I agree medication becomes a quality of life issue for some kids. My John is on risperdal and prozac for various issues. We did everything else diet, supplements, chelation, etc.....but he needed something more to cope with his life. I wish he didn't need meds, but in his case it was the right choice for him!!!!I feel we are at the point to medicate Damians adhd seems to be overcoming him and he cant calm down or controll himself. He seems very upset all the time because he cant even play with a toy he just cant focus. Im just nervous because of all the things that are said bad about them, but as he gets older I see if we dont help him soon he is going to be miserable his meltdowns are every 5 mins now and most of the time we cant even figure out what they are about because he goes from one thing to another so quick.Collin is on Risperdal as of now. He is on a once day dose of .25 mg. Its the lowest possible dose. We were kind of hitting a brick wall with his behavior. He was becomming more and more impossible and staring to abuse others and himself. This has been wonderful for him. It doesnt fix his behavior but it takes the edge off. He can cool off a little easier and he is not so upset all the time so he is learning more. It also helped very much with his sleep. We started him on it originally at 3yrs 3mos, which is really young. A lot of people get annoyed that we put such a young child on medication. But I do have to say is each family to its own and what works for them. We needed to do this for Collin, it was that or our loss of sanity and him being very distructive. I am happy with our decision because he has learned so much in the last couple months, because instead of screaming and hitting he is learning. HTH :)Im hearing alot about risperdal I think that is what we might try. Has anyone noticed any side affects and if so what are they?
I'll try ... I don't believe there is a medication for autism. There are medications for some of the other conditions that sometimes accompany autism (ADHD, OCD, Tics). In my youngest child, medication hasn't even been brought to the table. In my middle son's case, Risperdal has been discussed briefly, but I'd rather not medicate - I don't think he needs it. My oldest has been on a combination of Wellbutrin and Clonidin for 5 years, and I'm currently considering weaning him off or switching to something else, as he has frequent headaches and has recently had some major OCD thoughts. But - he isn't on the spectrum.
Medication has always been a quality of life issue for our family. My ds has been on a number of different med combo's and my dd as well. My ds is 9y/o, PDD-NOS, ADHD, and probably BiPolar as well. My dd is 8 y/o and VERY ADHD. These are not life threatening issues of course, and so their medication is not an absolute necessity as such. I think my sons case could be argued in favor of medical necessity though.
Prior to rispirdol at age 6 my son had regressed to the point of being basically non-functional. He barely talked, raged constantly and screeched all the time. This med changed his life. His brain began to work again and the quality of HIS life was completely changed for the better. Over time we have tuned-up the meds and added 2 and he is now functing the best he ever has. ST/OT and RSP have done their job too and the intense stress for me is lifting and I feel like my deep depression is also finally leaving as well (nope I don't take meds). YEAH.
My dd is so full of energy that when the adderall wears off in the evening, she is moving and talking so fast I can't even understand her. She has not always been on meds. Ritalin didn't work, concerta is the same thing, strattera made her a total witch. So we went without most of the time. She did ok at school. But she is so impulsive that her decisions are very bad and has trouble with social. Adderall is helping her to gain control over these things in a positive way. For her the benefit of the drug over-rules any argument against.
It is difficult and scary to make a decision about medication when it is a choice. There also may be practical reasons to not take a med, for instance some meds require blood work. But some meds have been used in children for a very long time so more is known about them. Sometimes, like for my son, there really is no real discussion needed, something has to be done.
I hope I've offered something helpful.
One of the side effects is drowsiness, thats why we give it to him before bed. Another big one is weight gain, but we havent seen this on ourselves. I dont know if its because it such a small dose or my son is super tiny anyways. There are more but I dont think they are very common.
The first time we medicated our son, he was 7. He was in first grade and in a self-contained, mixed disability classroom (inclusion was unheard of in our District back in 1998). He had learned to read at grade level, which was not hard since he was still in first grade, but he was beginning to slip. When I worked with him at home, I noticed that he would hesitate on the oddest words, like "a" and "I." He would often simply stop reading a sentence he had started with no hesitation. As I observed this, it became clear to me that he was losing his place. He was already dx'd with ADHD and we were putting up with the hyperactivity because we could deal with that using behavioral techniques, but the lack of focus was something nothing seemed to help with (including place markers on the page and colored acetates). I just couldn't stand by and watch my son's academics go down the tubes. Especially since his ability to read was outstripping his language and, because he is partially deaf, closed captioning was going to become important to him. SO, we took him to our local expert in autism, a reknown child psychiatrist. This expert listened to our concerns and confirmed that something like Ritalin might help immensely. He told us he does not like to put children who are under 60 lbs on any meds, if it's possible to avoid them, but that our son was over 60 lbs (don't remember the weight -- probably 70) and that we could have a trial. The trial was successful.
Our son is now 16 years old and has many other issues that have come up over the years. He is on several meds for a variety of reasons. At the recommendation of our psychiatrist (the same one), we have ALWAYS tried behavioral interventions at school and at home before trying any meds. We also have used the smallest possible doses and raised the meds very slowly when necessary over the years. Our son's medication has helped him in ways no behavior plan or sensory program was ever able to do. However, we did and still do ALL the other things that CAN help.
One of the MOST important things to do if you ever consider medication for your child is to go to a doctor who is an expert in autism. Someone who works with autistic kids every single day. Many times, kids on the spectrum have atypical reactions to medication, so you must go to someone who's btdt with our types of kids. Also, this past summer, Risperdal was the first medication approved specifically for autism. Of course, it doesn't take autism away, but it has a long history of being effective with autistic kids and addressing some of the issues our kids have. I am certainly not recommendin that medication or any other, but thought this is something all of us should know about.
What are you medicating for?
This is long, sorry.
Well, I'm trying to decide if it is the way to go. What is bringing this up now (which it has been brought up before and I've always dismissed it) is our IEP next week. Our pre-school teacher is pretty great and we have a good working relationship. Next year will be Chase's 3rd year of pre-school (with the same teacher) and it is in an all autistic class. I keep wanting him to be in with typical kids, but I know in my heart he cannot sit or even be with typical kids without being a total disruption to the class. This worries me as I see him at other places and he is ok, but definitely doesn't "get" how to hang out with other kids...
Ok, where I was going with this: His IEP draft that we got yesterday has 4 goals.
1. Chase will attend to and participate in adut directed activities until completion or up to 10 minutes, 3 out of 4 activities.
2. Chase will use targeted behaviors (e.g. request break, tap arm, or go to quiet area) to interact with his peers and express frustrations, 3 out of 4 opportunities. a. When Chase wants to interactwith a friend he will gently tap their arm to get their attention 3 out of 4 opportunities. b. Chase will choose from a list of strategies when frustrated (e.g. request a break or quiet area) 3/4 opportunities.
3. Chase will answer questions using a word, signs/gesture, and/or picture symbol during structured activities when given a maximum of 2 cues 3/4 opportunities.
4. Chase will use a single word/approximation from the target vocabulary list to label, request, and/or respond without cues 3/4 opportunities.
All of them have a. b. c. "short term objectives" that I didn't put in.
When talking to the teacher, there aren't any academic because he has mastered the ones from last year and he knows everything he needs for kindergarten. Its his behavior that is the most at issue now. Its not only at school either. That is what is bothersome to me. He is aggressive out of the blue. He'll be walking in the hallway and a child will be in the hallway going to his/her classroom and he reaches over and bites him/her. He pushes at random and can't calm himself down most of the time.
Chase is a wonderful loving child. Not seeing him be able to concentrate at times is tough. He will glaze over and zone or just go wild. I am not trying to do this for us or me. I am wondering if doing this will help him feel better. I'm struggling with this. One thing that helps is that my cousin who is now 15 is ADD. I was 17 when he was born so I really remember well. Chase is very much like he was at 4. Ray is not autistic. Ray has friends and is social, but his behaviors/concentration issues cause school issues. My aunt after a long time of trying everything else has put him on Strattera and the results are amazing. He is still Ray, but just having him at my house playing with the kids or talking is like night and day. Its so noticable. I keep wondering if this could possibly help Chase too. I would like to do a trial period just to see and if it isn't any better, then at least I know. I would hate though to have him have "goals" that physically aren't possible for him because he physically and mentally can't sit and participate in adult directed activities until completion or up to 10 minutes. Ya know? Oh and I have tried diet, OT, speech therapy, etc and while that helps tremendously, I have found lately that even at therapy he is more distant or disinterested...We are looking at meds for his adhd it is very severe and causes Damian to truely seem uncontrollable. He has shown signs of adhd since he was 9 months old. He has terrible sleep issues and here is a good example last night we happily got him to sleep at 11pm well guess who was up and running none stop at 527am. Normally we cant get him to go to sleep until 2am so then he sleeps until almost 8 and occasionally alittle past 8 so we get him up for the bus and he sleeps until they get here and sleeps the whole way to school. We took him to a therpist hoping to get some help and all I heard was wow he is always this way, and he seems to be in misery that he cant stop. And he suggested that maybe some meds will give him a better quaility of life, we have always said no to the meds but now we are at our wits end we have no control over him he is none stop from the time he gets up till he sleeps. Even when he sleeps he is still constantly moving. Do yall think meds will help?They will help, but the BEST thing to do, whether or not you medicate him (he really IS small for this) is to get training in positive behavioral intervention and put him on a behavior plan. ALso, get as much sensory integration therapy as you can and learn to address his sensory needs at home, too. Sensory Integration Dysfuntion is almost universal in ASD and it is at the foundation of ADHD, too. SOme kids are sensitive to some foods. There are studies that say that sugar doesn't affect kids, but many moms who'd swear otherwise. I would learn what calms him down and make sure he gets plenty of fresh air and exercise with NO exciting activities within a couple of hours of bedtime. If he doesn't sleep well, consider the OTC supplement Melatonin in probably a half mg level. Getting decent sleep helps with ADHD. Ritalin and other stimulants have been given to very young children, but they are appetite suppressants and some kids won't eat on them. That is WHY our doctor won't give them to kids under 60 lbs. Their bodies are too small to afford to lost much weight. But that can be monitored. STill, I'd put ALL the above suggestions in place before meds are tried. Also, read The OUt of SYnc Child
Thank you for your valuable input. We have a very well known and intelligent Ped Neurologist. I trust him so much. Last year he told me at our last appointment that he wouldn't even dream of meds unless his uncontrolled behavior was across the board at school, home and anywhere else. Since most of the time it was only at school, I didn't think twice about it. This year, it seems like something else is on his mind most of the time. Chase gets a LOT of sensory input at school, therapy AND at home. My house is a sensory heaven for him. I even let him ride around on a tricycle around the house! Oh and his sister is conveniently tagging along (see the pic!) where he gets to have to use even more pressure to carry her too. Sometimes a net swing will calm him down and its all he needs, but that isn't always the case. At school they have swings too, but he likes the jumping/rocking horse there most! He also has a pecs picture at school for when he needs a "break" and he can then go to rest on a recliner and read or on the rocking chair, etc. Then he is too smart and will start to abuse it so he doesn't have to work. I need to call his neuro and have a conversation with him. Again, thanks!
If you made the decision to use medication for your child, how did you go about it? Was there a final straw or something that just built upon itself?
How old was your child?
Does it work?Just a clarification...Cranio-Sacral therapy is mentioned twice on the list. This method of manual treatment was developed by doctors in the osteopathic profession. The second definition on the above list is more accurate. It is not specifically a form of myofascial therapy or release. It is a very subtle highly specialized form of manipulative medicine where the practitioner works to correct certain misalignments and imbalances in the body. The theory is that the bones of the skull although connected by sutures still have subtle movement as does the sacrum. These two regions are attached by the spine, and the brain and spinal cord are bathed in cerebrospinal fluid. If there is an injury or other insult to the body it can cause an imbalance in this delicate system of movement and CSF flow thereby resulting in problems or symptoms in the body. OVERSIMPLIFIED!!!HEY THAT IS A GREAT LIST//WHERE DID YOU GET IT?I REALLY NEED IT,ALONG WITH TZOYA'S...PLEASE LET ME KNOW
Thanks we have gone back to the Dr to work on the dosage.
Recent article on Risperdal:
Release Date:January 30, 2007
Antipsychotic Drug Controls Some Symptoms in Autism Disorder
By Kurt Ullman, Contributing Writer
Health Behavior News Service
Risperidone, a drug used to control schizophrenia symptoms, may also help treat behaviors found in autism spectrum disorder, according to a new review of studies.
The reviewers looked at three randomized, placebo-controlled studies of risperidone (Risperdal) involving 211 participants, including 31 adults.
"[We found] that risperidone may be beneficial for various aspects of autism including irritability, repetition and hyperactivity," said researchers led by Dr. Ora Jesner of the University of Bristol, in England. But the drug's benefits may be offset by its side effects, with weight gain the most prominent.
Often diagnosed within the first three years of life, autism spectrum disorder leads to difficulties with social relationships, language and communication skills. Symptoms include withdrawal from social interactions, irritability, problems communicating and repetitive behaviors.
It is known as a "spectrum" disorder because there is a wide variation in how it affects individuals. Figures from the U.S. Centers for Disease Control and Prevention show that as many as 1.5 million Americans may have some form of the disorder.
"Autism spectrum disorder affects many families worldwide," Jesner said. "At present many of the interventions available are not evidence-based." He said he and co-author Dr. Mehrnoosh Aref-Adib "wanted to analyze the evidence for one important antipsychotic [drug] used for the condition."
The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
Because of the small number of studies, wide range of different scales used to assess outcomes and sizes of the trials themselves, the researchers were only able to look at how well the patients responded for the three specific symptoms of irritability, repetitive movement and social withdrawal.
In addition to weight gain, significant side effects included involuntary muscle movements. As the studies were of short duration, long-term side effects and usefulness remain unknown. Since risperidone does not cure the disorder and may have to be continued for a long period of time, this is an important missing piece.
Susan Levy, M.D., director of the Regional Autism Center at The Children's Hospital of Philadelphia, said that the authors' weak support for the medication in the conclusion surprised her.
"The researchers seemed to be lukewarm towards their positive findings," said Levy, who was not involved with the study. "From my personal experience, this medication can be quite helpful for behavioral difficulties."
The Cochrane reviewers and Levy stress that parents and caregivers should be careful about expecting too much from the medication when talking about this treatment with their doctors. Not all behavioral problems can be helped with risperidone and both side effects and improvements from the drug should be considered.
"As ASD is diagnosed at a young age and these short trials lack long-term data, parents or caregivers need to be aware it is not known how long the medication needs to be continued — potentially for a lifetime," the researchers said. "This is particularly important given the side effects."
Levy termed risperidone "a more serious medication" that she would reserve for more serious difficulties.
"It needs to be stressed to the parents and others that this is not a cure for autism or for the core symptoms of ASD," Levy said. "But it works well for some of the associated problems."
# # #
FOR MORE INFORMATION:
Health Behavior News Service: Lisa Esposito, Editor, at (202) 387-2829 or hbns-editor@
Jesner OS, Aref-Adib M, Coren E. Risperidone for autism spectrum disorder (Review).
Cochrane Database of Systematic Reviews 2007, Issue 1.
The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane
FOR MORE INFORMATION:
Health Behavior News Service: (202) 387-2829 or www.hbns.org.
Center for the Advancement of Health
Health Behavior News Service
Contact: Lisa Esposito, Editor
See also the comments below under "Controversies".
There is no standard, universally accepted treatment of autism; in fact, every single method has its detractors. General approaches may be summarized as follows:
Note: Many of the programs mentioned above also use other approaches to some degree and an attempt was made to place them in the most appropriate category.
The literature seems to show that food allergies and the possibility of candida should be checked immediately because a significant number of children may be autistic because of these problems which can be controlled through drugs or diet. As far as other kinds of drug therapy are concerned, there is no drug that is universally successful in treating autistic symptoms and that in some cases usually useful drugs may produce negative results and vice-versa. Vitamin B6 with magnesium and some other vitamins and DMG produce positive results in many cases.
Any educational program (SI,AIT, psychotherapy, behavioral, etc), if done intensively, produces some positive results. There are rare cases of recovery claimed by every educational method. In addition, some methods have been reported by parents as producing negative results.
Behavioral approaches are backed by scientific studies as well as anecdotal evidence. The best known, because of the amount of related scientific literature, are Lovaas' version of discrete trial and the North Carolina TEACCH programs. Both are very structured programs with a lot of positive reinforcement, two factors which seem to important.
Clearly, it is important to have centers of expertise for PDD, autism, and related disorders in order to help families and school boards in experimenting and choosing the right therapy for each child.
Note: this list is far from complete at this time and misses some well-known treatments.
[QUOTE=tzoya]Wow -- This is a GREAT list! Where did you get it?[/QUOTE]
uuummmmm....I'll have to figure that out and let ya know. It was a link from a link from a link from a list of web sites from....someplace
Yeah, I do notice that if Chase is hungry or stressed that he just can't communicate at all. It makes it that more difficult.
Humble family doc here...
Each patient, each person, child or adult is different. Each should be evaluated based on their individual diagnosis, behaviors, signs, symptoms, etc. A complete physical should always be the first step. Assuming this has already been done, then all reasonable approaches should be tried. I believe Tzoya mentioned a Positive Behavioral Intervention Plan. I absolutely agree with this. But it must be done across the board, at school and at home, and it will take some time to see results. If you stick with it, and there are still aggressive behaviors coming out of the blue, then I would seriously consider a trial of medication. Just make sure that you are working with a physician who is very experienced with prescribing medications for young children with autism and related issues. You do not want to be working with a "pill pusher".
Medications get a bad name because they have been overprescribed in all fields of medicine, and many docs have used them as a "crutch" so to speak. But that does not change the fact that some children, as well as adults, would very much benefit from a particular prescription.
Do what you think is best based on all of the facts. You can always change course later.
When we started meds the first time at 4yo with my son---the decision was based on his aggressiveness and outbursts that had started in school. We had already gotten used to them at home ever since he was 18 mo.
At that time he was dx with anxiety and put on SSRI's. He couldn't take those(mania) and at 5y and a new psychiatrist, dx him with anxiety, bipolar and poss ASD. We started the bipolar med route. At 6y and nothing had REALLY helped--except risperdal, he was dx with ASD also then. Took him off all meds and went to DAN dr. Within 3 mo, had to put him back on risperdal. His rages were over an hour and all horribly physical. After an attack on his neuropsych that lasted a good 90 min with restraining, the decision was made to restart the risp. This was only just last May. By Aug---I wanted to be done worrying about his impulsiveness. He would open the van door to say hi to someone he knew walking down the street. And this is on a normal 35mph road!! Very impulsive. Never "thought", only "acted". Fun, fun, fun!!!
I asked our pdoc about ADHD meds. But since he had the bipolar dx---the chance was really low it would work. He had already tried Adderall in the past, which made his anxiety/OCD really high.
We decided to try Strattera--non-stimulant for ADHD-type behaviors. It's not suppose to work for about 3 weeks. We saw changes in 1 day. Anxiety went up. We made it thru it and now, after 5 months on it---he is a different child. Occas impulsive---especially when mad, but nothing like he was before.
Last year at school, he was a terror. He never was able to learn anything. Very aggressive and destructive. This year--new school and was able to READ after 2 weeks in school. His brain was finally able to "slow-down" so he could learn! After not knowing all the letters in the alphabet or any sounds------he was READING in 2 weeks!!! Something must had gone into his brain last year!! And we finally were able to open the door and let the knowledge out!
Now---yes, he is the same kid. Some bad days, some good days. Since Thanksgiving break, then 5 snow days, then Christmas break, then no electricity, etc. He has not been able to transition back well. (we live in WA state--bad this year)
Holly, Thank you for your story.My daughter was only 2 when when she was put on meds. We went through several before we found one that worked for her. Currently she takes seroquel and metadate. I never would have thought I would give my child this type of medication at such a young age but she couldn't even stand to be in a room with more than one person. The talking and moving of everyone is very overwhelming for her. The decision to medicate was only for her quality of life. I can deal with just about any behavior problem but she was miserable. She's been on the meds for about 6 mths now and she is alot happier.
I laughed so hard when I read about Chase, my daughter came running to see what was going on. He is just like my son has been lately. We have been trying my neighbourhood public school without a self contained room since the begining of January. We had 2 episodes of biting and other stuff. He got more aggressive at home as well. They kept saying without provocation. I studied the situation to see what was causing it.
My son has limited spontaneous verbal skill, this diminishes even further when he is hungry or stressed. At home I observed that this happens when he is hungry or is scared I am leaving the house without him. As for school, I don't think anyone has the patience or time to handle it the way I do. He is better at home now. Information I gathered from this site helped me. Here is the link. Good luck.
PS! He is on medication for agression. It used to work. I don't know what to think.