From the Guidelines
The diagnosis for autistic children who are non-verbal is Autism Spectrum Disorder (ASD) with a specifier of "with language impairment" or "with accompanying language impairment". This diagnosis recognizes that the child has autism and specifically identifies their communication challenges. Non-verbal autism is not a separate diagnosis but rather a presentation of autism where spoken language is absent or very limited. Children with this presentation may communicate through other means such as gestures, picture exchange systems, or assistive technology devices. The diagnosis is typically made by a multidisciplinary team including developmental pediatricians, child psychologists, and speech-language pathologists who conduct comprehensive evaluations of the child's social communication, behavior patterns, and developmental history, as outlined in the practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder 1.
Early intervention is crucial and typically includes:
- Speech therapy
- Applied behavior analysis (ABA)
- Augmentative and alternative communication (AAC) strategies These interventions can help improve communication skills and reduce behavioral challenges, and are supported by evidence from studies such as 1 and 1. While there are no medications specifically for non-verbal autism, some medications may be prescribed to address co-occurring conditions like anxiety, attention difficulties, or behavioral challenges, but these are determined on an individual basis by healthcare providers, as noted in 1.
It's essential to consider the child's overall developmental history, including their social communication, behavior patterns, and cognitive abilities, when making a diagnosis and developing a treatment plan, as emphasized in 1 and 1. By taking a comprehensive and multidisciplinary approach, healthcare providers can help children with non-verbal autism receive the support and services they need to thrive.
From the Research
Diagnosis for Non-Verbal Autistic Kids
- The diagnosis for non-verbal autistic kids typically involves a comprehensive evaluation of their behavior, communication, and developmental history 2, 3, 4.
- The Childhood Autism Rating Scale 2-Standard Test (CARS2-ST) and the Clinical Global Impression (CGI) scales are commonly used to assess the severity of autism spectrum disorder (ASD) symptoms 2, 3, 4.
- A retrospective case series study found that 96% of patients with ASD attained a CGI-I score of 2 or 1 following treatment with risperidone or aripiprazole, and 43% achieved complete resolution of their ASD signs and symptoms 4.
- Another study found that significant improvement was observed in 44% of cases, and complete resolution was observed in 56% of cases as per the CARS2-ST and CGI scales 3.
Treatment Options
- Risperidone and aripiprazole are approved by the USA Food and Drug Administration for the treatment of irritability and aggression in children with ASD, and have been shown to improve core signs and symptoms of ASD when combined with standard supportive therapies 2, 3, 4, 5.
- A systematic review found that aripiprazole is as effective and safe as risperidone for treating irritability in autism, but further studies with larger sample size and longer duration are required 5.
- However, antipsychotic medications can have side effects, such as extrapyramidal side effects (EPSE), which can be insidious and non-specific, and may be delayed in recognition and reporting 6.