who have yet to be diagnosed 240 00:12:31,955 --> 00:12:36,495 and who are in effect nurturing a disability 241 00:12:36,965 --> 00:12:38,175 that they don't know about. 242 00:12:39,655 --> 00:12:41,275 - That's such great perspective, you know, 243 00:12:41,275 --> 00:12:44,075 and really puts things into a clear picture, especially 244 00:12:44,095 --> 00:12:46,235 for people who may not understand, as you were saying, 245 00:12:46,615 --> 00:12:48,155 you know, this is their diagnosis 246 00:12:48,155 --> 00:12:50,875 or something that they're struggling through in their ways 247 00:12:50,945 --> 00:12:54,435 that they can manage that or, or seek extra help, 248 00:12:54,495 --> 00:12:55,795 but just haven't, it seems like 249 00:12:55,795 --> 00:12:58,875 because, um, they didn't know that it's something that, 250 00:12:59,015 --> 00:13:01,995 you know, um, they need to be thinking about or managing. 251 00:13:02,175 --> 00:13:04,675 So from your perspective, how important is it 252 00:13:04,675 --> 00:13:07,475 for leaders in the healthcare industry to advocate for 253 00:13:07,655 --> 00:13:09,635 and accommodate these marginalized groups? 254 00:13:09,815 --> 00:13:12,035 And can you share any examples from your role 255 00:13:12,055 --> 00:13:13,155 as a medical director? 256 00:13:14,125 --> 00:13:15,215 - Yeah, absolutely. 257 00:13:15,835 --> 00:13:19,455 Um, I've been so gratified over the past couple of years 258 00:13:19,595 --> 00:13:21,615 as I've done my own deep dive on autism 259 00:13:22,115 --> 00:13:23,895 to see these autistic traits show up in 260 00:13:23,895 --> 00:13:25,095 my patients in the hospital. 261 00:13:26,105 --> 00:13:31,005 Um, I've had patients when I questioned them, uh, 262 00:13:31,325 --> 00:13:35,605 revealed to me, um, issues around sensory, uh, intolerance. 263 00:13:36,145 --> 00:13:40,325 Uh, I, I can remember specific examples of, you know, 264 00:13:40,325 --> 00:13:43,165 asking about, you know, how is the sound level in your room? 265 00:13:43,745 --> 00:13:47,765 And I remember one patient saying back to me that, you know, 266 00:13:48,145 --> 00:13:49,205 I'm so glad you asked. 267 00:13:49,405 --> 00:13:51,125 I can hear the nurses talking up 268 00:13:51,125 --> 00:13:53,365 and down the hallway all day and all night. 269 00:13:54,225 --> 00:13:57,725 Um, this individual had been struggling with a long history 270 00:13:57,725 --> 00:13:59,765 of anxiety and sleep problems. 271 00:14:00,545 --> 00:14:03,365 And I said, Hey, you know, hang on a second. 272 00:14:03,365 --> 00:14:06,685 Lemme go get the sensory kit that we had put together, um, 273 00:14:07,015 --> 00:14:09,525 about a year and a half ago as part of, you know, 274 00:14:09,525 --> 00:14:11,005 an autism education program 275 00:14:11,035 --> 00:14:12,405 that we were doing in our health system. 276 00:14:13,345 --> 00:14:16,645 And into the room, I brought, uh, some headphones, just, 277 00:14:16,915 --> 00:14:18,765 just some quieting earmuffs. 278 00:14:19,265 --> 00:14:23,105 And I said, why don't you put these on? And she said, okay. 279 00:14:24,285 --> 00:14:28,385 And the moment that she put them on, she smiled 280 00:14:29,165 --> 00:14:30,185 and she looked at me 281 00:14:30,185 --> 00:14:34,325 and she says, wow, that really feels nice. 282 00:14:36,305 --> 00:14:40,725 And then I said, okay, well, how about the blinds? 283 00:14:41,185 --> 00:14:42,485 Do you want me to lower them? 284 00:14:42,715 --> 00:14:44,565 Well, we have blinds in all of our rooms, 285 00:14:44,705 --> 00:14:46,685 but they don't, they're not blackout blinds. 286 00:14:46,685 --> 00:14:48,285 So they let a fair amount of light in, 287 00:14:49,265 --> 00:14:52,565 and I said, do you want to try these sunglasses? 288 00:14:53,425 --> 00:14:57,145 And she put 'em on and she said, yeah, it's 289 00:14:57,145 --> 00:14:58,865 so bright in here all the time. 290 00:14:59,145 --> 00:15:00,465 I really appreciate having these. 291 00:15:01,465 --> 00:15:02,965 And then I took one more step 292 00:15:03,345 --> 00:15:04,965 and I said, how about this weighted blanket? 293 00:15:05,065 --> 00:15:08,045 Do you want to try this? And she said, she was kind 294 00:15:08,045 --> 00:15:09,245 of apprehensive in the beginning, 295 00:15:09,345 --> 00:15:11,565 but then she allowed me to place it on her lap. 296 00:15:11,625 --> 00:15:15,985 And, and she, she really just relaxed into these, 297 00:15:16,485 --> 00:15:18,465 um, very simple interventions. 298 00:15:19,275 --> 00:15:21,495 And what was so gratifying to me was 299 00:15:22,045 --> 00:15:23,495 when I returned the following day, 300 00:15:23,495 --> 00:15:26,215 she was asleep in her bedside chair with all 301 00:15:26,215 --> 00:15:31,015 of the equipment on, and I, I just touched her very gently 302 00:15:31,015 --> 00:15:32,575 and I stalled, startled her awake, 303 00:15:32,635 --> 00:15:36,445 and she said, I, I slept, I slept 304 00:15:36,465 --> 00:15:37,805 for several hours last night, 305 00:15:37,805 --> 00:15:41,055 and it's the first time in years, and she was so grateful. 306 00:15:41,715 --> 00:15:44,255 And we went back and we talked about, you know, 307 00:15:44,255 --> 00:15:47,855 different ways that we can, you know, support and, 308 00:15:48,195 --> 00:15:50,175 and certainly I don't want to give your listeners the 309 00:15:50,175 --> 00:15:51,575 impression that, you know, 310 00:15:51,575 --> 00:15:54,215 these simple interventions can solve all the problems of 311 00:15:54,485 --> 00:15:56,215 that autistic people face, but, 312 00:15:56,555 --> 00:15:58,535 but there are some very simple interventions 313 00:15:58,535 --> 00:16:00,295 that healthcare systems can implement 314 00:16:00,675 --> 00:16:03,095 and it can really make a big difference in the sensory 315 00:16:03,775 --> 00:16:06,935 overload that is so common, uh, 316 00:16:06,935 --> 00:16:08,775 for autistic patients in a healthcare setting. 317 00:16:10,895 --> 00:16:12,235 - That's a fantastic example. 318 00:16:12,375 --> 00:16:14,875 And, and certainly, you know, can make a big difference, 319 00:16:15,025 --> 00:16:17,235 like you were saying for the experience, then ability 320 00:16:17,375 --> 00:16:19,875 to get well, um, from, you know, 321 00:16:19,975 --> 00:16:21,235 the health side of things too. 322 00:16:21,935 --> 00:16:23,115 Dr. Peno, thank you so much 323 00:16:23,115 --> 00:16:24,595 for joining us on the podcast today. 324 00:16:24,665 --> 00:16:26,675 This has been a fascinating conversation. 325 00:16:26,995 --> 00:16:28,395 I really appreciate you opening up 326 00:16:28,395 --> 00:16:30,235 and sharing your own journey with us, as well 327 00:16:30,255 --> 00:16:32,795 as the advice you, you've been able to provide 328 00:16:32,795 --> 00:16:35,515 for other healthcare providers would be so meaningful, um, 329 00:16:35,615 --> 00:16:37,235 for them and their patients going forward. 330 00:16:37,595 --> 00:16:38,875 I appreciate this conversation 331 00:16:38,875 --> 00:16:40,595 and I look forward to connecting with you again soon. 332 00:16:41,515 --> 00:16:43,165 - Yeah, it was great talking to you, 333 00:16:43,165 --> 00:16:44,645 and I really wish you all the best.