Autistic disorder – Chronic
Definition
A pervasive developmental disorder characterized by communication deficits, impaired social interaction, and restricted behavior patterns
Clinical Evaluation
Suspected lead poisoning
* Lead measurement, quantitative, blood: In children, a blood lead level of 10 mcg/dL or higher is considered elevated level by the Centers for Disease Control (CDC) .
Medical History
* Family history of Autistic disorder
Findings
* Socialization alteration
* Disorder of language
* Repetitive routines
Tests
Suspected autism
* Diagnostic psychiatric interview: The diagnosis of autism requires use of screening tools and comprehensive diagnostic testing interviews .
Differential Diagnosis
* Rett's disorder
* Asperger's disorder
* Pervasive developmental disorder
* Childhood disintegrative disorder
* Schizophrenia - Chronic
* Elective mutism
* Speech and language disorder
* Mental retardation
* Stereotypy habit disorder
* Increased lead level
* Hearing loss
Treatment
Drug Therapy
Irritability in autistic children aged 5 years and older
RISPERIDONE
Pediatrics (Around 20 kg): Initial dose, 0.5 mg orally once daily or 0.25 mg orally twice daily; may increase after a minimum of 4 days to 1 mg/day. Maintenance dose, 1 mg orally once daily or 0.5 mg orally twice daily; maintain dose for a minimum of 14 days; may increase doses at 2-week intervals or longer in increments of 0.5 mg/day to achieve sufficient clinical response
Pediatrics (<20 kg): Initial dose, 0.25 mg orally once daily or 0.125 mg orally twice daily; may increase after a minimum of 4 days to 0.5 mg/day. Maintenance dose, 0.5 mg orally once daily or 0.25 mg orally twice daily; maintain dose for a minimum of 14 days; may increase doses at 2-week intervals or longer, in increments of 0.25 mg/day to achieve sufficient clinical response. Use with caution in children weighing less than 15 kg
Hyperactivity in children with autism
METHYLPHENIDATE
Autism
SERTRALINE HYDROCHLORIDE
FLUOXETINE HYDROCHLORIDE
CITALOPRAM HYDROBROMIDE
OLANZAPINE
Procedural Therapy
* Behavioral therapy: Behavioral management for autistic patients aims to minimize harmful or undesirable behavior while enhancing more desirable behavior .
* Parenting skills training: Teaching programs involving the parents and other family members may integrate the family into patient education and decrease family stress .
* Music therapy: Music therapy may be effective in patients with autism, although large studies examining long term results are lacking .
* Hearing therapy: Because of a lack of data showing efficacy, AIT therapy has not been endorsed outside of a research setting.
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