Minimally Verbal Individuals with Autism Spectrum Disorders/Intellectual Disability and Challenging Behaviors: Can Strategic Psychiatric Treatment Help?

(1) Background: Psychiatrists are increasingly required to treat minimally verbal (MV) individuals with autism spectrum disorder (ASD), intellectual disability (ID) and behavior problems without much published guidance. (2) Methods: We reviewed 80 charts of MV patients managed strategically for chal...

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Veröffentlicht in:Disabilities (Basel, Switzerland) Switzerland), 2024-06, Vol.4 (2), p.277-289
Hauptverfasser: Hellings, Jessica A., Singh, Saras Chen, Singh, Sham, Cheng, An-Lin
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Sprache:eng
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Zusammenfassung:(1) Background: Psychiatrists are increasingly required to treat minimally verbal (MV) individuals with autism spectrum disorder (ASD), intellectual disability (ID) and behavior problems without much published guidance. (2) Methods: We reviewed 80 charts of MV patients managed strategically for challenging behaviors, following IRB approval. Data extracted included demographics, ASD/ID level, diagnoses, epilepsy and medications. In this descriptive study, we examined the course of assessment and treatment and made recommendations for a strategic, person-centered approach. (3) Results: Of 53 males and 27 females, mean age 34 years (range 7–76), all had ID; 75 had ASD (94%). Diagnoses included seizures in 40/80 (50%), frequent aggression (89%), self-injury (80%), attention-deficit hyperactivity disorder (ADHD) (64%) and obsessive compulsive disorder (OCD) (34%). The commonest medication classes adjusted were antiseizure medications, antipsychotics, and non-stimulant ADHD medications. (4) Conclusions: Clinical impressions suggested that this strategic psychiatric approach was beneficial, notably a review of antiseizure and all other medications for polypharmacy, behavioral and other side effects, followed by a review of possible childhood/current ADHD and a trial of low-dose non-stimulant ADHD medications if warranted. Low-dose risperidone was often effective and tolerable for irritability and self-injury.
ISSN:2673-7272
2673-7272
DOI:10.3390/disabilities4020018