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Asperger’s Disorder

Until the criteria for Autism and Asperger’s Disorder are better delineated, clinicians should focus on the level of language development of children with PDDs in order to best estimate prognosis and treatment.

SSRI Antidepressants in Treating Children with Autistic Disorder

Ana Krishnan Penn State College of Medicine   I.      Overview (1)   Autistic disorder involves severe qualitative defects in all three of the following behavioral areas: Social interaction Language, communication, and play Stereotypies, perseveration, and narrow range of interest and activities Many of these patients do not tolerate changes in routine or environment, and can present with acute symptoms of anxiety, panic, irritability, or agitation. Autism is most often identified in toddlers, mostly boys, from 18 to 30 months of age, in whom parents or pediatricians note an absence or delay of speech development and a lack of normal interest in others or a regression of early speech and sociability Onset is usually during infancy to 30 months Males 4:1 Females Incidence is about 1-2/1000   DSM IV Criteria: A.  A total of 6 or more items from (1), (2), and (3) below: (1) Qualitative impairment in social interaction, as manifested by at least two of the following: a.  Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction b.  Failure to develop peer relationships appropriate to developmental level c.  Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people d.  Lack of social or emotional reciprocity (2) Qualitative impairments in communication as manifested by at least one of the following: a.  Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime) b.  In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others c.  Stereotyped and repetitive...

Multimodal Treatment Study of Children with ADHD (MTA Study)

Summary and Review by Matt Barcellona  Penn State College of Medicine 2002 Goal of study: 3 Questions 1) How do long term and behavioral treatments compare with one another? 2) Are there additional benefits of combining medicinal and behavioral treatments? 3) How does careful systematic treatment compare to routine community care?   Study Design: 4 Groups (Strategies) 1) Medication management 2) Behavioral Treatment 3) Combined Treatment 4) Community Care number of children = 579 over 14 month period   6 Major Outcome Domains 1) ADHD core symptoms (inattention, impulsivity, hyperactivity) 2) Oppositional/Aggressive symptoms 3) Social skills 4) Internalizing symptoms 5) Parent-Child relations 6) Academic achievement   Results & Conclusions – All groups showed marked reductions in symptoms over time, with significant differences in degrees of change. – Med management superior to behavioral treatment in controlling core symptoms of ADHD (parents/teachers). No significant difference on other domains. – Combined treatment and med management were superior to behavioral treatment in controlling core symptoms (parents/teachers) while Community Care was NOT. – No significant advantage of combined therapy versus medications alone on any domain -combined treatment consistently used lower doses than med management – Combined treatment superior to behavioral treatment on 4 domains:          1) Inattention (parents/teachers), Hyperactivity-Impulsivity (parents)          2) Oppositional/Aggressive behaviors (parents)          3) Internalizing symptoms (parents)          4) Academic achievement (reading) – Combined treatment was superior to Community Care on all 6 domains (parents). – Treatment satisfaction scores for parents of combined and behavioral treatments were superior to Med management parents.     Presentation References 1) Abukoff, HB, et al. “A 14-Month Randomized Clinical Trial of Treatment Strategies for ADHD.”...

The Affordable Care Act’s Impact for Former Foster Youth

By: Cara Baldari One of the most popular and bipartisan parts of the Affordable Care Act (P.L. 111–148, P.L. 111–152) is the provision allowing youth up to age 26 to remain on their parents’ health insurance. Yet there are thousands of youth who “age out” of foster care (meaning they no longer qualify for foster care services) each year and cannot take advantage of this option. Details at: First...