Autism and Social Anxiety Issues

My son who is 4 and in his last year of Pre-K hasn't been officially diagnosed with Autism but we pretty much know that he has the disorder. Everyone from the school therapist to his Pediatrician has said that he definitely exhibits all the characteristics for the disorder. We are on the waiting list for the Weisskopf Evaluation Center to see him and it could be another 4 to 5 months. He has always had bad behavior in school and daycare and this goes back to about age 1. He has been receiving Occupational and Speech Therapies through school and a state program until he turned age 2. He has been given a weighted vest to wear that had no effect. Recently it has gotten worst (eg. tantrums, unable to stay focused and refusing to sit down during required times, and overall unruly), and mainly at school. His teacher stated there were more students in the class and she believed he was having social anxiety issues. That information along with odd behaviors he exhibits with me when we are in an environment with large amounts of people sounded logical to me. I took him to the Pediatrician and he was prescribed Zoloft 25mg once daily because he too thought he had Social Anxiety Disorder. He took the medicine 6 days and became alot more violent/ aggressive than normal, and his behavior was worst at school. I am very confused as to what to do about the medicine. Are Autism and Social Anxiety linked?? Should he be on this med or are there anymore "kid friendly" med's for this??  I am just simply seeking a tranquilizer effect on him until we can be seen by specialists in this field.

[Eileen Roscoe, PhD]

Given the problem behavior you describe, I recommend that you seek the support of a Board Certified Behavior Analyst, who would be able to conduct the appropriate assessments and to assist in developing an assessment and treatment plan for these behaviors. Please visit the website of the Behavior Analysis Certification Board (http://www.bacb.com/) where you will find a directory of service providers. Although early intervention services can be helpful for increasing appropriate behavior and decreasing problem behavior among young children, there is no empirical evidence supporting the use of a weighted vest as a form of treatment for problem behavior among individuals with autism. Although it sounds likely that your son may receive an autism diagnosis, it may be helpful for you to seek the assistance of a qualified professional who specializes in the diagnosis of Pervasive Developmental Disorders so that you can receive an accurate diagnosis for your son. Although diagnosis alone will not point to an appropriate intervention, it will lead you to identify appropriate services for your son. I recommend that you seek the assistance of a pediatric psychiatrist who can systematically evaluate the effects of the Zoloft on your son’s problem behavior. If the medicine is consistently causing an increase in his problem behavior, then it does not sound like this medicine should remain in effect. However, a pediatric psychiatrist should be able to evaluate the effects of this medicine and inform you if this medication should be discontinued an alternate medicine prescribed. Regarding your question about whether Autism and Social Anxiety Disorder are linked, one of the characteristics of individuals diagnosed with autism is an impairment in social interaction (e.g., limited eye contact, lack of social initiations or interest in others). In addition, individuals with autism often engage in repetitive nonfunctional behavior (e.g., motor stereotypy) that may be socially stigmatizing. However, social anxiety disorder is not listed as a defining feature of autism.