Medicines in the management of autism
An outline of the current evidence-based approach for the management and support of autism (ASD).
General support measures
Informing and supporting families, carers and teachers
Children live and learn with their families and at school, and that is where the focus of management needs to be. Providing good information about the condition and how to manage it is the crucial first step in the process. Professionals working with children with ASD must have a planned way of informing parents and carers, such as:
- providing written information, and
- giving opportunities and time to discuss their questions.
Where possible attempt should be made to connect parents with other people who have experience of managing children with autism, including other parents. Many parents would also need social and financial support to meet the needs of the child.
Adjusting social physical environment to suit the child’s needs
Consider the physical environment to suit the child’s needs e.g.:
- Using visual supports, such as pictures or symbols that are meaningful for the child
- Addressing any sensory sensitivities such as towards noise or light
Specific interventions for the core features of autism
Psychosocial interventions suitable for the child’s developmental level
- Supporting and increasing parents’ and teachers’ understanding of, and sensitivity and responsiveness to, the child’s pattern of communication and social interaction
- Using techniques and aids e.g. pictures and symbols to support and enhance the child’s communication, social interaction and play patterns.
Interventions for difficult behaviours
Consider factors that may trigger or worsen difficult behaviours e.g.
o coexisting conditions,
o communication difficulties,
o physical environment e.g. noise
o poor social circumstances e.g. abuse
o poor structure for the child’s activities
o poor response to behaviour by parents and carers
o the impact of the behaviour e.g. the risk to the child an impact on the family
o the resources and lifestyle of parents
Provide intervention to include:
o a clearly identified and agreed targeted behaviour
o a focus on improving the Quality of Life of the child and the family
o parent education and training
o a review to monitor progress
Consider medication prescribing by a paediatrician or a psychiatrist if the psychosocial interventions are unsuccessful and there is a significant impact of the behaviour.
Interventions for improving life skills
These are provided to the child or the young person with ASD to help them cope with day to day challenges of life e.g. travelling, shopping etc.
Interventions for coexisting problems
Consider seeking advice and help from other professionals for any coexisting conditions.
Interventions for managing anxiety
Consider individual or group cognitive behaviour therapy.
What not to do:
The following interventions have poor or no evidence basis and should not be suggested or provided:
– auditory integration therapy
– hyperbaric oxygen therapy
– (snake oil). Unknown medicines or treatments can harm your child.
Also See: Sleep Problems
National Institute for Health and Care Excellence. Autism: the management and support of children and young people on the autism spectrum. (Clinicalguideline170.) 2013.http: //guidance.nice.org.uk/CG170
Volkmar, F., Cook, E. H., Pomeroy, J., Realmuto, G., & Tanguay, P. (1999). Practice parameters for the assessment and treatment of children, adolescents, and adults with autism and other pervasive developmental disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 38(12), 32S-54S.