ד"ר לידיה גביס
מנהלת המכון להתפתחות הילד ע"ש ויינברג, בי"ח אדמונד ולילי ספרא לילדים - מרכז רפואי שיבא - תל השומר ואוניברסיטת ת"א
Treating Core and Comorbidity in Autism
Lidia Gabis, MD
The Weinberg Developmental Center , Edmond and Lilly Safra Children’s Hospital, Tel Hashomer and Tel Aviv University
Impairments in autism spectrum disorders can be divided in core symptoms (social interaction, communication and restricted and repetitive activities) and related disabilities such as cognitive impairment (mental retardation >50%), epilepsy and comorbidity such as ADHD, mood disorder, anxiety, sleep and gastrointestinal symptoms.
Treatment approach to core symptoms are mainly behavioral and educational but to dual diagnosis is frequently approached pharmacologically. There are no US Food and Drug Administration (FDA)-approved drugs for the treatment of “autism” per se (core) and the medication target is specific behaviors that significantly interfere with daily function, meaning “Symptom controlling drugs”.
Questions regarding treatment of dual diagnosis:
Can we use the same diagnostic criteria?
Can we use same medications as in a person with typical development?
Can we expect the same side effects?
What are the treatment goals?
How treatment of comorbid symptomatology may influence the core symptoms?
What are the long term effects on the developing brain?
Risk of pharmacotherapy should be weighed against:
Aberrant behaviors may interfere with or impede educational and emotional progress despite Herculean efforts by teachers, therapists, and family members to replace them with more appropriate behaviors. These anomalous behaviors may endanger the child’s safety and educational placement. Pharmacotherapy may improve well-being, function and participation and facilitate educational progress.
We will present pharmacologic approach to specific symptoms and research trends in treating core phenomena. Treatment trends based on Acetyl Choline and Glutamate theories will be presented.