Many children with autism are on some kind of medication and many young children with signs
of autism, their parents wonder if medication might be appropriate, when it's appropriate.
Today, we are sharing a small snippet from a podcast that we recently rebroadcasted
podcast number 180 with Dr. Michael Murray. It's a great episode and a great little
snippet for you to think about more, um, about medication and autism.
I'm Dr. Mary Barbera, autism mom, behavior analyst, and bestselling author.
Each week, I provide you with one of my videos to help you turn things around, whether you're a
parent or professional, if you haven't subscribed to my YouTube channel, you should do that now.
Today, we are sharing a small clip from podcast 180 with Dr. Michael Murray, um,
here to give some wisdom. Let's check it out. There seems to be
a lot of confusion and controversy over treating kids with autism, with medication.
In general, what are the symptoms and issues that kids and adults with autism take medicine
to treat? What, what, what in your experience has been the common issues and the common
things that medications are prescribed for? Sure. So there are two medications that have FDA
approval for treating, um, conditions related to autism. So there's no medication for the
core symptoms of autism. I think that's really important to understand. We have not evolved
our understanding of the causes or the past the physiology of autism to the point that direct
medications to target those core symptoms. So everything that I will talk about for the
remainder of our time together is talking about, um, the issues that are kind of circle around
autism. Like, so some of the things that kind of go along with it, or our needs of dampening,
some of those core symptoms to allow other treatments to become more effective.
So like behavior analysis, right? So sometimes you are having someone in
such a state that they're not able to learn effectively and really kind of creating an
internal sense of calmness or relaxation so that, you know, the behavior strategies or,
you know, trying to teach new skills has a more chance, a better chance of being successful.
But The two medications are, um, you mentioned are Aripiprazole or Abilify or Risperidone or
Risperdal, and they both have indications for treating severe mood irritability,
severe aggression and severe self-injury. Um, and, but they would not be the pattern that
you were describing for Lucas, right? It'd be the pattern of having them very frequently every day.
Um, to a degree, uh, really, uh, concerning levels for safety, uh, of, of the individual or those
around them. So really, if you're thinking about those medications, we would be really looking
for frequent occurrence of these behaviors across settings to a high degree of intensity,
because as you also mentioned, they do have, um, side effects, which are concerning that.
So it's really needing to a very careful cost, uh, risk benefit ratio, and trying to make sure
that there's enough potential benefit, um, to justify the risks that, you know, you are
going to take on by utilizing these medications. However, just because there's only two that have
this FDA approval don't doesn't mean that we don't use other ones and can use them quite effectively.
So I think it's important for professionals listening and for families to listen, who are
listening is, um, just because someone has autism doesn't mean that they can't have any of the other
things that we could all suffer from as well. Like depression, like anxiety, you know, like ADHD,
right? So people with autism have those things. And in some cases they have the more commonly than
people who don't have autism. So, you know, those are the things that we’re
frequently monitoring folks for, you know, our, you know, as people age, um, there's much more
likelihood of them developing depression. Much more likelyhood of developing anxiety.
So we want to make sure that we are looking at those things. Are they developing to a degree of
severity that really maybe a medication can be helpful for them? Um, And then, you know, there
are, like, we were just talking about a minute ago is really kind of thinking about things that
may be interfering with other types of treatments. So, you know, if you have a, really an effective
behavior strategy or, you know, you feel like you're, you know, that you kind of gotten to a
certain degree and now you're plateauing and now, you know, what, what can, what can we do to. Um,
you know, try and keep the progress going. Those are sometimes we think about,
you know, situational anxiety, right? So is anxiety progressing to the point
in a demand situation where, you know, new skills or new environments are being, um, the person is
being exposed to those that, you know, the anxiety is rising to the level that's really interfering
with them, continuing to participate in learning and persisting through that.
So sometimes we're looking for medications that are just meant to augment the other treatments
that are making the other treatments more likely to be successful. Obviously. Anytime,
you're looking at a medication you want to do a very careful analysis of what you think the
potential benefit is versus the potential risk of being exposed to that medication.
And I love working with behavior analysts 'cause you can always,
you know, say, look, Hey, let's think about what this is going to look like behaviorally. So
this is what I think is going to be happening in the brain with me utilizing this medication, or
in the body. And, you know, so if we think about what this is happening internally,
what is it gonna look like externally? Right. So what do we expect to go away?
Right. As they're interfering behaviors, are there challenging behaviors? Or vice versa, you know,
what are skills that we think are going to progress more rapidly or start to emerge?
So kind of looking at a very kind of, um, uh, you know, having a clear operant definitions of
behaviors that you expect to change as a result of the medication exposure, and then working with
them to, okay, how's the data going to look? How often are you going to collect the data?
You know, and I think also kind of working with a psychiatrist also
can be really helpful. You know, it asks me what is the expected window of activation
for this drug, right? So if the medicines not expected to work for four to six weeks
taking data in week two isn't really informative. I mean, unless you need the data for something
else. But if you're looking at it for just looking at the efficacy of medication, it's too soon,
right. So, you know, if you've got good baseline data, then you need to wait until week four. So,
you know, I think it's just kind of having that dialogue between the behavior analyst and the
psychiatrist is really important and I think impactful and each of them doing a better job.
So. I hope you enjoyed that small clip, if you did and you'd like to watch the whole
podcast interview, it is marybarbera.com/180. If you liked this, leave a comment, give it thumbs
up or share it with somebody else who might benefit. And I'll see you right here next week.