Thursday, November 12, 2009

Clinic Notes: Treating Autism in a Rural Area While Waiting for Healthcare Reform

Many children with autism have ADHD like behavior and do well on stimulant drugs. Most pediatricians and family practice physicians have no problem prescribing these medications. But I am a psychologist practicing in a rural area and often see children who have no health insurance or their health insurance won't pay for the treatment of autism. So I'm supposed to treat a child with autism who has no access to a physician, and no way to pay for medication. Well, people in a rural area learn to get by with what they have available and I guess that includes me. Caffeine contains methylxanthine, which is a mild stimulate similar to what is found in ADHD stimulate drugs. (Stimulate drugs often have a paradoxical effect on ADHD behavior--decreasing it rather than increasing it.) Coffee can sometimes be used as a replacement ADHD drug sometimes in children as well as "energy drinks" like Red Bull. The problem is dosage. A child would have to drink a lot of coffee to get the equivalent stimulant effect of a large dose of an ADHD drug. But when only a small dosage in needed caffeine can work.