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Autism Spectrum Disorders Health Center

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Tips for Parenting a Child With Autism

5. Learn More About Behavioral Training continued...

An intensive approach using behavior therapy, often called applied behavior analysis (ABA), is uniformly recommended by experts, including a recommendation by the U.S. surgeon general. The prototype program is called classic ABA and involves intensive, one-on-one work for 30 to 40 hours a week. More commonly now, therapists use a “modified" ABA that calls for ten to 12 hours per week of intensive work, allowing for time in school, other therapies, and social interactions with family members and peers.

The goal of behavior therapy programs is to reinforce desirable behaviors and decrease undesirable ones. As an example, the child with autism is taught to perform tasks in a series of simple steps and is given a predictable schedule. The behavioral therapy is then continued at home.

Often, both behavioral therapy and occupational therapy are given at the same time. The downside is that this type of therapy is expensive and often not covered by health insurance plans.

For more information, you can find a review of all the educational programs that work in the book Educating Children With Autism. Written by the National Research Council, the book is available through the National Academies Press at http://www.nap.edu/catalog/10017.html.

6. Assess Your Child's Need for Medication

While there is no medication for autism, there are drugs for specific symptoms that kids with autism might display. As an example, the FDA approved Risperdal in 2006 for the treatment of irritability in children and teens with autism. Short attention spans can sometimes be improved with stimulant drugs that are used to treat ADD or ADHD. Children with autism who have anxiety, depression, or OCD behaviors can often be treated with anti-depressants.

Drugs have a limited role in improving symptoms of autism. However, some may help prevent self-injury and other behaviors that are causing difficulty. Medicines may also take a child with autism to a functional level at which they can benefit from other treatments.

The American Academy of Pediatrics suggests targeting the main problem behaviors when considering medicines. Medicines that are sometimes used to treat behaviors related to autism include selective serotonin reuptake inhibitors (antidepressants) and antipsychotic medicines.

Selective serotonin reuptake inhibitors (SSRIs) include Celexa, Prozac, and Zoloft, for example. The high rate of effectiveness for depression, anxiety, and obsessive, stereotypical behaviors has made these medicines a popular choice for managing autism. They may also improve general behavior, language, learning, and socialization. In addition, although SSRIs have side effects such as weight gain or loss, insomnia or drowsiness, and increased agitation, they tend to be less serious than those of antipsychotic medicines.

Antipsychotic medicines, such as Haldol, Risperdal, Zyprexa, and thioridazine work by changing the effects of brain chemicals. They may help decrease problem behaviors that can occur with autism. A well-designed study found that Risperdal was effective for the treatment of tantrums, aggression, and self-harming behavior in children with autism. Both Risperdal and Abilify have been formally approved by the FDA for treating irritability and aggression in children with autism.

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