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  • Writer's pictureHannah's Hope

What's New?

AutismParentingMagazine posted an article written by Andréas RB Deolinda, BA, BSc, a writer, teacher for schools with children with special needs and a special needs advocate who has served in many different communities in cultures, titled "Uncovering New Autism Treatment Methods." The premise of the article is to outline and describe existing treatment methods as well as unveil newer treatment plans and methods that may be worth considering for your child or someone you know. Before jumping into the in-depth overview of the new treatment options out there, it is important to recognize that autism is a very complex disorder and the symptoms very between each individual. Whether it's difficulty communicating with others, specific interests, repetitive behaviors or sensory sensitivities, there are new options available and more being tested to treat, mitigate, or calm any symptoms or tendencies that may be of concern. As always, remember that autism is not something that can be cured, nor should that be the goal of any and all treatments. The suggestions made by researchers, professionals, doctors and caregivers are intended for better management of symptoms and easier navigation for daily living. So, let's go through some currently available, more well-known and some of the newer treatment methods for autism as reviewed from biological research studies. There are symptomatic treatments that have proven benefits, like psychopharmacology agents, risperidone and aripiprazole. Non-biological treatments that fall under the umbrella of applied behavioral analysis (ABA) include: discrete trial training (DTT), early intensive behavioral intervention (EIBI), verbal behavioral intervention (VBI) and pivotal response treatment (PRT), which all have fairly promising results. There are other non-biological treatments that have also proven to be beneficial, which includes: TEACCH method, picture exchange communication system (PECS) and responsive teaching (RT). Let's break these down a bit though because there are a lot of acronyms and each one feels like a lot to grasp. Biological treatment methods are tested through clinical trials through what are known as double-blind placebo-controlled trials. In these types of trials, there are two key factors to note: the participants are either given a placebo, which looks like the drug, but isn't the real thing, or they are given the drug and neither the participants nor the researcher know which group is which. The computer is the only admin that knows which group has the drug and which does not via a code given to each participant that registers them to either the control group (placebo) or drug group (treatment). It is also important to note that there is exclusion criteria in place that ensures all of the participants are within the same age group, gender, ethnicity, etc. Clinical trials can take as long as years to be approved by the Food and Drug Administration (FDA) and that step is necessary in order to truly claim to provide benefits for any number of symptoms. With that being said, let's look at some of the methods that have been approved already. Psychopharmacologic agents are drugs that are used specifically for behavior modifications and alleviating symptoms. There are two types of these agetns, risperidone and aripiprazole, which are used to treat autism symptoms like irritability, anxiety, inattention, aggression, self-harm, repetitive behaviors, mood, sleep disturbance and hyperactivity. Let's take a look at these two separately. Risperidone is known as an atypical antipsychotic psychopharmacological treatment, FDA approved, and used to treat disruptive behaviors amongst autistic individuals. For children over five years old, this treatment aims to treat symptoms like irritability, self-injurious behavior and aggression. There is one significant side effect to Risperidone that is worth noting is weight gain. Aripiprazole is another atypical antipsychotic psychopharmacological treatment that is FDA approved, but one it's differences is the age range for appropriate treatment, which is children aged six to seventeen, and that is geared directly toward addressing irritability. A clinical trial has however shown that it may also be able to treat stereotypy (persistent repetition), irritability and hyperactivity which was measured by the Aberrant Behavior Checklist and Clinical Global Impressions Severity Scale. The side effects of this particular treatment include: vomiting, weight gain and fatigue. For these two treatments, the dosage and mode of application are critical and supplementation is important depending on the child's weight, age, autism-related symptoms, etc. As always, consult with your child's doctor regularly if using either of these two treatments because the effectiveness can change as the child grows and changes. These psychopharmocology agents should be secondary to any other environmental and behavioral interventions as they are not replacements for any and all other treatments, they can just provide secondary help; like a boost. Stimulants are another category of psychopharmocologic agents, however, these drugs/treatments stimulate or excite the brain and central nervous system (CNS), which has also been tested through double-blind placebo-controlled trials. Stimulants include: SSRIs, methlyphenidate and alpha-adrenergic agonists; these have shown effectiveness for improving ASD symptoms like alertness and mood, wakefulness, increase in speech and motor activity and decreasing appetite. SSRIs, specifically, are formally known as selective serotonin reuptake inhibitors, and they are the most popular treatments for symptoms like impulsivity, anxiety and repetitive behaviors in children with autism. This is due to the SSRIs ability to counter the low serotonin levels found in autistic children, which has been proven through double-blind two-way crossover trial. The main limitation found in these trials is that the results from therapy using SSRI treatment vary amongst each patient. It was also found that it is not possible to choose a specific SSRI for treatment of a singular symptom that is associated with autism. Methylphenidate, as studied through review, provide improvement in autistic symptoms like hyperactivity, inattention and impulsivity, however, the results are lower amongst children on the autism spectrum and higher for those with attention deficit hyperactivity disorder (ADHD). The side effects from this particular treatment include: decreased appetite, tics, irritability, stomach pain, discomfort, and/or increased heart rate. It has not fully been determined whether this form of treatment is best for ASD symptoms, so more trials need to be done in order to fully test its efficacy. The next option for psychopharmocologic treatments is alpha-ardrenergic agonists. An agonist is a chemic that binds to a receptor, thus activating it and causing a biological response. These specific agonists are used to treat symptoms of hyperactivity, impulsivity and inattention. There are two types, guanfacine and clondine, which were shown during double-blind placebo-controlled trials to be effective in reducing hyperactivity, irritability, stereotypy, outbursts, and more. However, there is still more research to be done to determine the dosage required for administration and response, which is known as the dose-response relationship. So, just what exactly is new? Up and coming research has found a link at the 16p 11.2 chromosomal region that is related to autism. Genetic studies have found that deletion in this region is related to autism spectrum disorder (ASD) as well. Lately, the Boston Children's Research Hospital has developed a potential new way to study this deletion of the human neurons that might open up more data on autism-related symptoms. This particular research is important as it could serve as the gateway for new treatment options in the near future. The particular chromosomal region in question here contains roughly twenty-nine genes and according to the researchers in Boston, the deletion in the 16p 11.2 region occurs in individuals lacking a small amount of DNA on copy of chromosome 16, for reference, chromosomes should always occur in pairs. To better understand the differences within the brain cells of these individuals, researchers have focused their efforts on dopaminergic neurons, which use the neurotransmitter dopamine to transmit information between nerve cells. Dopamine, as you most likely know, is what makes us feel pleasure. These specific neurons have been found to be implicated in autistic individuals; there is currently a study being conducted using two FDA approved drugs to act on the dopaminergic system in those with autism and treat irritability. As always, these new treatments being studied via biological trials, or any for that matter, are not to be expected for usage of "curing" autism. The point of new research and theories is to ease uncertainty and questioning regarding the pathophysiology of autism in parents, caregivers and professionals, thus providing opportunities for better decision-making when it comes to treatment. As with any intervention of treatment options, keep the lines of communication open with your child's practitioner and other therapy-type caregivers or professionals to ensure that each form of treatment is working together rather one against the other; the end goal is always to maintain overall health and happiness for yourself and your child.

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