When Should a Parent Consider Medication for their Child with an Autism Spectrum Disorder?

Kimberly Stigler, M.D.Kimberly Stigler, M.D.
Assistant Professor of Psychiatry
Medical Director, Christian Sarkine Autism Treatment Center
Indiana University School of Medicine

If your child has been diagnosed with an autism spectrum disorder (ASD), you are already aware that he or she has some underlying difficulties with social skills, communication, and repetitive behaviors. However, your child may also struggle with a variety of additional symptoms that may include aggression and self injury, as well as hyperactivity and inattention, among others. Non-medication treatments such as educational interventions are important as they may incorporate social skills training, and speech, occupational, and physical therapies. In addition, behavior therapy such as applied behavior analysis (ABA) may be helpful if your child is experiencing symptoms such as aggression or self injury. However, medication is often needed to effectively treat specific symptoms associated with ASDs. As a parent, you should consider medication treatment when your child’s symptoms are negatively impacting their ability to meaningfully participate in school, therapy, and other activities. Although there is no medication treatment for the ASD itself, such as social skills, there are many treatments that can diminish the associated symptoms. If you are concerned about your child’s symptoms, the first step is to have him or her evaluated by a child and adolescent psychiatrist. After obtaining a thorough history of your child’s problems, you and your doctor can decide whether a medication treatment could be helpful. Often the choice of medication is based on a “target symptom” approach, which means that the medications your doctor will consider will be specific to your child’s symptoms. In addition, your doctor will take the possible side effects of the medications into account. You should be aware that although many medications are beneficial for various target symptoms, only one medication, risperidone (Risperdal), has been approved by the U.S. Food and Drug Administration (FDA) to treat symptoms of irritability (aggression, self injury, tantrums) in youth with autistic disorder aged 5 to 16 years. This medication is in a group called the atypical antipsychotics that can be helpful for treating target symptoms of aggression and self injury. If your child has problems with hyperactivity and inattention, your doctor may consider guanfacine (Tenex), atomoxetine (Strattera), or sometimes a medication from the stimulant family such as methylphenidate (Ritalin). It is important to know that children with ASDs respond differently to medications and your doctor can help guide you in the best course of treatment for your child. As always, side effects are a concern with any medication and will vary depending on the medication you and your doctor decide upon.

Kim Stigler is a member of the American Academy of Child and Adolescent Psychiatry.