Alan Harchik, Ph.D., BCBA
medications be helpful to children with autism? The answer is "maybe."
Although there are no medications specifically designed to treat
autism, and none can cure autism, some medications may be useful
as part of a comprehensive treatment program to address behavioral
problems such as aggression, self-injury, tantrums, and ritualistic
behaviors can be caused by psychiatric disorders, but are sometimes
used by children to get attention, avoid unpleasant tasks, or obtain
pleasurable feelings and stimulation.
before medications are considered, a comprehensive program should
be in place that includes:
o a clear definition of the problem behavior
o an assessment of the causes of the behavior
o a specific response to the behavior, such as ignoring or interrupting
o a way to count each time the behavior occurs
o teaching alternatives, such as language and play
o opportunities to participate in a wide variety of activities
o rewards for good behavior, and
o a plan to regularly review and modify the program.
a program has been implemented for at least a few weeks, physicians
and parents may consider medications. There are six general classes
of medications to consider:
Anti-psychotics (neuroleptics): These work at the neurotransmitter
level in the brain and are used to address severe aggression and
self-injury. (Their use does not mean that the child has a psychotic
disorder.) The most typically prescribed antipsychotic is Risperdal®,
Zyprexa®, Seroquel®, and Geodon® are other anti-psychotics.
Mood stabilizers (anti-convulsants): Depakote®, Tegretol®,
Lamictal®, Neurontin®, and Topamax® are typically used
to treat seizure disorders, but are also used to stabilize moods.
Anti-depressants: A special group of medications are designed to
reduce depressive symptoms. These are called selective serotonin
reuptake inhibitors (SSRIs), and include Prozac®, Zoloft®,
Luvox®, and Anafranil®.
Anti-anxiety: Benzodiazepines, such as Ativan® and Klonopin®
are used to address nervous anxiety symptoms. Medications designed
for treating high blood pressure (beta-blockers, such as Inderal®
and Catapres®) are also used for this purpose. And frequently,
SSRIs are used to address repetitive, ritualistic, and compulsive
5. Stimulants: Sometimes medications prescribed for attention deficit
hyperactivity disorders, such as Ritalin®, are used. In my experience,
these medications are not typically effective for children with
Vitamins and supplements: Children sometimes receive vitamins and
other dietary supplements to address behavior problems. There is
little research to support these treatments.
fact, most of the above named medications were tested with adults,
not with autistic children. The decision to use medication is difficult.
I would advise parents to obtain as much information as possible
- from local physicians, books, and the Internet - about medications
for children with autism. Many children at the May Institute receive
medications. In some cases it is clearly helping, in others, we
are still evaluating the effects.
embarking on a program that includes medication, parents and physicians
need to take many factors into consideration including the age of
the child, side effects, dosage, other medications the child may
be taking, and duration and maintenance of the medication program.
must be taken when considering changes to successful medication
use. For example, in more than one case, after the child achieved
stability, medications were reduced too quickly and the beneficial
effects were lost and could not be repeated, even when the medication
taking the time to evaluate the effectiveness of the medication
is crucial. A daily count of each problem behavior should be kept
prior to and after the use of medication. Also, sometimes the expectation
of a positive effect can result in behavior change (also known as
a placebo effect). Multiple therapy changes should not occur at
the same time (for example, a new medication and a new reward system)
because it is then impossible to determine what might be responsible
for behavior change.
Institute operates schools for children and adolescents with autism,
Asperger's Syndrome, and other developmental disabilities in Chatham,
Randolph, and West Springfield, Mass., and in Freeport, Maine. For
more information, contact May Institute at 800-778-7601, or at www.mayinstitute.org.
information presented on this site is intended solely as a general
educational aid, and is neither medical nor healthcare advice for
any individual problem, nor a substitute for medical or other professional
advice and services from a qualified healthcare provider familiar
with your unique circumstances. Always seek the advice of your physician
or other qualified healthcare professional regarding any medical
condition and before starting any new treatment.