Article December 15, 2005

Treatment Planning for Patients With Autism Spectrum Disorders.

Michael G. Aman, PhD

J Clin Psychiatry 2005;66(suppl 10):38-45

Article Abstract

Patients with autism spectrum disorders (ASDs) can present with extremely heterogeneous issues,and, therefore, their treatment can be very challenging. Most patients with ASDs will benefit fromcontact with a multitude of disciplines. In this article, treatment planning is structured in terms of thepatient’s life stages. Early on, assessment of developmental milestones, metabolic conditions, andhearing; making the diagnosis of ASD; and providing genetic counseling are salient. As the childgrows, speech and language therapy, early intensive intervention, special education, parent training,and neurologic assessment become important. With greater age, behavior therapy, pharmacotherapy,occupational therapy, and sexuality issues are often in ascendancy. As the patient approaches and proceedsthrough adulthood, transition training, housing options, and guardianship issues may be priorities.Advocacy is relevant throughout the life span. Professionals have an obligation to familiarizeparents with interventions likely to be fruitful or unhelpful. There is growing evidence that early intensivebehavior intervention, though expensive, may produce lifelong gains in functioning. A varietyof experimental and/or unproven treatments are identified; mental health professionals can help familieswith members who have ASDs by guiding them toward effective treatments and away from therapiesof unknown value but with potential risks and/or costs.