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Tuesday, March 6, 2012

New Research Findings About Medication

Last spring when we were struggling so much with Nathan we were desperate. We were willing to try ANYTHING to help Nathan's behavior so both he and I would be safe. Things were really, really serious. So much so that we consulted with a whole range of specialists: developmental pediatrician, clinical psychologist and a child psychiatrist. Our big question was "Will medication help Nathan control his behavior and keep him and everyone around him safe?" Time after time EVERY SINGLE SPECIALIST said NO to medication. At the time we felt like no one wanted to help. They all kept telling us that we needed more consistent behavioral support at home and at school. I can't even begin to tell you how frustrating that felt. Our pediatrician, in particular, was extremely resistant and kept telling us that eventually we'd figure out the triggers or see the warning signs to prevent these behaviors from happening. Well, as much as I hate to admit it, they were right. I am not saying medication is a bad thing, but for Nathan it was not the time. I truly believe some kids really, really need it to help balance their neurochemistry. If in the future we felt it was necessary, we'd probably go that route with Nathan, too. It is a hard choice for lots of families.

These past few weeks a couple of research studies came out that are related to medication and children with autism spectrum disorders. One of them supported the exact point our specialists were trying to make to us last spring. I wanted to share the findings with you. Here is an excerpt and the link to the study article from NIH:

'Parent Training' May Help Kids with Autism Behave Better 
Senior study author Lawrence Scahill, a professor at Yale University School of Nursing and Child Study Center in New Haven, Conn.
The study involved 124 children aged 4 to 13 with an autism spectrum disorder and serious behavioral issues, including daily, prolonged tantrums, aggression or self-injurious behavior. The children were prescribed risperidone (Risperdal), an antipsychotic drug approved by the U.S. Food and Drug Administration for treating severe behavioral problems in children with autism.
Half the children and their parents were also assigned to a six-month, structured "parent training" program. Parents were asked to identify the most difficult, disruptive behaviors and to think about what preceded the incidents and why the child might do it. They then worked with counselors to devise strategies to avoid the triggers and help the child respond better to the everyday stressors. Parents who underwent training reported a greater decrease in problem behaviors than the parents of children on medication alone, researchers found. By the end of the study, the average dose of risperidone was lower for kids in the parent-training group.
"On the tantrums, the aggression and the self-injury, the combination of medications and parent training was better," said Scahill. "How much better? Not a huge amount, but it was an incremental improvement over an already effective improvement." Parents who received training also reported improvements on a test known as the Vineland Adaptive Behavior Scale, which measures how well a child does everyday activities, such as communicating, socializing, dressing, eating at the table and going to school. By diminishing serious problem behaviors, such as tantrums and aggression, children's skills in other areas improved, but the difference was not statistically significant.  To read more, go to: http://www.nlm.nih.gov/medlineplus/news/fullstory_122494.html

The second study that was published recently also looked at the use of medication in individuals with ASD. This one was a little bit scary, but still necessary for parents to read. Here is the excerpt and link to the article online:  
Meds for Autism Not Well Understood 
Children with autism may benefit from medications to treat children with attention-deficit hyperactivity disorder (ADHD) and other related disorders, but clearer guidelines are needed, a new study shows.
Researchers analyzed data from more than 1,000 U.S. teens enrolled in special education programs, to assess the use of psychiatric medications in those with autism, ADHD and both conditions. Patients with both autism and ADHD had the highest rates of medicine use (about 58 percent), followed by those with ADHD only (around 49 percent) and those with autism only (about 34 percent), according to study author Paul Shattuck, an assistant professor at Washington University in St. Louis, and colleagues. Black teenagers with autism only or with autism and ADHD were less likely to receive medications than whites.
"Observations from the present study reinforce the complexity of pharmacologic treatment of challenging behavior in kids with [autism spectrum disorders] and ADHD," Shattuck said in a university news release. "There needs to be a clearer guide for treating kids with both an [autism spectrum disorder] and ADHD."
He noted that drug treatment for autism reflects a trial-and-error approach based on associated symptoms, and there is a poor understanding of overall medication use for children with autism. "Also striking are the high rates of antipsychotic, antidepressant/anti-anxiety and stimulant medication use in these youths," Shattuck said. "Additional studies examining the treatment of core and associated [autism spectrum disorder] symptoms are needed to guide the treatment of these kids."  To read more, go to: http://www.nlm.nih.gov/medlineplus/news/fullstory_122261.html
Let's stay informed! Blessings!

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