MHM Magazine

18 | MENTALHEALTHMATTERS | Issue 5 | 2021 MHM multi-professional team (MDT). This team usually consists of a child and adolescent psychiatrist, a psychologist, an occupational therapist, a social worker, a nursing sister, a schoolteacher and an educational psychologist. • A final diagnosis of ASD should be based on the findings of the MDT, taking the results of the team’s assessments into account. • Parents should not attempt to diagnose their child or try treatment ideas without consulting with professionals. B. Interventions should focus on the following educational areas: 1. Improve functional spontaneous communication. 2. Enhance social skills. 3. Boost play skills. 4. Increase cognitive development in a natural setting. 5. Reduction of problem behaviours. 6. Teaching functional academic skills. C. Psychosocial support (assessments and therapies): 1. Family support: support groups, individual supportive counselling 2. Parent psychoeducation: Families play a key role in effective treatment for children with ASD. Individuals with ASD and their families should become partners with professionals in all aspects of planning. Assist parents in managing co-occurring disorders of sleep and feeding, gastrointestinal tract symptoms, obesity, seizures, attention- deficit/hyperactivity disorder, anxiety, and the increased risk of wandering behaviour. 3. Parent behavioural management training: Use of a behavioural specialist to help parents learn to employ behavioural management protocols to help their child learn appropriate behaviour. 4. Special education services should be individualised to the needs of the child 5. Diagnostic scales include the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview (ADI-R). 6. Occupational therapy (OT) and physical therapy (PT) evaluations. OT for sensory processing and the fine motor deficits, PT for coordination deficits. 7. Referral for speech therapy and language testing. 8. Referral for disability services and support: Ensure that the child and the family receive appropriate rights/privileges, suitable to the child and family needs. D. Psychopharmacological interventions: It’s not standard care to use the medication in all individuals. Effective drug treatments are available to help with the “irritability” in ASD. Overmedication should be avoided. • Behavioural disturbance of aggression and irritability: - Atypical antipsychotics such as risperidone and aripiprazole for aggression can also improve repetitive behaviour. Most common adverse effects include weight gain, hyperlipidaemia, hypertension, and increased prolactin. - Anticonvulsants and Lithium for treatment of aggression but blood monitoring may limit use. • Repetitive behaviour: Selective Serotonin Reuptake Inhibitors (SSRIs) such as fluoxetine, citalopram, escitalopram, fluvoxamine. Potential adverse effects include restlessness, insomnia, mania. • Hyperactivity and inattention to be treated with stimulants such as methylphenidate. • Alpha—2 agonists such as guanfacine, clonidine for hyperactivity, aggression, and sleep dysregulation. • Sleep dysregulation can be treated with melatonin. References available upon request