AutismTreatment, Prognosis |
Physician developed and monitored. Original source: www.neurologychannel.com
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Treatment
There is no cure for autism; however, with appropriate treatment and education, many children with the disorder can learn and develop. Early intervention often can reduce challenges associated with the disorder, lessen disruptive behavior, and provide some degree of independence.
Treatment depends on the individual needs of the patient. In most cases, a combination of treatment methods is more effective. Autism usually requires lifelong treatment.
Occupational therapy and physical therapy are sometimes used to treat autism. Occupational therapy helps improve independent function and teaches basic skills (e.g., buttoning a shirt, bathing). Physical therapy involves using exercise and other physical measures (e.g., massage, heat) to help patients control body movements.
Treatment includes the following:
There are several methods of behavior modification that are used to treat inappropriate, repetitive, and aggressive behavior and to provide autistic patients with skills necessary to function in their environment. Most types of behavior modification are based on the theory that rewarded behavior is more likely to be repeated than behavior that is ignored. This theory is called applied behavior analysis (ABA).
Behavior modification often involves highly structured, skill-oriented activities that are based on the patient's needs and interests. It usually requires intense, one-on-one training with a therapist and extensive caregiver involvement.
Sensory integration therapy is a type of behavior modification that focuses on helping autistic patients cope with sensory stimulation. Treatment may include having the patient handle materials with different textures or listen to different sounds.
Social interaction is often affected by limited emotional development that is common in autistic patients. Play therapy is a type of behavior modification that is used to improve emotional development, which in turn, improves social skills and learning. Play therapy involves adult-child interaction that is controlled by the child.
Social stories can also be used to improve undeveloped social skills. Stories are designed to help autistic patients understand the feelings, ideas, and points of view of others, or to suggest an alternate response to a particular situation. They also may be used to help patients understand and cope with their own feelings. Behavioral therapists can teach caregivers how to develop social stories.
Communication therapy is used to treat autistic patients who are unable to communicate verbally, or to initiate language development in young children with the disorder. Speech therapy may be used to help patients gain the ability to speak.
Picture exchange communication systems (PECS) enable autistic patients to communicate using pictures that represent ideas, activities, or items. The patient is able to convey requests, needs, and desires to others by simply handing them a picture.
Autism is not caused by diet and the use of dietary modifications and supplements to treat the disorder is controversial. Changing the diet or adding vitamin supplements may improve digestion and eliminate food intolerances or allergies, which may contribute to behavioral problems in autistic patients.
Researchers have found elevated levels of proteins found in wheat, oats and rye (gluten) and casein (protein in dairy products) byproducts in patients with autism, suggesting that the incomplete breakdown or excessive absorption of these substances may affect brain function. Eliminating foods that contain gluten and casein from the diet may cause side effects and should not be done without the advice of a health care practitioner.
Studies have shown that vitamin B, magnesium (improves the effects of vitamin B), and cod liver oil supplements (which contain vitamins A and D) may improve behavior, eye contact, attention span, and learning in autistic patients. Vitamin C has been shown to improve depression and lessen the severity of symptoms in patients with autism.
Medication may be used to treat various symptoms of autism (e.g., attention difficulties, anxiety) and can also be used to treat conditions that may accompany the disorder (e.g., epilepsy).
Depression, obsessive-compulsive behavior, and anxiety may be treated using antidepressants. These drugs often reduce the frequency and intensity of repetitive behavior; decrease irritability, tantrums, and aggression; and improve eye contact and responsiveness. Side effects include headache, insomnia, dizziness, and drowsiness. Medications include the following:
- Amitriptyline (Elavil®)
- Bupropion (Wellbutrin®)
- Clomipramine (Anafranil®)
- Fluvoxamine (Luvox®)
- Fluoxetine (Prozac®)
Benzodiazepines such as diazepam (Valium®), lorazepam (Ativan®), and alprazolam (Xanax®) may also be used to treat behavioral problems. Side effects include drowsiness, fatigue, lack of muscle coordination (ataxia), and dizziness. Discontinuing these drugs after long-term use may cause withdrawal symptoms including:
- Abdominal and muscle pain
- Convulsions and tremors
- Insomnia
- Sweating
- Vomiting
Antipsychotic medications such as clozapine (Clozaril®), risperidone (Risperdal®), olanzapine (Zyprexa®), and quetiapine (Seroquel®) may decrease hyperactivity, behavioral problems, withdrawal, and aggression in autistic patients. Side effects include the following:
- Agitation
- Anxiety
- Drowsiness
- Dizziness
- Headache
- Insomnia
- Sedation
Stimulants such as methylphenidate (Ritalin®), amphetamine (Adderall®), and dextroamphetamine (Dexedine®) may also be prescribed for autism. These drugs may increase focus and decrease impulsivity and hyperactivity in high-functioning patients. Prolonged use of stimulants may lead to drug dependence. Side effects are often dose-related and include the following:
- Abdominal pain
- High blood pressure (hypertension)
- Insomnia
- Loss of appetite
- Nervousness
- Rapid heart rate (tachycardia)
Patients with autism have normal life expectancies. With early intervention and appropriate treatment, some autistic patients can function productively and attain some degree of independence. Most patients require lifelong assistance.
Autism (continued...)
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