11/11/2018 T he ABCs of Me dic ation Manage me nt for Autism - - PDF document

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T he ABCs of Me dic ation Manage me nt for Autism Spe c tr um Disor de r

OR

HO W T O C O MPL EMENT BEHAVIO RAL T HERAPY

ABC L

• gging (F

BA) F ir st



We ne e d to kno w wha t, whe n, whe re a nd why b e ha vio rs ha ppe n.

 Ante c e de nt: Wha t ha ppe ne d rig ht b e fo re the b e ha vio r?  Be havior: i.e . ra g e , se lf injury, a g g re ssio n, e lo pe me nt, ste mming , withdra wa l  Conse que nc e: Wha t ha ppe ne d rig ht a fte r the b e ha vio r?  Possible F unc tion: g e tting a tte ntio n, a c c e ssing ite m o r a c tivity, e sc a pe , se nso ry

(Wha t wa s the o utc o me fo r the c hild? )

 Ke y Point: T he r ape utic inte r ve ntions to c hange be havior s should be e xplor e d BE F OR E me dic ation manage me nt is c onside r e d.

ABC L

• gging



We ne e d to fig uring o ut why a c hild a c ts a c e rta in wa y a nd unde rsta nd wha t’ s b e hind the ina ppro pria te b e ha vio rs.



K no wing wha t’ s b e hind the b e ha vio r c a n he lp find wa ys to c ha ng e the b e ha vio r. A c hild’ s b e ha vio r se rve s a purpo se a nd e xpre sse s a n e mo tio n.



We ne e d to fig ure o ut wha t trig g e rs c e rta in b e ha vio rs in yo ur c hild. It’ s impo rta nt to re me mb e r tha t the c a use s fo r the sa me b e ha vio r is diffe re nt fo r e ve ry c hild.

 Ke y Point: WHY a c hild re ac ts the way the y do not only he lps with be havioral the rapy planning but c an guide me dic ation tre atme nt options.

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ABC L

• gging

 De fine the be havior: 

Give a g o o d de sc riptio n o f c hild’ s b e ha vio r.



I t’ s impo rta nt to de sc rib e the b e ha vio r in a n o b je c tive , spe c ific wa y. T his c a n he lp to fo rmula te a b e ha vio ra l inte rve ntio n a s we ll a s he lping to c a te g o rize the b e ha vio rs a nd e mo tio ns. Do e s the b e ha vio r re fle c t a nxie ty, de fia nc e , sa dne ss, distre ss?

 Ke y Point: Physic ians don’t ofte n obse rve a c hild's e motional or be havior al dysr e gulation in our

• ffic e .

Impor tant De tails on Be haior s

 Colle c ting, c ompar ing and analyzing infor mation: 

Whe re is this b e ha vio r ha ppe ning ?



Whe re is it no t ha ppe ning ?



Ho w o fte n is the b e ha vio r o c c urring ?



Who is a ro und whe n it o c c urs?



Wha t te nds to ha ppe n rig ht b e fo re a nd rig ht a fte r the b e ha vio r?

What is My Child’s Be havior T e lling Me ?

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? ? ?

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Have T he r apy in Plac e

 De ve loping a plan: 

Onc e we kno w the c a use fo r a c hild’ s b e ha vio r, c a n c ha ng ing so me thing in the e nviro nme nt c ha ng e the b e ha vio r?



Ca n the physic a l e nviro nme nt b e mo difie d?



Ca n a c ha ng e b e ma de in a c hild’ s ro utine o r e ve nts tha t ha ppe n b e fo re the ina ppro pria te b e ha vio r to dive rt it?



Ca n c ha ng e s b e ma de in the re spo nse to the b e ha vio r o r to the c o nse q ue nc e s fo r a b e ha vio r?

 Ke y point: Me dic ation manage me nt c an c omplime nt the r apy and should not be c onside r e d fir st nor should it be c onside r e d without c onc ur r e nt the r apy.

Conside r Othe r T r e atme nts F ir st



Ma ny c hildre n with ASD ha ve c ha lle ng ing b e ha vio rs o r diffic ultie s with the ir fe e ling s a nd e mo tio ns. Ma ny tre a tme nts he lp. Me dic ine is o nly o ne

• f tho se tre a tme nt o ptio ns, a nd me dic ine is no t right fo r e ve ry c hild.



I t is b e st to c o nside r me dic ine o nly AF T E R b e ha vio ra l a nd e duc a tio na l me tho ds ha ve b e e n trie d first.

 Ke y point: F BA is a valuable tool that should be done . T he same infor mation gathe r e d fr

• m an F

BA c an he lp whe n c onside r ing the ne e d for me dic ation manage me nt.

T r e atme nt ‘E quation’

T r igge r  E motion  Be havior



T he trig g e r c a use s a n e mo tio n.



T he e mo tio n c a use s a b e ha vio r.



T he b e ha vio r is the RE SUL T .



Only tre a ting the b e ha vio r is like putting a b a nda id o n a n infe c tio n. T ha t’ s slo ppy.



We ne e d to unde rsta nd b o th the trig g e r (using ABC c he c klist, F BA) a nd the e mo tio n b e fo re we c a n fully c ha ng e the b e ha vio r.

 Ke y Point: IF me dic ation tr e atme nt is c onside r e d, we ne e d to ide ntify and tr e at a c hild’s e motional r e sponse (fe ar , ange r , fr ustr ation, sadne ss, distr e ss) and not just aim to me dic ate away the ir be havior (outbur sts, me ltdowns, aggr e ssion, se lf injury.)

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If a De c ision is Made to Use Me dic ation

 It is important familie s have the right information. 

A physic ia n sho uld:



E xpla in me dic ine c ho ic e s to fa milie s.



T e a c h fa milie s a b o ut wa tc hing fo r e ffe c tive ne ss.



T e a c h fa milie s a b o ut c he c king fo r side e ffe c ts a nd g o o d re spo nse .



Give info rma tio n a b o ut ma na g ing c o mmo n side e ffe c ts.



Be c le a r with fa milie s a b o ut g o a ls o f tre a tme nt, po ssib le risks a nd b e ne fits.

Whe r e to F ind He lp



Me dic ine s c o mmo nly pre sc rib e d fo r ASD a re usua lly pre sc rib e d b y a pe dia tric ia n, a psyc hia trist o r a ne uro lo g ist.



Who kno ws yo u a nd yo ur c hild?



Ha s e xpe rie nc e wo rking with c hildre n with ASD a nd b e ha vio r diffic ultie s.



I s kno wle dg e a b le a b o ut the use o f me dic ine s in c hildre n with ASD.



K no ws the po ssib le risks a nd po ssib le b e ne fits o f e a c h me dic ine .

T r e atme nt Que stions

 T he ‘NE E D T O KNOW’ list: 

Wha t e xa c tly a re we tre a ting ?



T he pro s a nd c o ns o f me dic a tio n o ptio ns.



Po ssib le side e ffe c ts a nd b e ne fits o f a ny me dic ine s fo r yo ur c hild.



Ho w lo ng will it ta ke to wo rk?



I f impro ve me nt is no t se e n, the n wha t do we do ?



I f side e ffe c ts ha ppe n, wha t do we do imme dia te ly a nd the n wha t?

 Ke y point: Me dic ation manage me nt DO ES NO T T REA T A SD. Me dic ations c an he lp ame lior ate BE HAVIOR S that ar e disr uptive or injur ious, or that ne gative ly impac t home and the e duc ational pr

• gr

e ss.

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Ide ntify the T ar ge t Symptoms

 What ar e T ar ge t Symptoms?  T a rg e t sympto ms a re tho se pro b le ms o r b e ha vio rs tha t a re c a using tro ub le fo r a c hild. It is impo rta nt to b e c le a r a b o ut wha t sympto ms a re the b ig g e st pro b le ms. T his will he lp to c ho o se the b e st me dic ine . Ha ving c le a rly ta rg e te d sympto ms will a lso he lp to me a sure if me dic ine is he lping a nd a sse ss e ffic a c y o f tre a tme nt.  Ke y point: T he re are no me dic ine s that tre at the c ore soc ial and c ommunic ation symptoms of ASD. Me dic ine s do not he lp with thinking and le arning proble ms. Howe ve r, by targe ting symptoms with me dic ine , a c hild might do be tte r in sc hool

• r in the rapy, whic h c an he lp the m to le ar

n be tte r and impr

• ve and e xpe dite

the rapy outc ome s.

Common T ar ge t Symptoms

 Hype ra c tivity  Sho rt a tte ntio n spa n  I

mpulsive b e ha vio rs

 I

rrita b ility

 Ag ita tio n  Ag g re ssio n  Se lf-injury

Common T ar ge t Symptoms

 T

a ntrums

 Re pe a ting tho ug hts, inte re sts a nd b e ha vio rs  Sle e p pro b le ms  Anxie ty  De pre ssio n  Mo o d pro b le ms  T

ic s

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De c iding What RX to Use



E ve ry de ta il c a n b e impo rta nt whe n c o nside ring wha t me dic a tio n to use :



Wha t b e ha vio ra l the ra pie s ha ve b e e n he lpful in mitig a ting sympto ms.



Also c o nside r: me dic a l histo ry, me ta b o lism, se ve rity o f sympto ms, fa mily histo ry, suppo rt syste ms in pla c e a t ho me , sc ho o l, c o mmunity, a c a de mic pe rfo rma nc e , IE P/ 504, risks to se lf o r o the rs, se lf injury, o the r sa fe ty c o nc e rns, e a ting ha b its, sle e p ha b its.



Me ta b o lic wo rkup ma y b e ne e de d prio r to sta rting me dic a tio ns.



Ge ne te sts ma y b e use ful in g uiding me dic a tio n c ho ic e s.

 Ke y Point: Multiple c onside rations are important for de c iding what me dic ations may be appropriate .

RX Dose



Onc e a de c isio n is ma de o n wha t me dic a tio n to use , the do se o f me dic ine is no t a lwa ys the sa me a nd c a n diffe r fo r e a c h c hild. E ve n with the sa me me dic ine , so me c hildre n do we ll o n a lo w do se a nd so me c hildre n ne e d hig he r do se s. T he do se de pe nds o n thing s like the se ve rity

• f e mo tio na l o r b e ha vio ra l dysre g ula tio n b e ing tre a te d , a g e , we ig ht,
• ve ra ll he a lth a nd sub se q ue nt to a sta rting do se , a c hild’ s re spo nse . A

c o nse rva tive a ppro a c h sho uld sta rt with a lo w do se a nd inc re a se slo wly until impro ve me nts a re se e n. T his c a n ide ntify the lo we st e ffe c tive do se .

 Ke y Points: A c onse r vative appr

• ac h to me dic ine is be st. T

hink: L e ss is mor e . And some me dic ations ar e dose d base d on SE VE R IT Y of symptoms and not ne c e ssarily on he ight, we ight or age .

RX E ffe c t Wait T ime



Ho w lo ng it ta ke s a me dic ine to b e e ffe c tive is diffe re nt fo r e ve ry me dic ine a nd e ve ry c la ss o f me dic a tio ns. Ad ditio na lly, a me dic a tio n e ffe c t time line will va ry fro m pe rso n to pe rso n.



So me me dic ine s pre sc rib e d fo r e mo tio na l a nd b e ha vio ra l dysre g ula tio n c a n wo rk within a fe w minute s. Othe rs c a n ta ke up to 6 we e ks to se e the full e ffe c t. T he physic ia n sho uld pro vide a n e xpe c te d time line fo r e ffe c ts to b e se e n.

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RX Side E ffe c ts

 What r e quir e s monitor ing and why? 

Side e ffe c ts a re ne g a tive o r unwa nte d e ffe c ts o f a me dic ine . Diffe re nt me dic ine s ha ve diffe re nt side e ffe c ts. F

• r tha t re a so n, so me me dic ine s

ha ve to b e mo nito re d muc h mo re c lo se ly.



So me me dic a tio ns re q uire b lo o d wo rk to me a sure c o nc e ntra tio n, o the r me dic a tio ns re q uire mo nito ring fo r a ny side e ffe c ts, suc h a s b lo o d sug a r c ha ng e s, c ho le ste ro l c ha ng e s, pro la c tin le ve ls, a nd impa c t o n the live r a nd kidne ys. A fe w me dic a tio ns re q uire o b ta ining a n E K G b e c a use o f impa c t o n the he a rt.

F DA Appr

• ve d vs. Off-L

abe l



Yo ur c hild’ s physic ia n sho uld indic a te if a me dic a tio n the y a re re c o mme nding is

• ff-la b e l.



Do n’ t b e a fra id to a sk wha t use s a me dic a tio n is F DA a ppro ve d fo r o r if it is b e ing pre sc rib e d o ff-la b e l. Ask a b o ut the studie s tha t suppo rts the o ff-la b e l use . T he F DA re c o g nize s tha t me dic a tio ns a re use d fo r o the r tha n its o rig ina l inte nt, a nd is c o nside re d “sta nda rd o f c a re ” e ve n tho ug h it ha s no t b e e n o ffic ia lly a ppro ve d fo r a pa rtic ula r use . T his is c o mmo n a nd no t ille g a l no t do e s it indic a te b a d me dic a l c a re .

 Ke y Points: T he dr ug’s we bsite will list the F DA- appr

• ve d use s and off- labe l use s

and the gr

• ups that ar

e appr

• ve d to take the dr
• ug. T

r uste d we bsite s, suc h as that

• f the National Institute of Me ntal He alth (NIMH)ar

e good sour c e s of infor mation about F DA- appr

• ve d and off- labe l me dic ation tr

e atme nt in ASD.

Me asur ing the Suc c e ss of T r e atme nt



Whe n sta rting a ne w me dic ine , it is impo rta nt to pla n a wa y to me a sure ho w he lpful it is.



Ho w this is do ne de pe nds o n the c hild, the fa mily, a nd the ta rg e t sympto ms. I n g e ne ra l, me a suring the he lpfulne ss o f a ny me dic a tio n inc lude s ke e ping tra c k

• f the ta rg e t sympto ms with a b e ha vio ra l c he c klist tha t sho uld inc lude :

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Be ha vio ra l T ra c king

 F r e que nc y: 

Numb e r o f ta ntrums e a c h da y



Numb e r o f time s c hild wa ke s during the nig ht e a c h we e k

 Se ve rity: 

Ho w hype ra c tive is the c hild?



Ho w se ve re is the ta ntrum?

 Dur ation 

Ho w lo ng do e s the ta rg e t sympto m o r ta ntrum la st?



Ho w lo ng do e s it ta ke the c hild to fa ll a sle e p?

Othe r F ac tor s that Influe nc e RX E ffe c t

 Impor tant life e ve nts might inc lude : 

Cha ng e in a c hild’ s e nviro nme nt c a n c ha ng e a me dic a tio ns e ffe c ts o n ta rg e t sympto ms. T his c a n ma ke it ha rde r to kno w if a me dic a tio n is he lping .



A ne w sc ho o l



Ne w te a c he r o r sub stitute te a c he r



Mo ving ho me s



A c ha ng e in the ra pist



A c ha ng e in fa mily, suc h a s divo rc e , ma rria g e o r b irth o f a c hild

Commonly Pr e sc r ibe d Me dic ine s for ASD

 ADHD/ ADD Stimulant Me dic ine s:  Me thylphe nidate De r ivative s: Rita lin, Me ta da te , Co nc e rta , Me thylin, Da ytra na ,

Co te mpla , Apte nsio , Quilliva nt, F

• c a lin

 Amphe tamine Salt De rivative s: Adde ra ll, Adze nys, Dya na ve l, Myda yis, De xe drine ,

Vyva nse , E ve ke o , Ze nze di, Pro Ce ntra

 T ar ge t Be havior s: Hype ra c tivity, sho rt a tte ntio n spa n, po o r fo c us, impulsivity  Common Side E ffe c ts: Sle e p disturb a nc e , le ss a ppe tite , irrita b ility  L e ss Common Side E ffe c ts: T

ic s, a nxie ty, de pre ssio n, re pe a ting b e ha vio rs a nd tho ug hts, he a da c he s, dia rrhe a , so c ia l withdra wa l, ra pid he a rt ra te o r rhythm

 Ke y point: Many R CT s show be ne fits.

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Commonly Pr e sc r ibe d Me dic ine s for ASD

 ADHD/ ADD Non- Stimulant Me dic ine s:  Stra tte ra  Alpha Ag onists Me dic ine s: g ua nfa c ine (T e ne x, Intuniv), c lo nidine (Ca ta pre s, K a pva y)  T arge t Be haviors: Hype ra c tivity, sho rt a tte ntio n spa n, impulsive b e ha vio rs, sle e p pro b le ms, tic s  Common Side E ffe c ts: Sle e pine ss, GI pro b le ms (na use a , vo miting , c o nstipa tio n), lo w a ppe tite , lo w b lo o d pre ssure , irrita b ility  L e ss Common Side E ffe c ts: Co nstipa tio n, hig h b lo o d pre ssure if sto ppe d q uic kly, tho ug hts o f ha rming se lf  Ke y point: Se ve ral RT Cs show be ne fits.

Commonly Pr e sc r ibe d Me dic ine s for ASD

 Anti- Anxie ty Me dic ine s:

 SSRIs: fluo xe tine , se rtra line , pa ro xe tine , c ita lo pra m, e sc ita lo pra m, fluvo xa mine  T arg e t Be haviors: De pre ssio n, a nxie ty, re pe a ting tho ug hts, re pe a ting b e ha vio rs (OCD sx),

pho b ia s/ fe a rs, rig id ity, o utb ursts

 Common Side E ffe c ts: GI pro b le ms (na use a , vo miting , c o nstipa tio n, lo w a ppe tite ),

he a d a c he s, pro b le ms fa lling a sle e p, sle e pine ss, a g ita tio n, inc re a se d a c tivity le ve l, mild we ig ht g a in

 L e ss Common Side E ffe c ts: Se izure s, he a rt rhythm pro b le ms, tho ug hts o f ha rming se lf,

suic id e , se ro to nin synd ro me

 Ke y point: RT C show be ne fits in a dult ASD, limite d e ffic a c y in c hildre n/ a dole sc e nts with

• ASD. E

ffic a c y strongly supporte d in anxie ty and de pre ssion in non-ASD.

Commonly Pr e sc r ibe d Me dic ine s for ASD

 Mood Stabilize rs, Se c ond Ge ne ration Antipsyc hotic Me dic ine s:  rispe rido ne , o la nza pine , q ue tia pine , a ripipra zo le , zipra sido ne  T arge t Be haviors: Irrita b ility, a g g re ssio n, ra g e , se lf-injury, ta ntrums, o utb ursts, sle e p pro b le ms, hype ra c tivity, re pe a ting b e ha vio rs, tic s  Common Side E ffe c ts: Sle e pine ss, dro o ling , inc re a se d a ppe tite , we ig ht g a in  L e ss Common Side E ffe c ts: Hig h c ho le ste ro l, hig h b lo o d sug a r, dia b e te s, mo ve me nt side e ffe c ts, e ye side e ffe c ts, he a rt side e ffe c ts  Ke y point: Multiple RCT for rispe ridone and aripiprazole show positive re sults and signific ant e ffic ac y, othe r SGAs are c onside re d off-labe l.

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Commonly Pr e sc r ibe d Me dic ine s for ASD

 Se izur e Me dic ine s: 

c a rb a ma ze pine (T e g re to l, Ca rb a tro l), va lpro ic a c id (De pa ko te , De pa ke ne ), la mo trig ine (L a mic ta l), o xc a rb a ze pine (T rile pta l), to pira ma te (T

• pa ma x)

 T ar ge t Be havior s: Se izure s, mo o d pro b le ms, a g g re ssio n, se lf-injury  Common Side E ffe c ts: Ra she s, sle e pine ss, na use a , vo miting , me mo ry pro b le ms  L e ss Common Side E ffe c ts: He pa titis, live r fa ilure , pa nc re a titis, b o ne ma rro w

suppre ssio n, tre mo r, dizzine ss

 Ke y point: Multiple RCT s show e ffic ac y.

T hank you for c oming. Q&A

Pe te r Stanbr

• , MD, MPH

Me dic a l Dire c to r a nd CE O Sta nb ro He a lthc a re Gro up L L C E dmo nd, OK & Clinic a l Assista nt Pro fe sso r, vo l. T he Unive rsity o f Okla ho ma He a lth Sc ie nc e s Ce nte r De pa rtme nt o f Psyc hia try & Be ha vio ra l Sc ie nc e s Okla ho ma City, OK

Additional Infor mation

 Additio na l info rma tio n o n spe c ific me dic ine s: http:/ / www.nlm.nih.g o v/ me dline plus/ drug info rma tio n.html  Mo ve me nt diso rde rs a re ra re b ut so me time s se rio us side e ffe c ts o f so me me dic ine s. T he se side e ffe c ts c a n ha ppe n rig ht a fte r sta rting a me dic ine , with do se inc re a se s, a fte r a pe rso n ha s ta ke n the me dic ine fo r a lo ng time , o r whe n me dic ine s a re sto ppe d. T he re a re se ve ra l diffe re nt type s o f mo ve me nt side e ffe c ts, b ut a ll inc lude c ha ng e s in ho w the c hild mo ve s his b o dy o r musc le s. Be c a use the se side e ffe c ts c a n b e se rio us, fa milie s sho uld se e k me dic a l c a re rig ht a wa y if the se type s o f c ha ng e s a re se e n. Be c a use c hildre n with a utism o fte n ha ve mo ve me nts tha t the y do o ve r a nd o ve r b e fo re sta rting me dic ine , it is so me time s diffic ult to kno w fo r sure if ne w mo ve me nts a re me dic ine side e ffe c ts. It is impo rta nt to wo rk with yo ur c hild’ s do c to r o r nurse to mo nito r. T hing s fa milie s mig ht se e tha t c o uld b e a mo ve me nt side e ffe c t: • Rig id o r stiff musc le s, a lo ng with hig h te mpe ra ture , c ha ng e in a le rtne ss, he a rt ra te o r b re a thing • Musc le spa sms o r c ra mping • Slo we d mo ve me nts o f the b o dy • Pa c ing , re stle ssne ss, ina b ility to sit still • Sta ring e piso de s, e ye b linking , unusua l e ye c lo sing , unusua l e ye mo ve me nts • Unusua l mo uth o r to ng ue mo ve me nts • Cha ng e s in wa lking , tre mo rs, re pe titive mo ve me nts the c hild c a nno t c o ntro l  So me me dic ine s ha ve a n a le rt a b o ut side e ffe c ts fro m the F

• o d a nd Drug Administra tio n (F

DA) c a lle d a b o xe d o r b la c k b o x wa rning . F

• r mo re info rma tio n o n side e ffe c ts

a nd b o xe d o r b la c k b o x wa rning s visit: www.a c c e ssda ta .fda .g o v/ sc ripts/ c de r/ d rug sa tfda /  Re so urc e Bo o ks: Dulc a n, Mina (2006). He lping Pa re nts, Yo uth, a nd T e a c he rs Unde rsta nd Me dic a tio ns fo r Be ha vio ra l a nd E mo tio na l Pro b le ms: A Re so urc e Bo o k o f Me dic a tio n Info rma tio n Ha ndo uts, Ame ric a n Psyc hia tric Pub lishing , 3rd e ditio n. Wile ns, T imo thy E . (2004). Stra ig ht T a lk Ab o ut Psyc hia tric Me dic a tio ns fo r K ids, T he Guilfo rd Pre ss, Re vise d e ditio n. T sa i, L uke Y. (2001). T a king the Myste ry Out o f Me dic a tio ns in Autism/ Aspe rg e r Syndro me s: A g uide fo r pa re nts a nd no n-me dic a l pro fe ssio na ls, F uture Ho rizo ns Pub lishing . Inte rne t Re so urc e s On Me dic ine s: Me dline Plus: pro vide s re lia b le info rma tio n o n spe c ific me dic ine s, vita mins, a nd supple me nts. A se rvic e o f the U.S. Na tio na l L ib ra ry o f Me dic ine , Na tio na l Institute s o f He a lth. www.nlm.nih.g o v/ me dline plus/ drug info rma tio n.html U.S. F

• o d a nd Drug Administra tio n • Drug s@ F

DA: pro vide s info rma tio n o n F DA a ppro va l o f me dic a tio ns www.a c c e ssda ta .fda .g o v/ sc ripts/ c de r/ d rug sa tfda / Inte rne t Re so urc e s On Ge ne ra l T re a tme nts Of Be ha vio r Cha lle ng e s, Me dic ine And No nMe dic ine T re a tme nts: Ame ric a n Ac a de my o f Child a nd Ado le sc e nt Psyc hia try (AACAP): na tio na l o rg a niza tio n o f c hild psyc hia trists a nd physic ia ns inte re ste d in me nta l he a lth. Pro vide s fa mily info rma tio n o n me dic ine a nd no n-me dic ine tre a tme nts fo r b e ha vio ra l a nd me nta l he a lth pro b le ms. Pro vide s re so urc e s fo r fa milie s o n a utism a nd me nta l he a lth pro b le ms. www.a a c a p.o rg / c s/ fo rFa milie s Ma ssa c huse tts Ge ne ra l Ho spita l Sc ho o l Psyc hia try pro g ra m & MADI Re so urc e Ce nte r: pro vide s info rma tio n a nd re so urc e s to fa milie s a nd pro fe ssio na ls o n dia g no sis, me dic a l tre a tme nts, no n-me dic a l tre a tme nts, a nd e duc a tio na l inte rve ntio ns fo r c hildre n with a utism, ADHD, a nd me nta l he a lth pro b le ms. www2.ma ssg e ne ra l.o rg / sc ho o lpsyc hia try/ inde x.a sp Na tio na l Institute o f Me nta l He a lth (NIMH): pro vide s fa mily a nd pro fe ssio na l info rma tio n o n dia g no sis a nd tre a tme nts o f a utism a nd me nta l he a lth pro b le ms. Ho me pa g e : www.nimh.nih.g o v Autism tre a tme nt info rma tio n: www.nimh.nih.g o v/ he a lth/ pub lic a tio ns/ a -pa re nts-g uide -to -a utismspe c trum-diso rde r/ c o mple te -inde x.shtml# pub 5