행동치료의 의학적 처방 Hyun S. Park, MD Developmental and Behavioral Pediatrician Neurodevelopmental Center, For OC Kids Assistant Clinical Professor of Pediatrics, UCI SOM

Autism Qualitative Social Interaction Impairments Qualitative Communication Impairments Repetitive and Restricted Stereotyped Patterns of Behavior, Activities and Interest

Incidence 1 child in 150 has autism spectrum disorder

Characteristic of behaviors Dangerous Hurt self and/or others Annoying disturbing

Common Behavior Problems Aggression to self and others Tantrums Agitation Obsessions and compulsions Rocking, spinning, wandering around

Hyperactivity, jumping, climbing Inattention, immobility, low energy Echolalia, non verbal Excessive talking, screaming, shouting MELTDOWNS

moodiness Fearful, fearless Pain reaction: too much- too little Sensory processing difficulties: auditory, visual, tactile, oral, vestibular.

What to do with behavior problem Identify the problem Understand what is going on with them Children with autism learn by repetition

Brain learning circuitry Reflex Associative

Children with autism learn by repetition of behaviors Routine in daily activities, schedules, environment Learned skill not able to generalize to different settings and situations Re-learn the skill in a different setting and situation

Visual learners Concrete thinkers

Focus your energy in teaching simple new skills such as praying, singing, greeting, sharing Reinforced with repetition

Lack of common sense Gradual introduction of change Ignoring negative behaviors

Medical consultations Primary physician – check for absence of illness Developmental and Behavioral Pediatrician- developmental and behavioral problem OT, PT, Speech therapist

Psychiatrist - mental and behavioral problem Behaviorist- behavioral modification Neurologist – possible seizure Gastroenterologist- diarrhea, food malabsorption, GER

Medications Stimulants Antidepressants Atypical neuroleptics Antiseizure

Psychostimulants Hyperactivity,inattention, impulsivity Ritalin, Metadate, Concerta Dexedrine, Adderall, Vyvanse

Strattera Hyperactivity,inattention, impulsivity

Antidepressants, anxiolytics Fluoxetine Paroxetine Citalopram Others SSRIs

Atypical neuroleptics Risperdal –Aggressive behavior, irritability, insomnia, mood swing

What can I do for these children Be loving, caring, PATIENT, provide warm environment. Be understanding of the child and family Guide and encourage families to seek help

Referrals to…. Early intervention programs Referral to Early Start Programs, Regional Center in California Public Schools Special Education programs

Education and information Mental health Community centers Medical specialist

You see them for short time, family lives with child 24/7.