#330 – Autism, ADHD, and Anxiety: Understanding the rise in autism and a multidisciplinary approach to diagnosis and treatment of each condition in children | Trenna Sutcliffe, M.D.

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Trenna Sutcliffe is a developmental behavioral pediatrician and the founder and medical director of the Sutcliffe Clinic in the San Francisco Bay Area, where she partners with families to provide care for children facing behavioral challenges, developmental differences, and school struggles. In this episode, Trenna shares her journey into developmental and behavioral pediatrics, including her pioneering work at Stanford and her expertise in autism, ADHD, and anxiety—the "three As." She explores the diagnostic processes, the overlap and comorbidities of these conditions, and the importance of personalized treatment plans that address both medical and environmental factors. Trenna offers valuable insights into the changing prevalence of autism, the impact of evolving diagnostic criteria, and the range of therapies and medications available to support children and their families. She also discusses the challenges in accessing care and the critical need for a holistic approach that bridges healthcare and education.

We discuss:

• Trenna’s passion for developmental-behavioral pediatrics (DBP), and the process of diagnosing anxiety, ADHD, and autism [3:15];
• Understanding anxiety and ADHD: assessing impairment and self-esteem and identifying anxiety and emotional well-being in young patients [9:45];
• The evolving diagnosis of autism: understanding the spectrum and individual needs [16:30];
• The dramatic rise in autism spectrum disorder (ASD): genetics, environment, expanded diagnostic criteria, and more [25:45];
• Exploring epigenetics and the potential multigenerational impact of environment exposures on susceptibility to certain disorders [37:15];
• The evolution of autism classifications, and the particular challenges for children with level 1 (mild) autism due to a lack of support [41:15];
• The broadening of the autism spectrum: benefits and risks of expanded diagnostic criteria and the need for future frameworks to focus on better outcomes [48:00];
• The overlap between ASD, ADHD, and anxiety [57:15];
• Understanding oppositional defiant disorder, and the importance of understanding the “why” behind a behavior when creating treatment plans [1:00:45];
• Defining developmental-behavioral pediatrics (DBP), and Trenna’s professional journey [1:07:00];
• Updated methods of ABA (applied behavioral analysis) therapy: evolution, controversies, challenges of scaling autism care, and the need for tailored interventions [1:13:45];
• Advice for parents trying to find and evaluate care for children with autism, ADHD, or anxiety [1:22:45];
Tailored treatments for ADHD: balancing stimulant medications with behavioral training [1:28:30];
• The interplay between medication, behavioral therapy, and neuroplasticity in managing ADHD, and the potential to grow out of the need for medication [1:39:45];
• Using medication to treat anxiety and other symptoms in kids with autism without ADHD [1:44:45];
• FAQs about medicating children with ADHD: benefits, side effects, dosage, and more [1:46:30];
• The “superpowers” associated with level 1 autism [1:48:45];
• The next steps to increase support f