Autism is a term that refers to a collection of developmental disorders that affect the brain. This brain disorder affects a person’s ability to communicate, form relationships with others, and respond appropriately to the external world. People with autism have a tendency to have repetitive behaviors or interests and rigid patterns of thinking.
The severity of autism varies greatly. Some people with autism can function at a relatively high level, with speech and intelligence intact. Others have serious cognitive impairments and language delays; some never speak.
What is the Picture Exchange Communication System?
One of the commonest disabilities found in autistic children is an impaired ability to communicate. While some children with autism will develop verbal language, others may never talk.
Are there other therapies that are useful in the treatment of behavioral symptoms in autistic children?
Yes, there are other therapies that may be helpful in the treatment of autism symptoms. As is mentioned, there is no cure for autism nor is there a standard therapy that works for all or even most people with autism.
Life will break you. Nobody can protect you from that, and living alone won`t either, for solitude will also break you with its yearning. You have to love. You have to feel. It is the reason you are here in the earth. You are here to risk your heart. You are here to be swallowed up. And when it happens that you are broken, or betrayed, or left, or hurt, or death brushes near, ;et yourself sit by an apple tree and listen to the apples falling all around you in heaps, wasting their sweetness. Tell yourself you tasted as many as you could.
Are medications useful in treating the behavioral problems of autistic children?
No medication can cure autism. Some autistic children may require medication for a short time and others require life-long treatment to help with their behavior or other symptoms. Most autistic children require no medication at all. Many distressing symptoms and unusual behaviors can be improved without the medication.
What types of medications are used to treat autistic children?
The types of medications used to treat an autistic child depend on the symptoms as well as any other condition that may contribute to unacceptable behavior. Medications commonly prescribed to treat the behaviors of autistic children include antidepressants, anticonvulsants, neuroleptic medications (also known as antipsychotic medications), sedatives, and stimulants. These medications all can have serious side effects and are not prescribed lightly by concerned physicians.
I’ve heard that antiseizure medications can be helpful in treating some behavior problems associated with autism. Is that true?
Yes. Antiseizure medications (also called anticonvulsants) are another group of medications that have demonstrated effectiveness in treating behavioral symptoms in autistic patients.
Although anticonvulsants are prescribed mainly for epilepsy, the mood-stabilizing and behavioral effects of this class of medication are increasingly being studied. Researchers have noticed that while treating autistic children for their seizures, their aggressive behaviors improved while on the antiseizure medication. How these medications work to curb aggressive behavior is unknown. Although these medications are designed to treat seizure activity, physicians will often prescribe them for children who suffer from both a seizure disorder as well as behavioral disorders. These medications have numerous side effects, some of which are severe. These include problems with liver function as well as with production of blood in the bone marrow. Therefore, each of these medications requires regular bloodtesting in order to ensure that liver or bone marrow damage does not occur.
Antiseizure medications commonly prescribed for autistic children include:
Depakote (divalproex sodium). In addition to treating seizures, Depakote is indicated in the treatment of bipolar disorder (manic-depression) as well as migraine headaches. It has the benefits of lessening explosive behaviors and aggression in patients with autism. Common side effects include sedation and upset stomach. Unusual, but dangerous, side effects include liver failure, pancreatitis, and low platelet counts. Frequent blood tests must be done to monitor the blood count, liver, and pancreatic enzymes.
Signs of irregularities should prompt a discontinuation of the medication and consultation with the prescribing physician.
Tegretol (carbamazapine). Like Depakote, Tegretol is indicated for treatment of seizures and bipolar disorder. Some studies demonstrate improvement in behavioral symptoms in autistic children. Side effects are numerous and include drowsiness, headache, dizziness, fatigue, and allergic skin reactions. A rare side effect is to decrease the bone marrow’s ability to produce blood cells. As with Depakote, regular visits to the doctor are necessary for blood tests.
Neurontin (Gabapentin) and lamictal (Lamotrigine) are other medications that show potential but have not been studied sufficiently to be recommended for use with children. They appear to provide the same benefits as Depakote, as well as the same side effects, but insufficient data exist on their overall effect.
Behavioral disorders - Disorders affecting behavior and emotional well-being.
How are anxiety and depression treated in an autistic person?
Although depression has been described in autistic children, limited information is available about how frequently depression occurs. Experts believe that the rate of depression in autistic children is higher than in typical children. Common types of treatment for depression include the selective serotonin reuptake inhibitors (SSRIs) and the tricyclic antidepressants.
The SSRIs are the medications most often prescribed for symptoms of anxiety, depression, and/or obsessivecompulsive disorder (OCD). These medications are generally considered safe and have few side effects.
Treatment with these medications is associated with decreased frequency of repetitive, ritualistic behavior and improvement in aggression and self-injurious behaviors. Use of SSRIs has been reported to improve a child’s eye contact and social interactions. The FDA is studying and analyzing data to understand how to use the SSRIs safely, effectively, and at the lowest dose possible.
Some examples of the SSRIs include:
Fluoxetine (Prozac). A selective serotonin reuptake inhibitor (SSRI) type of antidepressant; it has been approved by the FDA for both OCD and depression in children ages 7 and older.
Fluvoxamine (Luvox). A selective serotonin reuptake inhibitor (SSRI) type of antidepressant; it has been approved by the FDA for both OCD and depression in children ages 8 and older. Although not as popular as fluoxetine, fluvoxamine has a sedating effect that is not found in Prozac. This may prove to be an advantage in hyperactive children
Sertraline (Zoloft). A selective serotonin reuptake inhibitor (SSRI) type of antidepressant; it has been approved by the FDA for both OCD and depression in children ages 6 and older. It causes less agitation than Prozac but is associated with weight gain. Tricyclic antidepressants, while effective, are associated with many more side effects and are not as safe to use as the SSRIs. Tricyclic agents should be used with extreme caution in patients with a history of convulsions or epilepsy. These agents are known to increase the tendency for seizures. Tricyclics should also be used with caution in children with irregular heartbeats, because they can cause a worsening of irregular heart beats (cardiac arrhythmias). A frequently used medication in this class is clomipramine.
Clomipramine (Anafranil). Clomipramine is a tricyclic antidepressant agent with both antidepressant and antiobsessional properties. Like other tricyclic antidepressant agents, clomipramine inhibits norepinephrine and serotonin uptake into central nerve terminals.
It is approved for treatment of depression and obsessive compulsive disorder in children ages 10 and older. Clomipramine also appears to have a mild sedative effect that may be helpful in alleviating the anxiety component often accompanying depression.
Other drugs, such as Elavil (amitriptyline hydrochloride) and Wellbutrin (buproprion hydrochloride), have not been studied as much as others but may have a role in treating depression as well as the behavioral symptoms in autism. Keep in mind that all these drugs have potential side effects, which should be discussed with the treating physician before treatment isstarted. Parents should be alerted to these side effects so that they are able to discuss the effects of the medication with the physician, who may adjust the dose or stop the medication.
Selective serotonin reuptake inhibitor (SSRI) - A class of drugs used as antidepressants. Functionally, they increase the levels of serotonin in the body.These drugs can be dangerous if mixed with other drugs such as other antidepressants, illicit drugs, some antihistamines, antibiotics, and calcium-channel blockers. Some examples of SSRIs are Prozac, Zoloft, and Paxil.
Serotonin - A neurotransmitter implicated in the behavioralphysiological processes of sleep, pain and sensory perception,motor function, appetite, learning, and memory.
Convulsions - Involuntary spasms especially those affecting the full body.
Experts believe that the rate of depression in autistic children is higher than in Typical children.
What medications are used to treat seizures in autistic children?
Seizure disorder, a condition also known as epilepsy, occurs more commonly in autistic children than in typically developed children. In fact, one in four persons with autism has a seizure disorder. The onset of seizure activity in the autistic usually occurs during infancy, childhood, or adolescence.
Seizures result from an abnormal electrical discharge in the brain. Causes of this abnormal electrical activity can include an imbalance of the salt or sugar in the blood, head injuries, infections of the brain and its coverings, or, rarely, brain tumors. Often the cause of the seizure is unknown. Epilepsy is the diagnosis given to patients who suffer from repeated seizures that occur without an identifiable cause.
Seizures in autistic patients are commonly of two varieties. The majority of seizures in autistic children are of the grand mal type, while a smaller number suffer from petite mal seizures. Grand mal seizures (also known as tonic-clonic seizures or convulsions). A grand mal seizure is a common type of seizure. Patients suffering from a seizure can be recognized by the symptoms that may include a loss of consciousness and loss of motor control that, if they are standing, may make them fall down. They frequently lose control of their bowel or bladder and will soil their clothes after a seizure. However, the most characteristic sign of a seizure disorder is rhythmic convulsions of the whole body. These seizures rarely last more than a minute or two. After the seizure, the patient is often confused and lethargic and may complain of headache.
Petite mal seizures (also known as absence seizure). Unlike a grand mal seizure, an absence seizure causes a loss of consciousness that is usually 30 seconds or less and is barely noticeable. Rather than falling down, the person simply stops moving or speaking, stares straight ahead blankly, and does not respond to questions.
During a petit mal seizure, small jerks sometimes occur involving the facial muscles, jaw, or hands. Each seizure lasts only seconds or minutes, but hundreds may occur each day and the patient may be unaware that a seizure has occurred. A person who experiences a petit mal seizure can usually resume normal activities immediately after the seizure ends.
Parents concerned about symptoms that may be seizure related should have their child evaluated by a pediatric neurologist, who may recommend a test that measures brain waves. This test is called an electroencephalogram or EEG.
The treatment of seizures in autistic patients varies depending on their needs and the severity of the condition. When medication is indicated, the treatment of seizure disorder requires one or more anticonvulsants. Although anticonvulsants usually reduce the number of seizures, they cannot always eliminate them. Anticonvulsants commonly prescribed include carbamazepine (Tegretol), lamotrigine (Lamictal), topiramate (Topamax), As noted in the previous section, these medications are associated with many side effects; therefore, frequent monitoring of medication levels in the blood as well as blood cell counts and liver and pancreatic enzyme levels are required.