Therapy and Psychotropic Medication Use in Young Children With Autism Spectrum Disorder.


Journal

Pediatrics
ISSN: 1098-4275
Titre abrégé: Pediatrics
Pays: United States
ID NLM: 0376422

Informations de publication

Date de publication:
04 2020
Historique:
accepted: 27 01 2020
entrez: 3 4 2020
pubmed: 3 4 2020
medline: 17 7 2020
Statut: ppublish

Résumé

Guidelines suggest young children with autism spectrum disorder (ASD) receive intensive nonpharmacologic interventions. Additionally, associated symptoms may be treated with psychotropic medications. Actual intervention use by young children has not been well characterized. Our aim in this study was to describe interventions received by young children (3-6 years old) with ASD. The association with sociodemographic factors was also explored. Data were analyzed from the Autism Speaks Autism Treatment Network (AS-ATN), a research registry of children with ASD from 17 sites in the United States and Canada. AS-ATN participants receive a diagnostic evaluation and treatment recommendations. Parents report intervention use at follow-up visits. At follow-up, 805 participants had data available about therapies received, and 613 had data available about medications received. The median total hours per week of therapy was 5.5 hours (interquartile range 2.0-15.0), and only 33.4% of participants were reported to be getting behaviorally based therapies. A univariate analysis and a multiple regression model predicting total therapy time showed that a diagnosis of ASD before enrollment in the AS-ATN was a significant predictor. Additionally, 16.3% of participants were on ≥1 psychotropic medication. A univariate analysis and a multiple logistic model predicting psychotropic medication use showed site region as a significant predictor. Relatively few young children with ASD are receiving behavioral therapies or total therapy hours at the recommended intensity. There is regional variability in psychotropic medication use. Further research is needed to improve access to evidence-based treatments for young children with ASD.

Sections du résumé

BACKGROUND AND OBJECTIVES
Guidelines suggest young children with autism spectrum disorder (ASD) receive intensive nonpharmacologic interventions. Additionally, associated symptoms may be treated with psychotropic medications. Actual intervention use by young children has not been well characterized. Our aim in this study was to describe interventions received by young children (3-6 years old) with ASD. The association with sociodemographic factors was also explored.
METHODS
Data were analyzed from the Autism Speaks Autism Treatment Network (AS-ATN), a research registry of children with ASD from 17 sites in the United States and Canada. AS-ATN participants receive a diagnostic evaluation and treatment recommendations. Parents report intervention use at follow-up visits. At follow-up, 805 participants had data available about therapies received, and 613 had data available about medications received.
RESULTS
The median total hours per week of therapy was 5.5 hours (interquartile range 2.0-15.0), and only 33.4% of participants were reported to be getting behaviorally based therapies. A univariate analysis and a multiple regression model predicting total therapy time showed that a diagnosis of ASD before enrollment in the AS-ATN was a significant predictor. Additionally, 16.3% of participants were on ≥1 psychotropic medication. A univariate analysis and a multiple logistic model predicting psychotropic medication use showed site region as a significant predictor.
CONCLUSIONS
Relatively few young children with ASD are receiving behavioral therapies or total therapy hours at the recommended intensity. There is regional variability in psychotropic medication use. Further research is needed to improve access to evidence-based treatments for young children with ASD.

Identifiants

pubmed: 32238536
pii: peds.2019-1895M
doi: 10.1542/peds.2019-1895M
doi:

Substances chimiques

Psychotropic Drugs 0

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

S99-S107

Informations de copyright

Copyright © 2020 by the American Academy of Pediatrics.

Déclaration de conflit d'intérêts

POTENTIAL CONFLICT OF INTEREST: Dr Bennett receives research funding from Autism Speaks, Neurim Pharmaceuticals, Stemina Biomarker Discovery, and Roche Pharmaceuticals, and her spouse is employed at Pfizer; the other authors have indicated they have no potential conflicts of interest to disclose.

Auteurs

Daniela Ziskind (D)

Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and ziskindd@email.chop.edu.

Amanda Bennett (A)

Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and.

Abbas Jawad (A)

Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Nathan Blum (N)

Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

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Classifications MeSH