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Autism & Asperger's Syndrome (Expert Forum)
Asperger's syndrome
Answered by
Jason C Bourret, Ph.D., BCBA - autism
The New England Center for Children
Questions in the Autism & Asperger's Syndrome forum are answered by researchers at the New England Center for Children. Topics covered include Attention Deficit Hyperactivity Disorder (ADHD), Antisocial Personality Disorder, Asperger Syndrome, Autism, blindness, bullying, clinical depression, deafness, dyslexia, mental retardation, and social alienation.
Asperger's syndrome
by brandy777, Jan 04, 2008 09:35PM
My four year old has Asperger's syndrome. He also suffers from rage...He is very smart, not potty trained but very mean sometimes. Even though he is my youngest of four children, he runs my house and my other children are all scared of his next move. As a last resort, we have decided on medication...We have tried Topomax and Ambilify and Respidol...now his doctor has him on 7mg of seroquil. It seems to not have any side affects..Please tell me I am not alone!
Doctor's Answer
by Jason C Bourret, Ph.D., BCBA, Jan 08, 2008 12:42PM
, Jan 08, 2008 12:42PM
To: brandy777
Hi Brandy,
I just posted below in response to a similar question posed by another poster. Making a decision regarding starting your child on behavior-control medication is difficult. I'd like to stress two main things. One, to make sure that you're seeing qualified doctors who have proscribed psychotropic medication to individuals with diagnoses similar to your son's before. Two, to make sure that your son is recieving adequate non-pharmacutical treatment for problem behavior. For this, look for a board certified behavior analyst in your area who has worked successfully with children similar to your son in the past. Early intensive behavioral intervention is one of the best predictors of success for children diagnosed with ASDs. The post copied from the other thread is below.
It is not uncommon for children diagnosed with an ASD to emit severe problem behavior.
Regarding the medication, make sure that you are working with a proscriber that you are comfortable with. The doctor supervising the use of the medication should be explaining to you exactly what a medication is targeting for your children, how the effects of the medication will be measured, and what the overall plan is for determining if the medication is successful. For example, the plan might be to target the child’s aggression with risperidone, starting at a certain dose and titrating the dose upward to a certain point until either a clinically significant effect is observed (in which case, you’re convinced that the child is on the right med at the right dose) or a clinically significant effect has not been observed (in which case, you’re convinced that the child is not on the right med and the med should be removed). Make sure that you’re clear on the plan, data collection system, and reasons why decisions are being made. If you’re not happy with the proscribing doctor, seek a second opinion. Look for a physician is one that has experience proscribing psychotropic medication to individuals diagnosed with ASDs.
Regarding the problem behavior, although medication can, in some cases, be effective in suppressing problem behavior in children diagnosed with ASDs, the intervention that has been shown to be most reliably effective is applied behavior analysis. Over 20 years of rigorous experimental evidence has shown that children can learn appropriate alternatives to severe problem behavior given the right teaching arrangement. Behavior analytic interventions typically involve identifying the situations that are most problematic for a child and the things that are most rewarding and systematically teaching a child more appropriate ways of handling problematic situations and of obtaining reinforcing things and events. These interventions are individualized to the needs of the particular child and, with the right services, the prognosis for treatment of severe problem behavior can be quite good. I recommend that you also look into identifying a board certified behavior analyst who has experience treating behavior problems exhibited by children diagnosed with ASDs. You could start at the certificant registry on the BCBA website: http://www.bacb.com/
I just posted below in response to a similar question posed by another poster. Making a decision regarding starting your child on behavior-control medication is difficult. I'd like to stress two main things. One, to make sure that you're seeing qualified doctors who have proscribed psychotropic medication to individuals with diagnoses similar to your son's before. Two, to make sure that your son is recieving adequate non-pharmacutical treatment for problem behavior. For this, look for a board certified behavior analyst in your area who has worked successfully with children similar to your son in the past. Early intensive behavioral intervention is one of the best predictors of success for children diagnosed with ASDs. The post copied from the other thread is below.
It is not uncommon for children diagnosed with an ASD to emit severe problem behavior.
Regarding the medication, make sure that you are working with a proscriber that you are comfortable with. The doctor supervising the use of the medication should be explaining to you exactly what a medication is targeting for your children, how the effects of the medication will be measured, and what the overall plan is for determining if the medication is successful. For example, the plan might be to target the child’s aggression with risperidone, starting at a certain dose and titrating the dose upward to a certain point until either a clinically significant effect is observed (in which case, you’re convinced that the child is on the right med at the right dose) or a clinically significant effect has not been observed (in which case, you’re convinced that the child is not on the right med and the med should be removed). Make sure that you’re clear on the plan, data collection system, and reasons why decisions are being made. If you’re not happy with the proscribing doctor, seek a second opinion. Look for a physician is one that has experience proscribing psychotropic medication to individuals diagnosed with ASDs.
Regarding the problem behavior, although medication can, in some cases, be effective in suppressing problem behavior in children diagnosed with ASDs, the intervention that has been shown to be most reliably effective is applied behavior analysis. Over 20 years of rigorous experimental evidence has shown that children can learn appropriate alternatives to severe problem behavior given the right teaching arrangement. Behavior analytic interventions typically involve identifying the situations that are most problematic for a child and the things that are most rewarding and systematically teaching a child more appropriate ways of handling problematic situations and of obtaining reinforcing things and events. These interventions are individualized to the needs of the particular child and, with the right services, the prognosis for treatment of severe problem behavior can be quite good. I recommend that you also look into identifying a board certified behavior analyst who has experience treating behavior problems exhibited by children diagnosed with ASDs. You could start at the certificant registry on the BCBA website: http://www.bacb.com/
Member Comments (2)
by MJIthewriter, Jan 04, 2008 09:58PM
To: brandy777
I wonder if he's stressed out over something. It's hard to sday. Are there certain sounds that trigger more bad behavior than others? I'm trying to get an idea what is going on with what bewhavior. If there's lots of noise going on when he gets aggressive, he could be overstimulated by the noise and retaliating. Are the other children touching him, and then he reacts? Being PDD NOS myself, I don't tolerate being touched unless it's a back rub or a hug (if I ask first or am asked.) My younger sister learned not to touch or poke me, and she learned that the hard way, I'm sorry to say.
