But before jumping to prescription drugs, there are some non-prescription alternatives you can consider, like valerian, omega-3 fatty acids, melatonin (for daytime use), and lavender. Feder: It might be time to think about medications. Mara : Okay, so we’ve tried all the non-pharmacologic treatments and the irritability is still an issue. By taking this comprehensive approach, we can minimize the use of medications and improve the quality of life for autistic individuals and their families. It's also important to collaborate with occupational therapists, speech and language pathologists, and special educators to address challenges related to sensory processing, motor planning, communication, and learning that may be contributing to irritability. For anxiety, depression, or everyday problem-solving, parent-implemented developmental relationship-based intervention or some forms of modified CBT can be effective. For ADHD, breaking down tasks can be helpful. This can involve things like exercise and cognitive behavioral therapy for insomnia, modified for autistic patients by using visualization techniques. It's important to start with non-pharmacologic approaches for conditions such as sleep problems, ADHD, depression, and anxiety. Feder: Definitely! Another approach to tackling irritability in autistic individuals is by addressing co-occurring conditions that may be driving the irritability. The idea is to focus on what really matters to the autistic individual, and help them live their best life possible.ĭr. Mara : Some examples of functional goals might include finding ways to sustain meaningful interactions, managing sensory differences, or learning how to respond adaptively to social problems like teasing. And that can actually help reduce the need for medications. By setting functional goals, we can work together to brainstorm ways to address those underlying factors. Maybe they're overwhelmed by a busy household, or having trouble processing requests from their parents. Feder: Think about it this way: if we just tell an autistic person to "stop screaming," we're not really getting to the root of the problem. But functional goals are more about promoting meaningful interaction.ĭr. Now, you might be wondering, what's the difference between functional goals and behavioral goals? Well, with behavioral goals, the focus is on changing specific behaviors, kind of like what's done in applied behavioral analysis. So, one of the first things we can do to tackle irritability in autistic children is to set functional goals. Mara : And I’m Mara Goverman, a Licensed Clinical Social Worker in Southern California with a private practice. Josh Feder, The Editor-in-Chief of The Carlat Child Psychiatry Report and co-author of The Child Medication Fact Book for Psychiatric Practice and the brand-new book, Prescribing Psychotropics. In this podcast, Mara and I will delve into the topic of irritability in autistic children, and explore alternative approaches to minimizing the use of antipsychotic medications. While there are FDA-approved medications for treating irritability in autistic children, such as risperidone and aripiprazole, they can come with some undesirable side effects, including weight gain, neurotoxicity, tardive dyskinesia, and even worsening of catatonia. Feder: Irritability can be a significant challenge for autistic individuals, as well as their families. There are usually multiple steps to try before using the FDA-approved antipsychotic medications.ĭr. Don’t be the prescriber who hears irritability in autism and immediately prescribes antipsychotics. Antipsychotics can be very effective for irritability in autism, but they are often unnecessary, and the side effects are truly problematic.
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