Hero: Patty Manning, developmental pediatrician, Cincinnati, Ohio
Nominator quote: “I remember one session when Kenzie was very young, Dr. Manning did our appointment while walking back to our van because Kenzie wasn’t having a good day.”
Patty Manning, a developmental pediatrician at Cincinnati Children’s Hospital Medical Center in Ohio, sometimes sees patients in unusual places — in a car seat, walking around the hospital’s library, or simply in the clinic hallway. As a specialist treating children with autism spectrum disorders, she follows her patients’ needs and moods on that particular day. “You have to meet families and kids where they are,” Manning says. “I never wear a skirt on clinic days because I know I’ll probably end up on the floor at some point.”
In the late 1990s, Manning launched the Kelly O’Leary Center for Autism Spectrum Disorders at CCH. The inspiration for the clinic came from families who wanted more than just a diagnosis of autism. They needed ongoing treatment in one place. “That’s always influenced how I guide the program,” she says.
The clinic provides care for a variety of issues affecting people with autism, such as seizures, sleep disorders and gastrointestinal problems. As in a diabetes clinic, patients visit the same place and the same doctors over time. Manning has followed some patients from toddlers to adults. “That’s made recruitment for SPARK fun and easy because I’ve been working with some of these people for 10 to 20 years,” Manning says.
Manning is passionate about access to care. “It’s unacceptable in my mind that someone has to wait weeks or months or years to get a diagnosis and treatment,” she says. “It’s not enough to serve a few kids really well. We have to be creative in our system development to serve more kids in a timely manner.”
To expand access, Manning and her team hired more staff. But they also worked with access specialists to redesign how they diagnose and treat patients. A diagnosis for a child under three used to take four visits over the course of four to six months. They’ve collapsed that down to two visits over three to four weeks. Families generally get an appointment within six weeks. “Some people think you can’t improve access because there is too much demand and not enough supply, but that’s not acceptable,” Manning says. “We can make it better without sacrificing the integrity or quality of what we’re doing.”
Many families don’t have access to a specialty clinic like the O’Leary Center. For them, Manning suggests forging a strong partnership with a primary care provider. “If you can’t do that, find another one,” she says. “There are PCPs out there who have a special interest in children with autism.” For providers interested in autism who would like more training or experience, she says, centers like hers often host physicians for a day or two. Joining the board of a local autism society is another opportunity for an informal education, she says. “You don’t have to be an expert. You just have to be a partner with the family.”