Autism Spectrum Disorders

KEY FEATURES

• A neurodevelopmental disorder in which patients suffer from pervasive difficulties with social communication and have repetitive, restricted interests and behaviors

• Affects about 1% of the adult population with an estimated heritability of about 90%

• Approximately 20–30% of individuals in whom autism is diagnosed also have a substance use problem as well as a higher risk of attention deficit hyperactivity disorder, mood, or obsessive-compulsive disorders

CLINICAL FINDINGS

• Persistent issues with social communication and interactions

• Repetitive behaviors, interests, or activities

• Symptoms interfere with functioning

• May or may not have accompanying language or intellectual impairment

DIAGNOSIS

• National Institute of Health and Clinical Excellence (UK) guidelines recommend that assessment be a comprehensive and multidisciplinary approach that includes

  • Asking about core autism spectrum disorders difficulties

  • Early development

  • Medical and family history

  • Behavior

  • Education

  • Employment

  • Needs assessment

  • Risks

  • Physical examination, with laboratory testing as indicated

  • Feedback to the individual

TREATMENT

• No treatments for core symptoms have been validated

• Two antipsychotics, risperidone and paliperidone, are approved for treating irritability in patients with autism spectrum disorders

  • Can help with some behavioral symptoms of autism

  • Carry a risk of metabolic side effects and extrapyramidal symptoms

• There is some evidence for therapy, such as applied behavioral analysis, to address social communications and behaviors