Autism spectrum disorder has become a neurodevelopmental problem that has been growing very rapidly in recent years. Autism seems to be an area in which everyone has the courage to say something about the subject and intervene by thinking that it helps our children, or to abuse our children. Scientific recognition of autism will increase awareness of this field.
The use of medicines in autism is perhaps one of the areas where families with children affected by autism spectrum disorder and educators working with these children experience the most problems.
It is not necessary to use medication for every child affected by autism. The use of medication in autism is necessary when there are additional symptoms besides autism. The medication does not correct autism, the treatment of autism is special education.
Effective medication for the main symptoms of autism has not yet been found. However, drug treatment may be necessary due to the accompanying attention deficit, behavioral problems, sleep problems, anger control problems in some children with autism.
However, if the child has additional problems, for example, if he/she has depression, or if like other children suffer from depression, the child affected by autism may have a depression problem as well. The child affected by autism may also have sleep problems or behavioral problems. Along with autism, medication is used to treat these symptoms. If the child does not have any additional symptoms besides autism, the medication is not offered and used.
Various psychiatric medications are used to reduce behavioral problems and increase the attention of children with autism such as excessive mobility, temper tantrums, and obsessions. Physicians, pediatric psychologists and child neurologists who evaluate the child regarding drug treatment, decide on drug treatment and apply this treatment. Which of these drugs should be used in which dosages are of great importance. Therefore, the effects and side effects of the drugs used must be closely monitored by specialists. Therefore, children undergoing medication should be taken to control once or twice a year.
Professionals sometimes use medications to deal with specific behavior. Because of the fact that if they can minimize the problem behavior, it would be easier to work on other behaviors they need to be achieved. According to researches conducted to investigate effects on medication, when it is used as a complementary method for behavioral therapy, it increases its effectiveness.
In autism, not every child may need to use medication, but if any child affected by autism goes to a physician at the moment, there are some behavioral problems or if the intensity of stereotypical movements disturbs the child’s daily life, the physician may offer to take some medication to reduce those behaviors. But then the family can be disconnected from the doctor and the family is using this medicine for so long. The child comes back two years later, but in those two years, so many things change…
So, during the medication use, the controls should be done and the side effect controls should be evaluated by the physician. This is the most common problem encountered in practice in autism. The child who uses medication should come to control every three months on average. The use of some medicines longer than necessary causes additional problems. The medication is something that should be used absolutely when needed, but it should be stopped when not needed. Starting and stopping medication are two areas that are difficult for autism.
Drugs such as Risperdal and Abilify are used extensively in autism. There have been a lot of studies with these drugs. These drugs are effective in reducing a certain number of behavioral patterns in autism and increasing the social relationship according to studies.
One of the biggest problems with these drugs is that it causes weight gain in the child. Although it is considered good by the family at first, it causes obesity and some metabolic problems in the future. Therefore, when using these drugs, blood levels, blood sugars, liver functions, cholesterol levels, and body fat ratio should be checked at regular intervals. Of course, if there is no need for medicine, it is absolutely necessary to stop the medicine.
Especially drugs such as Risperdal and Abilify, which are called antipsychotics, are effective in reducing behavioral problems such as violent behavior, reducing stereotypical movements and increasing the social harmony of the child. Because these behaviors are those that affect learning skills. The aim is to increase the learning skills of children on the autism spectrum. These drugs reduce the movement to some extent in a very active child.
If the child with autism has depression, in addition to these drugs, antidepressant use can be started, or combinations of different uses vary depending on the child. Sometimes depression can be the underlying cause of anger behavior in children with autism.
The use of some antipsychotic drugs, such as risperidone and aripiprazole, for treating irritability associated with autism in children between certain ages. Parents should talk with their child’s healthcare providers about any medications for children with an autism spectrum disorder.
Since these children cannot express themselves by using language and social communication appropriately, the way of expressing emotions such as not enjoying pleasure in depression and unhappiness in their inner worlds can arise with anger. In other words, since the functioning of the brain is very different in autism, the symptoms of depression can be very different. For this reason, it can be benefited from antidepressants.
All medications carry risks, some of them serious. Families should work closely with their children’s healthcare providers to ensure the safe use of any medication.
Medications can make children on the autism spectrum sleepy for several days, as a side effect, and they are not the main purpose of using medication. These are the side effects of the drugs and these side effects disappear when they are discussed with the physician and the dose is adjusted or waited for a few days. The absence of periodic controls is also a problem in this case.
These are side effects and they are not the desired effects. These will pass in cooperation with the physician, the purpose here is not to put the child to sleep to reduce problem behaviors. This is a side effect and can be adjusted by dose. The purpose of the drug is not to make the child sleep.
If necessary, educators say that their work has been much more productive when the appropriate dose of medication is used. Medicines can also have individual side effects, so even if you take an antibiotic, no physician can guarantee that that antibiotic will have any side effects. Since an antibiotic has an allergy in a child, there is no such thing as an allergy in all children. We should not generalize. It can be a very important weapon when the drug is used in a dose suitable for the enemy.
Many drugs have proven efficacy, and not giving drugs when necessary also harms the child. It should not be too simple to think. It makes a very simple definition of the drug that makes the child sleep. The goal is to climb to the top of the mountain and there are many ways to get there. Sometimes a path can be blocked, the other path can be followed, sometimes the path of medication should be open, but a special training path should always be there.
The most important point of using medication is that it should be under the control of a physician. When starting the medication, the negative thoughts of the family and the lack of control in the dimension of use are the most common problems.
Medication provides serious benefits when used appropriately for proper diagnosis, and should not be deprived of this. There is no such thing that a hundred percent of medicine will be used in the treatment of autism spectrum disorder. Antidepressants can be used, antipsychotics can be used, or sleeping drugs can be used. Drug use varies depending on the child’s current problem.
Even though it is a very common and high effective treatment, applied behavior analysis (ABA) is not the only treatment method for autism. Autism has become a more known disorder during the medication has gain popularity and brought to market. During those years, ABA was the least proper method because everyone wanted to use the psychiatric drug and believed that it is the only way. Due to its comorbidity, autism can be treated with drug therapy, not autism itself but its side effects.
Selective serotonin re-uptake inhibitors (SSRIs)
- Type of antidepressants
- Useful for imbalance problems due to chemical system of our bodies
- Decrease the occurrence of repetitive behaviors
- Reduce some problematic behaviors, such as anxiety, irritability, tantrums, and aggressiveness
- Help to develop having eye contact
Tricyclics
- Type of antidepressant
- Mostly used in treatment for depression and OCD behaviors
- Doesn’t cause that much side effect as SSRIs do
- May more efficient than SSRIs
Psychoactive or anti-psychotic medications
- Affect the brain directly
- Highly efficient for people on the autism spectrum
- Risperidone, which is one of the anti-psychotics, decreases irritability in some autism cases
- Decrease hyperactivity among people on the autism spectrum
- Decrease stereotyped and repetitive behaviors among people on the autism spectrum
- Help to minimize withdrawal and aggressive behaviors among people on the spectrum
Stimulants
- Help to increase focusing time among people on the autism spectrum
- Decrease hyperactivity behaviors among people on the autism spectrum
- Especially helpful for people who have mild autism symptoms
Anti-anxiety medications
- Help to reduce anxiety and panic disorders
- Relatively, it helps to reduce ASD symptoms
Anticonvulsants
- Useful in the treatment of seizures and seizure disorders. Epilepsy is one of them.
- Most of the people on the spectrum of autism have seizures/ seizure disorders.
To Create a Medication Plan
When you visit a healthcare provider, such as psychologists, psychiatrists, or social workers, ou will get a medication probably. They usually prescribe on a trial basis. They need to see whether the medication helps or not. Because, when the child starts to take medication, in the beginning, symptoms can be worsened. It may need a couple of times to work properly. It could be even weeks. Your child may need to try different dosages or different combinations. After some trials, your healthcare provider can understand and decide which medication plan is most helpful and effective for your child’s needs.
All medications carry risks, some of them serious. Families should work closely with their children’s healthcare providers to ensure the safe use of any medication. Families, caregivers, and professionals need to be together in this job, in terms of medication plan. They have to be sure that the plan is safe and the child gains benefit from it.
You have to keep in mind that there is not absolute medication to cure autism and there is no definite medication to help each person on the autism spectrum. Each medication can affect each person differently. Each person on the spectrum responds differently than others. While one gain benefit from one specific drug, another one cannot. There are some medications that include some serious risks while in their use.
Behaviors of Parents of Individuals With Autism Towards Medication
Families do not know how to start when their children start to use medication, nor do they know how to finish at the point they need to finish. It may be that too many uncontrolled drugs are used. There may be families who continue the same dose for two years and three years without going to a doctor. Then it can be said that this drug did not help them.
Parents mostly don’t want their children to take medications. They try other intervention and treatment methods. In the end, if there is no opportunity, they are forced to use medication. On the other hand, there are some families who think that medication is the best treatment method. As you can imagine, these parents could be exhausted, overwhelmed, and frustrated from time to time. For some parents, instead of therapies, they want a quicker solution. Because people mostly think that medication is an easier solution. If someone takes medication, it means they don’t need to see healthcare providers frequently, according to their opinions. They think that it takes less time and less energy. In the short run, it is true, on the other hand, families need long term solutions.
For some children, there may no need for pharmacologic interventions. There may be some other more natural or behavioral solutions. Parents should consider them first. The family’s need for support, breaks, and sleep should also be considered. These reasons may be the reasons why families prefer medication. But the good news is that for many parents, the drug is the last method they prefer to use after other treatments that usually start with early interventions have proved to be unsuccessful.
Indeed, parents are worried about the possible side effects of the drugs, even if they ultimately resort to drug use. Most of them want their children to be able to good and handle themselves easily, but their concern is mostly something else. They know that the medication more or less will change their children in a bad way or good way. They don’t want to lose them. That’s way, they are afraid of after medication their child won’t be the same person again and it will change their child a lot.
On the other hand, there are some children on the spectrum who have the inclination to show uncontrollable aggression. As a result, their families count antipsychotics as a solution. For them, the drug is the only obstacle between staying at home and staying at residential care. There is another rare situation, for example, their child has ADHD as well, and only because of ADHD limits their children’s lives, then they decide to use medication.
Parents do not easily accept their child’s use of medication. Although they do not want this to happen, their children may be forced to use the medication by the school after they start school. Unfortunately, parents may have to use drugs for their children because their children are not in separate classes than their peers, they do not want them to study in a different way, or academics do not want them to see them differently. Parents may want to give these drugs a chance, as some drugs allow children with autism to perceive the world, at least like their peers.
You need to be aware that children with autism spectrum disorder exhibit a wide range of side effects. They show side effects more than normally developed individuals do. They are mostly misprescribed. They are though as having a ‘raw brain’ effect. You need to be more careful about getting started.
There is another concern. This a new trend toward using multiple medications at the same time. There are two things that are observed based on trials by professionals and healthcare professionals. The first one is when they start medication, they prone to continue. Despite the fact that they are not likely, they need to. As a second one, they may want to use more than they need, which means overdose. Increasing the amount of the dose or trying another drug may become increasingly tempting.
All researchers agree with the idea that this field needs more research. There is not enough or little evidence about the effectiveness of most of the drugs. Even though it needs to be in the age of evidence-based, there are not many studies that rely on age. Before criticizing parents why they chose the medication as a method, there is a need to live with one to those children. Their life, their children’s lives, that uncertainty always exists in their life, etc. should be very difficult. So, maybe using drugs make their lives less chaotic and more liveable.
What Are the Treatments for Autism?
Even though your child doesnt have officially diagnosed, he or she may gain benefits from treatments designed for individuals on the autism spectrum. The child needs to receive a treatment that fits his or her needs. It should completely depend on individual needs. Because as the name implied autism is a spectrum disorder and each child has his/ her own unique symptoms. As a result, there are a variety of treatment methods available to meet the individual’s needs.
Different kinds of therapies and different medication plans can help to reduce the symptoms and effects of autism and autism-related problems. Eventually, the aim is the same as all of the treatments which are reducing the effect of symptoms and help individuals to live their lives in a better condition.
Behavior and Communication Treatments
Applied Behavior Analysis (ABA): It is a treatment mostly used in schools and clinics. It is designed to help the child while learning positive behavior, decreasing negative behaviors. With this method, you can teach skills to an individual on the spectrum. Depends on the situations and behaviors, there are different types of ABA. These types are discrete trial training, pivotal response training, early intensive behavioral intervention, and verbal behavior intervention.
Developmental, Individual Differences, Relationship-Based Approach (DIR): It is known as a floortime treatment. As the name implied, you need to get on the floor with your child in this method. You need to play with your child on the floor and do the activities in the way he or she does and likes. It’s designed to support the child’s emotional and intellectual growth. It aims to teach the child’s communication skills and emotions.
TEACCH: Treatment and Education of Autistic and Related Communication-handicapped Children: There are visual cuses that are used in this method. These cues are generally picture cards. These cards help individuals on the autism spectrum to help daily routine activities. Professionals teach them to step by step by breaking down all activities into steps. In this way, individuals on the spectrum can learn them easily.
The Picture Exchange Communication System (PECS): It is a visual-based treatment. The difference between TEACCH is, instead of cards, symbols are used. It provides the individuals on the spectrum to learn to ask and communicate through symbols. These symbols are special symbols.
Occupational Therapy: It helps the child on the spectrum learn life skills and challenges. For example, eating by own, dressing, bathing, understanding other people. Those skills are the skills that help them to live as independently as they can.
Sensory Integration Therapy: Mostly children on the spectrum are very sensitive to bright light, certain sounds, being touched and etc. This therapy method helps those individuals to deal with this sensory information in daily life.
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Medications
As far as we know, there is no absolute cure and specific medication for autism spectrum disorder. There are, of course, some medications but they are only helpful and useful for decreased side effects and the effectiveness of symptoms. There are some medicines to help decrease autism-related symptoms or outcomes of autism. Nevertheless, it is scientifically approved that medication combined with behavioral therapies is the best treatment method for individuals on the autism spectrum.
There is only one drug that is approved and can be used by children on the autism spectrum. It is risperidone (Risperdal). Doctors prescribe some specific drugs for specific symptoms. But you need to know as a parent, they are not FDA-approved drugs for autism spectrum disorder. You need to talk with your healthcare providers about a medication plan. You may need to hear all the possible treatment methods that will help your child.
Nutrition
Even though there is no recommended diet by professionals, there are no specific diets recommended, getting sufficient, proper and enough nutrition is essential for children with autism. Sometimes kids on the autism spectrum need to restrict their food. They shouldn’t eat everything as normally developed individuals. Parents may need to eliminate specific nutrition, such as gluten. If parents may see that these nutrients may worsen their children’s symptoms, they need to cut that specific nutrition.
On the other hand, there is no research scientifically proven about the gluten-casein diet. We are not sure that removing them from the diet is helpful for kids with autism or not. Also, it is a fact that if you put a restriction on foods, for example for dairy products, it is not a good thing for bone development in terms of preventing its development.
Nevertheless, it is known that individuals on the spectrum have thinner bones compared to their peers. Because of that reason, it is essential to consume food to build bones. In this case, it may be helpful to work with a nutritionist or dietitian. They need to have a healthy and sufficient eating plan.
