Leucovorin and More: What Providers Should Know
This guide is designed to help clinicians through the decision‑making process for autism referrals, including when to consider genetic evaluation, FRAT testing and the use of leucovorin. By outlining key clinical presentations and recommended next steps, this tool helps ensure consistent, evidence‑based care for children with Autism Spectrum Disorder. Use this guide to determine appropriate referrals, identify indications for additional testing and support families with clear, informed recommendations.
Step One: Review clinical presentation for associated neurological findings
What is the clinical presentation? Does patient exhibit seizures, motor delay, intellectual disability, hypotonia, movement disorder (dyskinesia, ataxia, dystonia), or unexplained cerebral palsy-like presentation.
- If YES: proceed to step two
- If NO: proceed to step three
Step Two: Review Genetic Evaluation
Has a genetic evaluation been done?
- If YES: Proceed to step three
- If NO: Refer to Neurogenetics or Rare Disease Institute for evaluation and consideration of genetic testing.
Step 3: Review Neurological Findings
Was genetic diagnosis consistent with Cerebral Folate Deficiency?
- If YES: Consider treatment with leucovorin. Provide handout about Leucovorin and FRAT testing
- If NO: Continue current management; no indication for FRAT testing