Psychotropic Medication Use Among Children With Autism Spectrum Disorders Enrolled in a National Registry, 2007-2008
Department of Medical Informatics, Kennedy Krieger Institute, 3825 Greenspring Avenue, Painter Building, 1st Floor, Baltimore, MD, 21211, USA. Journal of Autism and Developmental Disorders
(Impact Factor: 3.06).
10/2009; 40(3):342-51. DOI: 10.1007/s10803-009-0878-1
Patterns of current psychotropic medication use among 5,181 children with autism spectrum disorders (ASD) enrolled in a Web-based registry were examined. Overall, 35% used at least one psychotropic medication, most commonly stimulants, neuroleptics, and/or antidepressants. Those who were uninsured or exclusively privately insured were less likely to use >or=3 medications than were those insured by Medicaid. Psychiatrists and neurologists prescribed the majority of psychotropic medications. In multivariate analysis, older age, presence of intellectual disability or psychiatric comorbidity, and residing in a poorer county or in the South or Midwest regions of the United States increased the odds of psychotropic medication use. Factors external to clinical presentation likely affect odds of psychotropic medication use among children with ASD.
Available from: PubMed Central
- "Similarly, Oswald and Sonenklar reported 83% of autistics had at least one drug claim during one year . While in a recent study investigating the patterns of psychotropic medication use among 5,181 children with autism in USA, Rosenberg and colleagues reported that 35% used at least one psychotropic medication, most commonly stimulants, neuroleptics, and/or antidepressants . The majority of psychotropic medications were prescribed for older age, or in the presence of intellectual disability or psychiatric comorbidity, and when the patient resided in a poorer county . "
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ABSTRACT: Autism is a biological disorder with clearly defined phenomenology. Studies from the Middle East on this topic have been particularly rare. Little is known about the influence of culture on clinical features, presentations and management of autism. The current study was done to compare characteristics of autism in two groups of Egyptian as well as Saudi children.
The sample included 48 children with Autism Spectrum Disorder. They were recruited from the Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt and Al-Amal Complex for Mental Health, Dammam, Kingdom of Saudi Arabia. They were grouped into an Egyptian group (n = 20) and a Saudi group (n = 28). They were assessed both clinically and psychometrically using the GARS, the Vineland adaptive behavioral scale, and the Stanford Binnet IQ test.
Typical autism was more prevalent than atypical autism in both groups. There were no statistically significant differences in clinical variables like regression, hyperactivity, epilepsy or mental retardation. Delayed language development was significantly higher in the Egyptian group while delay in all developmental milestones was more significant in the Saudi group. The Vineland communication subscale showed more significant severe and profound communication defects in the Saudi group while the Gilliam developmental subscale showed significantly more average scores in the Egyptian group. Both groups differed significantly such that the age of noticing abnormality was younger in the Saudi group. The age at diagnosis and at the commencement of intervention was lower in the Egyptian group. The Saudi group showed a higher percentage of missing examinations, older birth order and significantly higher preference to drug treatment, while the Egyptian group showed a high preference to behavioral and phoniatric therapies, higher paternal and maternal education, higher employment among parents and higher family concern.
Cultural context may significantly influence the age of noticing abnormality, the age of starting intervention, developmental and perinatal problems, family concerns about managing the problem as well as familial tendency for neurodevelopmental disorders, all of which have important impact on clinical symptomatology and severity of autism. Culture also influences significantly the ways of investigating and treating autism.
Available from: Howard L Taras
- "In addition, out of the 100 families surveyed, only 19 % reported that their children were on prescription medication. This is lower than current statistics regarding the percentage of children with ASD who are on prescription medication (Rosenberg et al., 2010). One possible reason for this is because these families were receiving behavioral treatment services, and therefore, a large percentage of them may not have found the need for adjunctive medication treatment. "
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ABSTRACT: Background: The current prevalence of medication usage among children with autism spectrum disorders (ASD) is high and has greatly increased in recent years (Oswald & Sonenklar, 2007; Aman, Lam, & Van Bourgondien, 2005). It is typical in current practice for a psychiatrist to prescribe medication to a child with ASD based on a brief interaction with the child coupled with parent report of his/her behaviors. Medication often continues to be used for many years, with an increasing probability for additional medications to be prescribed, as the individual grows older (Ebensen, Greenberg, Seltzer, & Aman, 2008). How these prescribing practices extend to the classroom, and whether educators are aware of which medication a child is on, is unknown. Also, there is a lack of research about the extent to which teachers, who are working with the children for many hours daily, provide information to the prescribing doctor with regard to any effects the medication is having on the child during the school day.
Objectives: A first step in this process was to assess whether teachers were knowledgeable regarding medication their students with ASD were taking, and if so, what type of medication. We also assessed what information, if any, is coordinated with the prescribing doctor.
Methods: One hundred and four families receiving Pivotal Response Treatment services through the Koegel Autism Center at University of California, Santa Barbara and other agencies in Southern California were surveyed to determine if their children were taking medication. Eleven of these families surveyed had children who were taking a prescribed medication. After obtaining parent consent, the teachers of the eleven children were given a questionnaire regarding medication information about those particular students.
Results: Of the eleven teacher questionnaires, 54% knew the children were taking medication. Of those, 9% (one teacher) knew what type of medication and none were aware of the dosage. None of the teachers were coordinating with the prescribing doctor, and only two of the teachers were reporting back to the parents only about any side effects.
Conclusions: The data from this survey suggest that there is a lack of coordination between teachers and prescribing doctors regarding medication information as it relates to child behavior and performance for children with ASD. It is currently not required for schools to monitor the effects a medication may have an a student with a disability; however, we would argue that because medications may positively or negatively affect a child’s behavior, it is important for teachers to know whether or not their students are on medication and for prescribing doctors to understand how the medications are effecting the child’s performance and behavior. Future research will assess whether coordination of information across professionals for monitoring the improvement of the behavior of a child with an ASD is warranted. This coordination may be essential for monitoring the effectiveness of medication use and ensuring that the child receives optimal services.
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ABSTRACT: In this paper it is shown that if an input-output discrete-time model is available, feedback linearization can be easily accomplished without the use of geometric differential tools and without the need for measurements of all states or state observers. Feedback linearization is sub-sequently combined with internal model controller design to obtain a nonlinear controller that can stabilize unstable steady states, follow setpoint changes and reject disturbances. Global stability is proved in the absence of plant/model mismatch and zero steady-state offset is guaranteed if the closed loop system is stable, even for inaccurate models. Subsequently, the above controller is used to develop a nonlinear adaptive controller. The effectiveness of the adaptive controller is demonstrated by application to a highly nonlinear simulated continuous stirred-tank reactor.
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