Autism Spectrum Disorder: Primary Care Principles

Am Fam Physician. 2016 Dec 15;94(12):972-979.

Abstract

Autism spectrum disorder is characterized by difficulty with social communication and restricted, repetitive patterns of behavior, interest, or activities. The Diagnostic and Statistical Manual of Mental Disorders, 5th ed., created an umbrella diagnosis that includes several previously separate conditions: autistic disorder, Asperger syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified. There is insufficient evidence to recommend screening for autism spectrum disorder in children 18 to 30 months of age in whom the disorder is not suspected; however, there is a growing body of evidence that early intensive behavioral intervention based on applied behavior analysis improves cognitive ability, language, and adaptive skills. Therefore, early identification of autism spectrum disorder is important, and experts recommend the use of a validated screening tool at 18- and 24-month well-child visits. Medications can be used as adjunctive treatment for maladaptive behaviors and comorbid psychiatric conditions, but there is no single medical therapy that is effective for all symptoms of autism spectrum disorder. Prognosis is heavily affected by the severity of diagnosis and the presence of intellectual disability. Children with optimal outcomes receive earlier, more intensive behavioral interventions and less pharmacologic treatment.

Publication types

  • Review

MeSH terms

  • Antipsychotic Agents / therapeutic use
  • Aripiprazole / therapeutic use
  • Asperger Syndrome / diagnosis
  • Asperger Syndrome / psychology
  • Asperger Syndrome / therapy
  • Autism Spectrum Disorder / diagnosis*
  • Autism Spectrum Disorder / psychology
  • Autism Spectrum Disorder / therapy
  • Autistic Disorder / diagnosis
  • Autistic Disorder / psychology
  • Autistic Disorder / therapy
  • Behavior Therapy
  • Child Development Disorders, Pervasive / diagnosis
  • Child Development Disorders, Pervasive / psychology
  • Child Development Disorders, Pervasive / therapy
  • Child, Preschool
  • Early Diagnosis
  • Early Medical Intervention
  • Humans
  • Infant
  • Primary Health Care*
  • Referral and Consultation
  • Risperidone / therapeutic use

Substances

  • Antipsychotic Agents
  • Aripiprazole
  • Risperidone