The purpose of this study was to identify evidenced-based, focused intervention practices for children and youth with autism spectrum disorder. This study was an extension and elaboration of a previous evidence-based practice review reported by Odom et al. (Prev Sch Fail 54:275–282, 2010b, doi:
 10.1080/10459881003785506
 ). In the current study, a computer search initially yielded 29,105 articles, and the subsequent screening and evaluation process found 456 studies to meet inclusion and methodological criteria. From this set of research studies, the authors found 27 focused intervention practices that met the criteria for evidence-based practice (EBP). Six new EBPs were identified in this review, and one EBP from the previous review was removed. The authors discuss implications for current practices and future research.

Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review.

http://www.socsci.ru.nl/meulenbroek/Publications/Sowa%20and%20Meulenbroek%20-%202011.pdf

Effects of physical exercise on Autism Spectrum Disorders: A meta-analysis

Efficacy of group social skills interventions for youth with autism spectrum disorder: A systematic review and meta-analysis

* Abbreviations:
 ASD — : autism spectrum disorder
 GI — : gastrointestinal
 5-HT — : serotonin

Autism spectrum disorders (ASDs) are a set of complex neurodevelopmental disorders defined behaviorally by impaired social interaction, delayed and disordered language, repetitive or stereotypic behavior, and a restricted range of interests. ASDs represent a significant public health issue with recent estimates indicating that as many as 1% of children in the United States are diagnosed with an ASD.1,2 Many individuals with ASDs have symptoms of associated medical conditions, including seizures, sleep problems, metabolic conditions, and gastrointestinal (GI) disorders, which have significant health, developmental, social, and educational impacts. Gastrointestinal complaints are a commonly reported concern for parents and may be related to problem behaviors and other medical issues such as dysregulated sleep (ATN Annual Registry Report, unpublished data, November 2009).3 Despite the magnitude of these issues, potential GI problems are not routinely considered in ASD evaluations. This likely reflects several factors, including variability in reported rates of GI disorders, controversies regarding the relationship between GI symptoms and the putative causes of autism, the limited verbal capacity of many ASD patients, and the lack of recognition by clinicians that certain behavioral manifestations in children with ASDs are indicators of GI problems (eg, pain, discomfort, or nausea).4–10

Whether GI issues in this population are directly related to the pathophysiology of autism, or are strictly a comorbid condition of ASD remains to be determined, but clinical practice and research to date indicate the important role of GI conditions in ASDs and their impact on children as well as their parents and clinicians.9

On November 15, 2009, a symposium addressing these issues was organized as an adjunct to the annual meeting of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. A … 

Address correspondence to Daniel L. Coury, MD, Professor of Pediatrics and Psychiatry, The Ohio State University, Chief, Developmental & Behavioral Pediatrics, Nationwide Children's Hospital, 700 Children's Dr, Timken G-350, Columbus OH 43205-2696

/pdf/gastrointestinal-conditions-in-children-with-autism-spectrum-39ugdvb1xj.pdf

Gastrointestinal Conditions in Children With Autism Spectrum Disorder: Developing a Research Agenda

Medication use was examined in 286 adolescents and adults with ASD over a 4.5 year period. A total of 70% were taking a psychotropic or non-psychotropic medication at the beginning of the study. Both the number of psychotropic and non-psychotropic medications taken, and the proportion of individuals taking these medications, increased significantly over the study period, with 81% taking at least one medication 4.5 years later. Our findings suggested a high likelihood of staying medicated over time. Thus, adolescents and adults with ASD are a highly and increasingly medicated population.

/pdf/a-longitudinal-investigation-of-psychotropic-and-non-54vadu88uq.pdf

A Longitudinal Investigation of Psychotropic and Non-Psychotropic Medication Use Among Adolescents and Adults with Autism Spectrum Disorders

A randomized controlled design was employed to evaluate a social skills intervention for children with pervasive developmental disorders. Aims included evaluating the acceptability of the program and gathering preliminary evidence on efficacy. Forty-four children, ages 8-11 years, were randomly assigned to treatment or wait list. Treatment consisted of a 16-week group intervention designed to teach appropriate social behavior. Between group comparisons showed that children in treatment were rated as improved on the primary outcome measure, (unblinded parent report), but not on the secondary outcome measure, a parent questionnaire. Parents reported a high level of satisfaction with the intervention. The study supports the feasibility of this intervention to families and highlights challenges for future research in social skills intervention.

Promoting Social Skill Development in Children With Pervasive Developmental Disorders: A Feasibility and Efficacy Study

Background Risperidone may be effective in improving tantrums, aggression, or self‐injurious behaviour in children with autism, but often leads to weight gain.Method Using a quantitative Food Frequency Questionnaire (FFQ), we prospectively examined the nutritional intake of 20 children with autism participating in a randomised placebo‐controlled trial of risperidone for disruptive behaviours.Results At baseline, the mean intakes for macronutrients, vitamins and minerals exceeded Dietary Reference Intakes (DRIs). However there was substantial inter‐participant variability, with individual deficiencies (<80% of DRI) in the intake of calcium (9 of 20 participants), pantothenic acid (6 of 20), vitamin D (5 of 20) and vitamin K (8 of 20). For the participants for whom FFQs were available, there was an increase in weight and an increase in vitamin K intake after 2 months of risperidone treatment (n = 9) compared to placebo (n = 8). An additional 4 months of risperidone treatment (n = 8) did not result i...

Dietary status and impact of risperidone on nutritional balance in children with autism: a pilot study.

Risperidone approved for the treatment of serious behavioral problems in children with autism.

(1) Depression is a serious mental health problem particularly in children and adolescents that requires early identification and intervention. (2) Cognitive-behavioral therapy is a highly effective treatment that decreases symptoms within 3 months and maintains gains at 2 years posttreatment. It works by changing cognitive distortions and teaching problem solving and coping strategies. (3.)Interpersonal psychotherapy demonstrates effectiveness by teaching adolescents how to self-monitor feelings, problem solve, link affect to events, and foster communication skills within the context of a supportive relationship. 4(.)Psychopharmacological treatment has shown moderate effectiveness in treating depression in children and adolescents, but close monitoring is required to evaluate for adverse events, including suicidal behavior and agitation.

Child & adolescent depression: review of the latest evidence-based treatments.

TOPIC: Pediatric bipolar disorder can cause severe disturbances in global functioning. Diagnosing pediatric bipolar disorder is challenging due to the range of symptom expression, developmental differences as compared to adults, presence of comorbid disorders, and developing diagnostic criteria. Treating this disorder can be equally challenging due to frequent symptom relapse and the dearth of research until recently on effective psychopharmacological interventions that guide clinical prescribing practices.



PURPOSE: This paper will help child psychiatric nurses have a better understanding of the unique presentation of pediatric bipolar disorder to facilitate selection of appropriate medication treatment options, taking into account symptom presentation, presence of comorbid diagnosis, drug efficacy, adverse effects, and drug–drug interactions based on research findings.



SOURCES: Literature specific to assessment and psychopharmacological treatment of pediatric bipolar disorder was reviewed.



CONCLUSIONS: Screening of youth with mood spectrum problems for bipolar disorder should occur in every diagnostic assessment and should be ongoing due to range of mood symptoms and the cyclical and episodic nature of this disorder. Youth with bipolar disorder may manifest symptoms and course that differ from adults. Additionally, co-occuring disorders are common in this population, which can complicate medication selection. Psychopharmacological treatment with the use of specific mood stabilizers and/or atypical antipsychotic medications is warranted depending on symptom presentation; however, monotherapy with mood stabilizers has not demonstrated effectiveness in long-term remission of pediatric bipolar symptoms. Recent research indicates that a combined treatment with two mood stabilizers or a mood stabilizer and an antipsychotic holds promising results for pediatric bipolar I, for youth with acute manic symptoms plus psychosis, and for long-term remission of symptoms.

/pdf/pediatric-bipolar-disorder-evidence-based-3qvyg07h72.pdf

Maryellen Pachler

Papers

Promoting Social Skill Development in Children With Pervasive Developmental Disorders: A Feasibility and Efficacy Study

Dietary status and impact of risperidone on nutritional balance in children with autism: a pilot study.

Risperidone approved for the treatment of serious behavioral problems in children with autism.

Child & adolescent depression: review of the latest evidence-based treatments.

Pediatric bipolar disorder: evidence-based psychopharmacological treatments.