Management of symptoms in children with autism spectrum disorders: a comprehensive review of pharmacologic and complementary-alternative medicine treatments.
ABSTRACT In the care of children with autism spectrum disorders (ASD), medical treatment is typically considered an adjunct to educational and behavioral interventions. Nonetheless, large proportions of children with ASD are managed medically and receive both pharmacologic and complementary-alternative medicine (CAM) treatments. Although many medical treatments have been studied in children with ASD, studies vary widely in terms of the sample, sample size, research design, purposes of treatment, and measurements of change. Surprisingly, comprehensive reviews of the options for medical management in ASD are lacking, particularly reviews that address both pharmacologic and CAM treatments. Furthermore, reviews to date tend to emphasize general effects of medication; this perspective contradicts medical practice, which targets particular symptoms during treatment selection and monitoring. This review of 115 studies adds to the ASD treatment literature by (1) including studies of individuals 0 to 22 years of age; (2) aggregating studies of pharmacologic treatments and CAM treatments; and importantly, (3) organizing treatment response by ASD symptoms, differentiating core and associated symptoms.
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ABSTRACT: Research Open Access High use of complementary and alternative medication among children with autism is not associated with the severity of core symptoms Abstract Background: Complementary and alternative medicine (CAM) is commonly used by individuals with autism spectrum disorder (ASD). No study has examined individual, family and clinical characteristics associated with CAM use. Methods: Parents of 169 Australian children with a clinical diagnosis of ASD completed a questionnaire about socio-demographics, medical history and CAM use. Children were administered the Autism Diagnostic Observation Schedule. Results: The majority (54%) of this sample had used CAM. Fish oil was the most common type of CAM administered (48% of total sample) and the most common reason for CAM use was to ameliorate non-core ASD symptoms such as hyperactivity and irritability. Chi-square analyses identified no differences between CAM and non-CAM users in gender, age of child, age at diagnosis, parental age at birth, parental education, ethnicity or family income. No group differences in the proportion of children classified with different ASD, based on clinical diagnosis and ADOS severity scores were observed. CAM users (37%) were more likely than non-CAM users (22%) to take psychotropic medication (p<0.05). Conclusions: This study provided evidence for high rate of CAM use in an Australian paediatric ASD population, similar to other countries. CAM use was not associated with core ASD deficits. There is a clear need for robust evidence to determine complex influencing factors on CAM uptake and its efficacy on ASD core and non-core symptoms with a view to assist with parental informed decisions and clinical guidelines.
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ABSTRACT: Empirical research in the treatment of autism spectrum disorders (ASDs) has resulted in the identification of numerous evidence‐based interventions (EBIs). Adolescents with an ASD are faced with unique academic challenges, complex social environments, and physiological changes. They often require interventions to aid in acclimating to their evolving social environments and physical changes. One of the many challenges for practitioners working with adolescents is turning research findings into practice. We provide a framework to build capacity within a middle or high‐school setting to implement EBIs for adolescent students with an ASD. Key elements of implementing EBIs in the school setting include: developing a team of professionals dedicated to achieving a system change, a systematic plan, monitoring progress, and a plan for sustainability. Teacher training is an essential part of implementing EBIs in an educational setting. Empirical evidence suggests that teacher training consists of different strategies including in‐vivo training. Accessing resources outside of the school system, such as professionals at universities and teaching hospitals, can aid in training and other aspects of implementing EBIs in the classroom.Psychology in the Schools 11/2013; 50(9). DOI:10.1002/pits.21712 · 0.72 Impact Factor
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ABSTRACT: Abstract Objective: The objective of this study was to investigate the short-term treatment effects of atomoxetine on autism spectrum disorder (ASD) symptoms in children and adolescents with both ASD and attention-deficit/hyperactivity disorder (ADHD). Methods: A total of 97 patients 6-17 years of age, with ASD and ADHD, were treated with 1.2 mg/kg/day of atomoxetine during an 8 week double-blind placebo-controlled period. Here, we investigated effects on two parent-based secondary outcome measures, the Aberrant Behavior Checklist (ABC) and the Children's Social Behavior Questionnaire (CSBQ). Results: After 8 weeks of double-blind treatment, atomoxetine administration was associated with significant treatment effects on the ABC subscales Hyperactivity, Inappropriate Speech, and Stereotypic Behavior, and on the CSBQ subscale Fear for Changes. Conclusions: Our study results indicate no beneficial effects of atomoxetine on social functioning. However, atomoxetine may ameliorate restricted and stereotyped behaviors and communication. This study has been registered in ClinicalTrials.gov ( www.clinicaltrials.gov ) under registration number NCT00380692.Journal of Child and Adolescent Psychopharmacology 11/2014; 24(9). DOI:10.1089/cap.2014.0026 · 3.07 Impact Factor