Sunday, September 23, 2007

Clinic Notes: Anorexia and Autism

Kids with autism are often finicky eaters, rejecting foods on both taste and/or texture. The consensus is that this is just another one of those sensory issues which plague kids with autism. But now an interesting hypothesis carries the finicky eating problem one step further. Prof Treasure suggests that anorexia and autism share the same genetics. According to her, twenty percent of patients with an anorexia diagnosis could also be on the autism spectrum. Furthermore, anorexia might be the female form of Asperger's. It is true that perseveration occurs in autism and anorexia, as well as communication and social problems. But this hypothesis seems long on speculation and short on data.

Monday, September 17, 2007

Clinic Notes: Bipolar Disorder in Children and ABA?

According to a recent news report Bipolar Disorder is being diagnosed more frequently in children. Recently, a pediatrician referred a two-year old girl to my clinic whose psychiatrist had diagnosed with Bipolar Disorder and prescribed Depkote, and lithium, which are commonly used to treat Bipolar Disorder in adults. These are powerful medications, not approved for children, and this two-year old girl ended up in the hospital because of the drug's side effects. I evaluated this child and took a detailed history from the parents. I saw nothing but a spoiled child who ignored her parents when she didn't get what she wanted and then got very upset and threw tantrums if that did not work. After several weeks of ABA, teaching the parents some much-needed parenting skills, this child was okay. I was curious if the psychiatrist who diagnosed this child with Bipolar Disorder had children of his own.

Thursday, September 06, 2007

Clinic Notes: Girls with Autism and ABA

Boys are three to four times more likely to be diagnosed with autism than girls. Last week I saw 35 children in my clinic with an autism diagnosis. Only 7 were girls. Not only is autism diagnosed less frequently in girls, it seems to me that the autism in not as severe. (Of course there are exceptions and I do occasionally see girls with moderate to severe autism.) Most of the girls I see with autism do okay with their academic subjects. They have problems handling concepts, and are very literal in their reading. Idioms and other peculiarities of language cause them problems, but for the most part academics is not their biggest problem. Girls with autism tend to have more problems socially than any other area. But then the same could be said of normally developing girls as well.