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Autism Treatment Guidelines: Long Overdue Update by Psychiatric Academy

For the first time in 15 years, the American Academy of Child and Adolescent Psychiatry has updated its treatment guidelines for autism spectrum disorder (ASD).

The comprehensive new guidelines urge physicians to look beyond behavioral issues to assess medical conditions associated with autism. They also call for multidisciplinary care by a coordinated team of specialists. Other key recommendations include genetic testing and the careful use of medications as needed in a treatment plan that includes behavioral therapies.

The guidelines appear in the February issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

Embracing “whole-person” care for autism
“We enthusiastically welcome the academy’s publication of guidelines that mirror the whole-person care model pioneered by Autism Speaks Autism Treatment Network,” says developmental pediatrician Paul Wang, Autism Speaks senior vice president for medical research. “These new practice parameters will help raise the standard of care of children and adolescents with autism across the nation.” 

The Autism Speaks Autism Treatment Network (AS-ATN) is a collaboration of medical centers dedicated to providing families with state of the art, multidisciplinary care for autism and its associated health conditions. In its role as the federally funded Autism Intervention Research Network on Physical Health, the AS-ATN has pioneered treatment guidelines for many medical conditions associated with autism. These include GI distress, sleep disorder and attention deficit and hyperactivity disorder. (These guidelines can be found in a special supplement of the journal Pediatrics, here.)

Academy’s update long overdue
The academy’s new practice guidelines replace 1999 guidelines that were “woefully out of date,” says co-author Matthew Siegel. Dr. Siegel is a child psychiatrist and director of the Developmental Disorders Program at Maine’s Spring Harbor Hospital. The new recommendations address both assessment and treatment of autism.

Assessment Recommendations
The assessment recommendations call on doctors to routinely assess young children for developmental issues including autism. If the screen shows significant symptoms of autism, the doctor should refer the child for a full evaluation. These recommendations are in line with those of the Autism Speaks Early Access to Care program.

Once a diagnosis of autism is made, the academy guidelines call on the child’s doctor to coordinate the multidisciplinary assessments needed to develop a comprehensive treatment plan. These should include behavioral assessments, communication and psychological tests, genetic screening and a physical exam. The physical exam should include evaluation for medical conditions that commonly co-occur with autism (seizures, sleep and GI disorders, etc.)

Treatment Recommendations
The academy’s new guidelines also emphasize four basic treatment recommendations: First, physicians should help families obtain appropriate, evidence-based educational and behavioral interventions. Second, doctors should ask about use of alternative or complementary treatments. Third, they should offer medications for behavioral problems only after all other approaches have been tried. And fourth, they should maintain an active role in long-term treatment.