From the Guidelines
For children with autism who exhibit aggression, yearly in-person psychiatric visits are insufficient and more frequent visits are necessary to ensure proper management and monitoring of their condition. These children should be seen at least every 3-6 months by a psychiatrist or specialized healthcare provider, with more frequent visits (monthly or bimonthly) when starting or adjusting medications. The lack of evidence for most other forms of psychosocial intervention, as noted in the practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder 1, highlights the importance of regular psychiatric visits. Cognitive behavioral therapy has shown efficacy for anxiety and anger management in high functioning youth with ASD, but more research is needed to support other forms of intervention.
Some key considerations for the management of aggression in children with autism include:
- Regular monitoring of medication side effects and behavioral symptoms
- Careful titration of medications to find the optimal therapeutic dose while minimizing adverse effects
- Ongoing assessment of behavioral interventions that should be implemented alongside medication management
- Access to the provider for urgent concerns about medication side effects or worsening behaviors between scheduled appointments.
Given the complexity of autism spectrum disorder and the need for individualized care, a more intensive monitoring schedule is necessary to ensure the best possible outcomes for these children. This approach is supported by the most recent and highest quality study available, which emphasizes the importance of regular psychiatric visits and careful management of medications and behavioral interventions 1.
From the Research
Yearly In-Person Psychiatric Visits for Children with Autism Who Exhibit Aggression
- There is no direct evidence to suggest that yearly in-person psychiatric visits are necessary for children with autism who exhibit aggression 2, 3, 4, 5, 6.
- However, studies suggest that early intervention and regular monitoring are crucial in managing aggression and irritability in children with autism spectrum disorder (ASD) 2, 3, 4, 5, 6.
- Medications such as risperidone and aripiprazole have been approved for the treatment of irritability and aggression in children with ASD, and regular psychiatric visits may be necessary to monitor their effectiveness and potential side effects 2, 3, 5, 6.
- Therapeutic strategies, including functional behavioral assessment, reinforcement strategies, and functional communication training, may also be beneficial in reducing aggressive behavior in individuals with ASD, and regular psychiatric visits can help to assess their effectiveness 3, 4.
Treatment Options for Aggression in Autism Spectrum Disorder
- Pharmacologic treatments, particularly the use of second-generation antipsychotics, may be beneficial in reducing aggression in individuals with ASD 3, 5, 6.
- Therapeutic strategies, including functional behavioral assessment, reinforcement strategies, and functional communication training, may also be effective in reducing aggressive behavior in individuals with ASD 3, 4.
- Identifying and addressing underlying causes of irritability and aggression, such as coexisting medical conditions and environmental factors, is also important in managing these symptoms 5.