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Query: UMLS:C0004352 (autism)
 32,579 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Self-injurious behaviors (SIB) are common in individuals who have autism and related developmental disabilities. When an individual engages in SIB, these behaviors frequently become the primary treatment target because of the potential for injury. A thorough behavioral assessment aimed at determining the function of the behaviors is the first step to developing a treatment plan. This article presents a brief background of SIB and a discussion of the behavioral assessment and treatment of these behaviors to familiarize readers with the behavioral perspective on SIB in individuals who have autism and other developmental disabilities.
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PMID:Behavioral assessment and treatment of self-injurious behavior in autism. 1877 75

Although most research on autistic behavior has considered autism categorically, the increasingly apparent genetic and phenotypic complexities of autism are prompting a more dimensional approach to this area. The long-standing interest in a less categorical approach is made clear from a review of literature. The accumulating empirical support for viewing autism-related phenomena as separable and fractionable is outlined and includes data indicating that many of the behaviors occur in isolation in family members and the general population, are not highly correlated within individuals, and appear to be inherited separately. However, it is emphasized that some of the most common and characteristic phenomena observed in individuals diagnosed with autism do not run in their families. It is suggested that these novel, "emergent," phenomena may arise in the individual from interacting configurations of co-occurring traits or from the interaction of genetic and biological factors underlying the traits. A number of autism-related phenomena including intellectual disability, seizures, persistence of primitive reflexes, stereotypies, self-injurious behavior, savant abilities, and morphological abnormalities, among others, are discussed as potentially being emergent. It is concluded that consideration of the role of emergence in autistic behavior and related phenomena should complement a reductionist approach and might help illuminate the components and complexities of autism.
Autism Res 2008 Feb
PMID:The potential role for emergence in autism. 1936 Jun 47

New evidence suggests that autism may be associated with (a) varied behavioral responses to folate therapy and (b) metabolic anomalies, including those in folate metabolism, that contribute to hypomethylation of DNA. We hypothesized that children with autism who are homozygous for the MTHFR 677 T allele (TT) and, to a lesser extent those with the CT variant, would exhibit more behavioral problems and/or more severe problematic behaviors than homozygous wild-type (CC) individuals because of difficulties in effectively converting 5,10-MTHF to 5-MTHF. Data from the Autism Genetic Resource Exchange (AGRE) collection were analyzed for all children who met strict criteria for autism per the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) and who had been genotyped for the 677 C to T MTHFR polymorphism (n=147). Chi-square tests, logistic regression, and one-way ANOVAs were used to determine whether differences existed among MTHFR genotypes for specific behaviors on the ADI-R and indices for level of functioning. Exploratory results indicated four behaviors from the ADI-R that were more common and problematic (95% CI) among those with at least one copy of the T allele as compared to homozygous wild-type individuals: direct gaze, current complex body movements, a history of self-injurious behavior, and current overactivity (ORs=2.72, 2.33, 2.12, 2.47, respectively). No differences existed among genotypes for level of functioning as measured with the Peabody Picture Vocabulary Test-Third Edition, Ravens Colored Progressive Matrices, or the Vineland Adaptive Behavior Scales. Findings call for further investigation of the relationship between folate metabolism and problem behaviors among children with autism.
Autism Res 2009 Apr
PMID:The MTHFR 677C-->T polymorphism and behaviors in children with autism: exploratory genotype-phenotype correlations. 1945 42

ABSTRACT Pemoline-induced self-biting behavior has been compared to similar self-injurious behavior (SIB) that occurs in the context of some mental retardation syndromes. The opiate antagonist, naltrexone, has been used successfully in the treatment of SIB in individuals with autism or mental retardation. This is the first report of the effect of naltrexone in an animal model of self-biting behavior. Naltrexone (0.01 mg/kg s.c.) significantly reduced the severity of self-biting behavior, but higher doses (0.10-10 mg/kg s.c.) had no such effect. Consistent with these results in the rat, a review of the clinical use of naltrexone in SIB is also suggestive of a relative loss of efficacy at higher doses (apparent therapeutic window). Naltrexone has higher affinity for mu receptors than other opioid receptor subtypes. Thus, the effect of naltrexone in treating SIB appears to be due to (mu-receptor interactions, with the loss of effect at higher doses due to supervening kappa receptor binding. Speculatively, one may ask if dosage reduction would convert naltrexone nonresponders to responders by lowering kappa receptor-mediated effects. Given the co-localization of opioids and dopamine inputs in some neurons, opioid-dopamine system interactions may also be important in pemoline-induced self-biting behavior.
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PMID:Low-dose naltrexone inhibits pemoline-induced self-biting behavior in prepubertal rats. 1963 Jun 39

Autism is a neurodevelopmental disorder characterized by abnormal reciprocal social interactions, communication deficits, and repetitive behaviors with restricted interests. BTBR T+tf/J (BTBR) is an inbred mouse strain that shows robust behavioral phenotypes with analogies to all three of the diagnostic symptoms of autism, including well-replicated deficits in reciprocal social interactions and social approach, unusual patterns of ultrasonic vocalization, and high levels of repetitive self-grooming. These phenotypes offer straightforward behavioral assays for translational investigations of pharmacological compounds. Two suggested treatments for autism were evaluated in the BTBR mouse model. Methyl-6-phenylethynyl-pyridine (MPEP), an antagonist of the mGluR5 metabotropic glutamate receptor, blocks aberrant phenotypes in the Fmr1 mouse model of Fragile X, a comorbid neurodevelopmental disorder with autistic features. Risperidone has been approved by the United States Food and Drug Administration for the treatment of irritability, tantrums, and self-injurious behavior in autistic individuals. We evaluated the actions of MPEP and risperidone on two BTBR phenotypes, low sociability and high repetitive self-grooming. Open field activity served as an independent control for non-social exploratory activity and motor functions. C57BL/6J (B6), an inbred strain with high sociability and low self-grooming, served as the strain control. MPEP significantly reduced repetitive self-grooming in BTBR, at doses that had no sedating effects on open field activity. Risperidone reduced repetitive self-grooming in BTBR, but only at doses that induced sedation in both strains. No overall improvements in sociability were detected in BTBR after treatment with either MPEP or risperidone. Our findings suggest that antagonists of mGluR5 receptors may have selective therapeutic efficacy in treating repetitive behaviors in autism.
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PMID:Repetitive self-grooming behavior in the BTBR mouse model of autism is blocked by the mGluR5 antagonist MPEP. 2003 69

Autism spectrum disorder (ASD) is often accompanied by self-injurious behavior (SIB), aggression, and tantrums, symptoms that have reportedly improved with micronutrient (vitamins and minerals) treatment. The current study took advantage of naturally occurring differences in parental preferences for treatment approaches. The micronutrient group asked for treatment without pharmaceuticals (n = 44, aged 2-28 years at entry [M = 8.39 +/- 5.58]). Their records were matched with those of 44 similar children whose families requested conventional treatment (medication group). Both groups improved on both the Childhood Autism Rating Scale and the Childhood Psychiatric Rating Scale (all p values <0.0001). Both groups also exhibited significant decreases in total Aberrant Behavior Checklist scores, but the micronutrient group's improvement was significantly greater (p < 0.0001). SIB Intensity was lower in the micronutrient group at the end of the study (p = 0.005), and improvement on the Clinical Global Impressions scale was greater for the micronutrient group (p = 0.0029). It is difficult to determine whether the observed changes were exerted through improvement in mood disorder or through an independent effect on autistic disorder. There were some advantages to treatment with micronutrients-lower activity level, less social withdrawal, less anger, better spontaneity with the examiner, less irritability, lower intensity SIB, markedly fewer adverse events, and less weight gain. Advantages of medication management were insurance coverage, fewer pills, and less frequent dosing.
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PMID:Micronutrients versus standard medication management in autism: a naturalistic case-control study. 2041 4

Behavior problems such as aggression, property destruction, stereotypy, self-injurious behavior, and other disruptive behavior are commonly observed among adults with intellectual disabilities (ID), autism spectrum disorders (ASD), and epilepsy residing at state-run facilities. However, it is unknown how these populations differ on behavior problem indicies. Assessment of behavior problems were made with the ASD-behavior problems-adult version battery. One hundred participants with ID were matched and compared across four equal groups comprising 25 participants with ID, 25 participants with epilepsy, 25 participants with ASD, and 25 participants with combined ASD and epilepsy. When controlling for age, gender, race, level of ID, and hearing and visual impairments, significant differences were found among the four groups, Wilks's Lambda=.79, F(12, 246)=1.93, p<.05. The multivariate eta2 based on Wilks's Lambda was .08. A one-way ANOVA was conducted for each of the four subscales of the ASD-BPA as follow-up tests to the MANOVA. Groups differed on the aggression/destruction subscale, F(3, 96)=.79, p>.05, eta2=.03, and stereotypy subscale, F(3, 96)=2.62, p>.05, eta2=.08. No significant differences were found on the self-injury subscale and disruptive behavior subscale. Trend analysis demonstrated that individuals with ID expressing combined co-morbid ASD and epilepsy were significantly more impaired than the control group (ID only) or groups containing only a single co-morbid factor with ID (ASD or epilepsy only) on these four subscales. Implications of these findings in the context of known issues in ID, epilepsy, and ASD, current assessment practices among these populations and associated challenges are discussed.
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PMID:Behavior problems: differences among intellectually disabled adults with co-morbid autism spectrum disorders and epilepsy. 2045 41

Autism spectrum disorders (ASDs) are childhood onset developmental disorders characterized by impairment of social skills and repetitive behavior, and also for classic autistic disorder, a significant impairment of communication. In addition to these core symptom domains, persons with ASDs frequently exhibit interfering behavioral symptoms, including irritability marked by aggression, self-injurious behavior, and severe tantrums. Aripiprazole is an atypical or newer generation antipsychotic with a unique mechanism of action impacting dopaminergic and serotonergic neurotransmission. The drug has been found efficacious for several indications, including most recently for use targeting irritability associated with autistic disorder in youth. Fragile X syndrome is the most common inherited cause of developmental disability and the most common known single gene cause of ASDs. As in idiopathic ASDs, irritable behavior is often exhibited by persons with fragile X syndrome. However, research to date in this disorder has not focused on this target symptom cluster. An initial pilot study has begun to assess the impact of aripiprazole on irritability in youth with fragile X syndrome.
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PMID:Aripiprazole in autism spectrum disorders and fragile X syndrome. 2064 78

We used National Fragile X Survey data in order to examine reported self-injurious behavior (SIB) to (a) generate lifetime and point prevalence estimates, (b) document detailed features of SIB (frequency, types, location, severity) in relation to gender, and (c) compare comorbid conditions between matched pairs (SIB vs. no SIB). Results indicate significant gender differences in frequency, topography, and location of SIB as well as sleep difficulties, comorbid conditions, pain sensitivity, and seizures. Matched pair comparisons (SIB vs. no SIB) revealed differences for males in sensory and attention problems, hyperactivity, aggression, autism, and anxiety and for females, in autism, attention, and anxiety. These results further clarify gender differences as well as comorbidity patterns between children with fragile X syndrome with and without SIB.
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PMID:Self-injurious behavior and fragile X syndrome: findings from the national fragile X survey. 2094

Children with autism and autism spectrum disorders have a high rate of irritability and aggressive symptoms. In one study up to 20% of children with autism have symptoms of irritability and aggression including aggression, severe tantrums, and deliberate self injurious behavior (Lecavalier [2006] J. Autism Dev. Disord. 36:1101-1114.). These symptoms can lead to impairment and distress in both home and school settings. Medications to treat the irritability will be discussed across categories of antipsychotics, antidepressants, antihypertensive agents, and others. Emphasis will be placed on medications with the most safety and efficacy and FDA approval.
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PMID:Managing irritability and aggression in autism spectrum disorders in children and adolescents. 2098 64


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