Autism Spectrum Disorder

Treatment of Autism Spectrum Disorder

Reading time: 7 min

Each child or adult with autism is unique; each intervention plan must therefore be adapted to manage their specific needs.

The general aims of treatment are:

  • To minimise deficits in social interaction, social communication and repetitive behaviours (primary symptoms), and also in any associated symptoms. 
  • To improve independence and functioning, thus facilitating academic learning, the acquisition of day-to-day life skills and the development of enjoyable activities.
  • To reduce all behaviours that interfere with the individual’s daily functioning.

The majority of the interventions used to achieve these objectives are carried out by the parents and specialised professionals, psychologists, behavioural therapists, teachers and doctors. It is better if the interventions focus on the person’s normal environment.

In some instances, medical treatment could form a key part of the intervention in order to treat specific problems, e.g., aggressiveness or self-harm, or other associated psychiatric or neurological disorders.

At the beginning, intensive behavioural intervention requires the whole family to work in close collaboration with the healthcare team, who in some cases may enter into the family environment. In other cases, this therapy is provided through a specialised centre or in preschool classrooms.

The various interventions and types of support are adapted to the child’s development as they acquire more social and learning skills. When children with autism go to school they benefit from training in specific social skills and specialised and adapted approaches in teaching.

Research shows that treatments that include the parents, achieve better results.

Parent training, either directly with therapists or through parent groups, plays a vital role in autism treatment. Research shows that treatments that include the parents and give them the tools needed to learn to handle their child’s dysfunctional behaviours and those required to develop and reinforce learning in adaptive skills achieve better results. Hence programmes have been developed that focus specifically on parents of children and adolescents with autism (The Incredible Years® programme).

Additionally, it is also very important to treat any other psychiatric disorders presented by people with autism. The presence of other psychiatric disorders associated with autism is common in a substantial proportion of children, adolescents and adults with autism and tends to significantly limit their quality of life. Some psychological intervention programmes used to treat anxiety disorders, for example, have been specifically adapted to the characteristics of people with autism in order to enhance their effectiveness in terms of improving any comorbidities (the Coping Cat programme).

Drug therapy

Psychopharmacological treatment is the use of medications to bring about behavioural, emotional or cognitive changes. There is no treatment currently available that focuses specifically on improving the characteristic symptoms of communication and social interaction deficit associated with autism. However, psychoactive drugs can be effective in treating a certain symptomatology that is very common in ASD and which can interfere in the socialisation, educational progress, safety and quality of life of people with autism.

Some of the so-called pharmacological “targets” are irritability, aggressiveness, self-harm, ADHD symptomatology (inattention, distractibility, impulsivity, hyperactivity), anxiety, mood disorders and sleep problems.

  • Atypical antipsychotics, e.g., risperidone and aripiprazole. These are used to reduce irritability as well as aggressiveness, self-harm and behavioural disturbances in both children and adolescents with ASD.
  • Methylphenidate, atomoxetine and guanfacine. These address inattention, impulsivity and hyperactivity.
  • Atypical antipsychotics (risperidone, aripiprazole), some serotonin reuptake inhibitors (fluoxetine, fluvoxamine, sertraline) and anticonvulsants (e.g. sodium valproate). Used to treat the repetitive behaviours and inflexibility associated with autism.
  • Melatonin. This is effective at helping patients who find it hard to fall asleep.

Side effects

All psychoactive drugs can have side effects. The following points must be implemented upon taking the decision to try out a psychoactive treatment:

  • Clear identification of the medication’s target symptoms.
  • Monitoring of these and other symptoms, which could be due to side effects of the treatment.
  • Although treatment with just one drug is preferable, more complex cases may require a combination of drugs and therefore any potential interactions between them must be taken into account and monitored.

The medical indication to continue with a given drug therapy is determined on an individual basis and depends on the balance between its effectiveness and the possible side effects. Both the person with ASD and their family should participate in this decision. 

The most common side effects of each treatment are:

  • Atypical antipsychotics, e.g., risperidone and aripiprazole. These tend to cause weight gain and, in some cases, increased sedation.
  • Methylphenidate. The most common side effects are a loss of appetite, a delay in managing to fall asleep and the appearance or worsening of motor tics.
  • Atomoxetine. Typical side effects are headaches and gastrointestinal discomfort which improve if the medication is taken with meals, preferably with dairy products.
  • Guanfacine. This can cause drowsiness and sedation, particularly when starting the treatment, and sometimes headaches as well.
  • Serotonin reuptake inhibitors (fluoxetine, fluvoxamine, sertraline). These tend to produce gastrointestinal discomfort, headaches and an overall increase in food intake leading to weight gain.

Substantiated information by:

Antonia Bretones
Rosa Maria Calvo

Published: 20 February 2018
Updated: 20 February 2018

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