TABLE 10

Considerations Surrounding Medication Use

No current medication corrects core social and communication symptoms of ASD
Accurate diagnosis of coexisting psychiatric conditions guide therapy
Medication is used to help manage
 • Coexisting behavioral health disorders (eg, ADHD, mood disorders, or anxiety disorders)
 • Associated problem behaviors or symptoms causing significant impairment and distress
   o Examples include the following: aggression, self-injurious behavior, sleep disturbance, mood lability, anxiety, hyperactivity, impulsivity, inattention
Medication should only be considered after
 • Careful accounting of when the behavior started and what seems to exacerbate it
 • A functional behavioral assessment should guide development of a treatment plan in the school setting
   o Consider whether the behavior serves as communication of distress or refusal
 • Consider referral to a behavior therapist outside of school to assess the reasons for the behavior, provide the family with strategies, and collaborate in care
 • Careful history and physical to look for medical factors that may cause or exacerbate challenging behaviors (eg, gastroesophageal reflux and acute sources of pain, such as otitis media, dental injury, fracture, and others)34,380,391,485,579
Consider medication after treatable medical conditions and behavioral factors assessed and intervention does not address the symptoms of concern
Include the family and patient in shared decision making that considers their goals and values543