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The right help at the right time!BASIC TREATMENT INTERVENTIONS FOR AUTISM AND AUTISTIC SPECTRUM DISORDERS (ASD)When treating autism and autistic spectrum disorders, behavioral interventions are the treatment of choice for improving quality of life, while medications are used for the associated symptoms that often can slow or deter the ability to perform behavioral interventions. Before treatment is begun, it is important to educate families about the condition, the prognosis, expectations and difficulties with treatment as well as getting their support and commitment. Families should be made aware of all the treatment options and informed about local support groups and community programs available. There should be a point person when possible who can assure that adequate coordination of care and communication is occurs among all parties, including schools, pediatricians, therapists and psychiatrists, if involved. One of the more commonly used behavioral interventions for treating autism and autistic spectrum disorders is Applied Behavioral Analysis (ABA). This intervention seems to be most effective when the disorder is recognized in the earlier years. Some ABA interventions include the Lovaas method and the Discrete Trial Teaching. Such treatments are based on the principle that behavior which is rewarded is more likely to be repeated than behaviors ignored. Usually such treatments are performed one to one at home and at school. With some interventions, such as the Discrete Trial Teaching, the therapist works with the person 30 or more hours a week. There are many other behavioral interventions, including Pivotal Response training and the Treatment and Education of Autistic Communication –Handicapped Children (TEACCH). In addition, occupational, language and sensory therapies should be part of the treatment. As required by law, an Individualized Education Plan (IEP) must be done through the school if the person being treated is school–aged, and an Individual Family Service Plan (IFSP) forM must be completed for preschoolers. In most states, local school districts are responsible for providing educational services for children with autism. Medications can be helpful in the overall management of ASD when used along with various educational, developmental and behavioral treatments. Medications can help to decrease the associated symptoms that can derail attempts to apply behavioral treatments. Varied and associated symptoms may wax and wane, or at times be persistent. Some of these associated symptoms are often difficult to treat or can be confused with similar symptoms seen with other disorders, like ADHD. Medications may not always affect people with ASD the same as they do others without ASD and similar symptoms. In addition, those with Autism or ASD can be very sensitive to medications and often the side effects can exacerbate other symptoms. Therefore, it is important to proceed with caution and to monitor closely for side effects and changes in behaviors. Many different medications are used for targeted symptoms seen in autism and ASD. Unfortunately, for the majority of them there have been only a limited number of studies done on a large scale. A short list of some of the more commonly used medications and associated symptoms treated include: atypical antipsychotics for hyperactivity, aggression, repetitive behaviors and severe tantrums; SSRI’s for depression, anxiety, obsession and compulsion, and impulsivity; stimulants and non- stimulants for hyperactivity and distractible inattention; mood stabilizers (in particular Divalproex) for anger, temper tantrums and mood instability; and Alpha-agonists like Clonidine for anxiety, hyperactivity, sleep disturbances and impulsivity. To date, only Risperidone (Risperdal) has been FDA approved for the treatment of irritability associated with autism, including aggression, self-injurious behaviors, temper tantrums and quickly changing moods. It is worth mentioning briefly that there are other biomedical treatments, including complementary and alternative medicine (CAM), which is based on the premise that ASD and autism are disorders of metabolism or food allergies. Some treatments have included chelation, gluten-free diets, giving Omega-3 fatty acids or methyl B12. To date, there is limited published clinical data to support proven efficacy. Other Featured Articles:NATIONAL CARE CENTER'S DEPRESSION PREVENTIVE HEALTH PROGRAM
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